Streptococcus pneumoniae sepsis in the newborn.

BACKGROUND: Streptococcus pneumoniae (SP) is an uncommon cause of neonatal sepsis. AIMS: To report on the spectrum of morbidity associated with SP infections in the neonatal period. METHODS: A case series of SP infection in the neonatal period was studied. Maternal and neonatal outcomes were noted. RESULTS: Four cases of neonatal SP infection are reported, one of which was due to a strain with reduced susceptibility to penicillin. All four cases had very early onset of severe clinical disease with bacteremia and pneumonia. In one case a retrospective diagnosis of meningitis was made as well. Maternal illness was a feature in one of these infants. CONCLUSIONS: Although less common now than in the pre-antibiotic era, Streptococcus pneumoniae remains a rare but important cause of neonatal sepsis and can mimic early onset Group B streptococcal sepsis. It is unclear whether current infant or adult pneumococcal immunisation programs might influence its incidence in the neonatal period. The potential for strains with reduced susceptibility to ß-lactam antibiotics to cause neonatal infection needs to be considered in relevant settings.