[Streptococcus B meningitis in infants older than 3 months]. / Méningites à streptocoque du groupe B chez le nourrisson de plus de 3 mois.

ABSTRACT

OBJECTIVE: Bacterial meningitis is a major cause of morbitidy and mortality in childhood. It can be responsible for deafness, mental retardation, epilepsy or behavioural disorders. Group B Streptococcus (GBS) is the leading cause of sepsis and meningitis in newborn. Although clinical features of neonatal SGB meningitis occurring in the first days of life have been well documented, little is known about GBS meningitis occurring in pediatric patients after this period. This study presents the epidemiology of GBS meningitis in France and compares their clinical presentation and evolution with S. pneumoniae (PNC) meningitis, main germ responsible for bacterial meningitis in children less than 2 years old. METHODS: From January 2001 to December 2005, clinical and biological data were recorded by ACTIV/GPIP, a nationwide active surveillance network. The medical files of meningitis of SGB were reviewed. RESULTS: Seventeen cases of meningococcal SGB were compared with all cases of meningococcal PNC occurred in the same age group (n=60). Univariate analysis showed that gestational age was significantly lower in the GBS group compared with PNC group (respectively 36.6 weeks vs 38.6 weeks, p =0.035). The neurological complications were significantly more frequent in the PNC meningitis group. The seizures after the begining of treatment were reported in 58 % of cases of PNC meningitis vs 17.6 % (p=0.004) and coma in 37.3 % of cases of PNC meningitis vs 6 % (p=0.013). No significant difference was assessed between the two groups for the usual blood tests (blood count, biochemistry and cytology CSF) and case fatality rate. The predominant GBS serotype was serotype III (70 %). CONCLUSION: This cohort of GBS meningitis in infants over 3 months is the largest published until now. These meningitis appear less severe than the pneumococcal meningitis occurring in the same age group.