Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Group B streptococcal meningitis has long-term effects on children's developmental outcomes

13.06.2012
Nearly one-half of infants with GBS meningitis experience developmental delays

Parents of infants who survive bacterial meningitis caused by group B Streptococcus might have to live with the effects of the disease on their children long after they're discharged from the hospital.

A new study in the journal Pediatrics finds that even though mortality rates of children infected with GBS meningitis have decreased in the past 25 years, just under half of children who survive the disease will suffer impairment as a result of the disease.

"These bacteria can quickly cause significant damage to the developing infant brain very quickly despite the infant's having received excellent medical care," says Morven S. Edwards, M.D., professor of Pediatrics at Baylor College of Medicine and a co-author on the paper. "This is a potentially devastating illness and we still have a large percentage of infants who have poor outcomes after the infection."

According to the CDC, 25 percent of pregnant women carry GBS. It is routine for these women to receive antibiotics during labor to protect the baby from infection occurring in the first days of life. There is no way to prevent late-onset GBS infections in infants.

"We haven't had recent data on the outcomes of GBS meningitis in over 25 years and the quality of medical care has changed," says Prachi Shah, M.D., a clinical assistant professor at the University of Michigan Medical School Department of Pediatrics and Communicable Diseases, and a senior author on the paper. "We wanted to know, in this era of using antibiotics during birth, whether outcomes have changed for infants who do acquire GBS meningitis. Our study counsels families to be very vigilant about their child if they've had GBS."

The current study shows that, although modern day medicine has improved survival rates, children can still suffer adverse long-term outcomes.

"Despite the fact that mortality has decreased in the last 25 years, survivors of GBS meningitis continue to have substantial long-term morbidity," says Romina Libster, M.D., a physician in the Department of Pediatrics at Vanderbilt University and first author on the paper.

The overall impact of invasive GBS infection in infants is just over 2,000 cases per year in the United States. Among those with bloodstream infection, 10 to 20 percent can also develop meningitis.

The relative importance of GBS as a cause of meningitis has grown in recent years. "GBS is responsible for over 85 percent of bacterial meningitis in children under two months of age," says Edwards. "Vaccination with the newer pneumococcal vaccines has led to tremendous reductions in meningitis from those bacteria."

Using three different and distinctly defined levels to measure functionality, researchers find that 56 percent of children who survived GBS meningitis went on to have age-appropriate (or normal) development, 25 percent had mild-to-moderate impairment and 19 percent had severe impairment.

Signs of mild-to-moderate impairment include continual and significant academic underachievement as well as evidence of mild neurological or functional impairment. Indications of severe impairment include blindness, hearing loss, cerebral palsy, and significantly delayed development.

According to lab data and cranial images at the time of discharge, there are a number of factors that can help predict the likelihood of long-term severe impairment in GBS meningitis survivors, including a failed hearing screening, an abnormal neurologic exam, and abnormal imaging of the head. However, data and imaging cannot as accurately predict children who will have mild impairments, according to the study.

"The more subtle developmental delays suggest that any child who has had GBS meningitis should have ongoing developmental evaluation," says Edwards, "so that problems can be identified early and addressed even before the child actually starts school so that the child has the best chance to fulfill their potential."

The study examined 43 survivors of GBS meningitis between the ages of three and 12 years. Patients were examined physically, neurologically, with hearing and vision screening, and were also assessed using standardized developmental assessments.

Parents were also questioned on perceptions of their child's development. Parents of children who either had normal or severely impaired functionality are able to accurately identify their children as such. However, according to the report, parents of children with mild-to-moderate impairments are less likely to accurately label their child's developmental delay. Because of this, Shah suggests the importance of follow-up evaluations. "Parent self-report is not always an accurate identifier of children who have mild impairment," she says, "which is why survivors of GBS meningitis should receive long-term development surveillance."

According to Edwards, there are two important steps to be taken moving forward. The first is the development of a vaccine for mothers so that the disease can be prevented altogether. "The other," Edwards says, "is just to enhance awareness of the consequences of the infection and of the need for its prevention."

Currently, clinical testing is already underway for a GBS vaccine developed by Novartis Vaccines & Diagnostics.

Additional Authors: Kathryn M. Edwards, M.D., Vanderbilt University Medical Center; Fatma Levent, M.D., Texas Tech University Health Science Center; Marcia A. Rench, R.N., Baylor College of Medicine/Texas Children's Hospital; Luis A. Castagnini, M.D, Blank Children's Hospital; Timothy Cooper, Psy.D., Vanderbilt University Medical Center; Robert C. Sparks, L.P.N./E.M.T.P, Vanderbilt University Medical Center; Carol J. Baker, M.D., Baylor College of Medicine.

Funding: The Max It Out Foundation for Pediatric Research; Vanderbilt University Medical Center, Nashville, TN; Group B Strep Association, Chapel Hill, NC

Disclosure: Dr. M. Edwards is a consultant to and receives consultancy fees and research funding from Novartis Vaccines & Diagnostics.

Reference: Libster et al, "Long Term Outcomes of Group B Streptococcal Meningitis," Pediatrics; originally published online June 11, 2012; DOI: 10.1542/peds.2011-3453

Patients interested in learning more about group B streptococcal meningitis care for pregnant women, newborns and children at the U-M Health System should call 877-475-6688.

The U.S. Centers for Disease Control and Prevention has more information on GBS in pregnancy at http://www.cdc.gov/groupbstrep/index.html

Rebeka Cohan | EurekAlert!
Further information:
http://www.umich.edu

More articles from Health and Medicine:

nachricht NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University

nachricht How to turn white fat brown
07.12.2016 | University of Pennsylvania School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

NTU scientists build new ultrasound device using 3-D printing technology

07.12.2016 | Health and Medicine

The balancing act: An enzyme that links endocytosis to membrane recycling

07.12.2016 | Life Sciences

How to turn white fat brown

07.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>