Clinical features and epidemiology of septicaemia and meningitis in neonates due to Streptococcus agalactiae in Copenhagen County, Denmark: a 10 year survey from 1992 to 2001

Acta Paediatr. 2004 Oct;93(10):1334-9. doi: 10.1080/08035250410023016.


Aim: To elucidate the clinical and biochemical features, and to estimate the incidence and outcome of invasive culture-verified group B streptococcal (GBS) septicaemia/meningitis in neonates in Denmark.

Methods: Clinical microbiology laboratory records in patients 0-3 mo of age were searched for culture-verified GBS during 1992-2001 in Copenhagen County. Clinical records at the neonatal intensive care unit were reviewed retrospectively. Selected clinical and biochemical parameters were evaluated.

Results: 61 neonates had culture-verified GBS septicaemia/meningitis. The mean annual incidence was 0.76 cases per 1000 livebirths (range 0.0-1.91). A significant decrease in incidence was observed in the latest 3 y. The male:female ratio was 1.3:1. Eighty percent of the neonates had early-onset GBS within 24 h, 57% with symptoms at birth. Predominant initial symptoms were respiratory (72%), cardiovascular (69%) and neurological (63%). Only 4% developed GBS by day 7-90. Seventy-five percent had maternal or neonatal risk factors for early-onset GBS disease; 21% had clinical asphyxia, 37% of the mothers had premature rupture of membranes and 31% of the mothers were febrile. Initial C-reactive protein (CRP) was low, but increased significantly after more than 12 h duration of symptoms in 82% of patients. Leucopenia was an important initial haematological marker.

Conclusion: The incidence of early-onset GBS has decreased significantly in Denmark, probably because of preventive measures in pregnancy and during birth. Respiratory symptoms are early signs of early-onset GBS. Initial leucopenia and a late (12-48 h) increase in CRP are valuable markers for invasive GBS.

MeSH terms

  • C-Reactive Protein / analysis
  • Denmark / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Meningitis, Bacterial / blood
  • Meningitis, Bacterial / epidemiology*
  • Meningitis, Bacterial / physiopathology
  • Pregnancy
  • Pregnancy Complications
  • Retrospective Studies
  • Risk Factors
  • Sepsis / blood
  • Sepsis / epidemiology*
  • Sepsis / physiopathology
  • Streptococcal Infections / blood
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / physiopathology
  • Streptococcus agalactiae*


  • C-Reactive Protein