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 Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

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: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

Im Focus: Using graphene to create quantum bits

In the race to produce a quantum computer, a number of projects are seeking a way to create quantum bits -- or qubits -- that are stable, meaning they are not much affected by changes in their environment. This normally needs highly nonlinear non-dissipative elements capable of functioning at very low temperatures.

In pursuit of this goal, researchers at EPFL's Laboratory of Photonics and Quantum Measurements LPQM (STI/SB), have investigated a nonlinear graphene-based...

Im Focus: Bacteria harness the lotus effect to protect themselves

Biofilms: Researchers find the causes of water-repelling properties

Dental plaque and the viscous brown slime in drainpipes are two familiar examples of bacterial biofilms. Removing such bacterial depositions from surfaces is...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

Innovation 4.0: Shaping a humane fourth industrial revolution

17.05.2017 | Event News

 
Latest News

Scientists propose synestia, a new type of planetary object

23.05.2017 | Physics and Astronomy

Zap! Graphene is bad news for bacteria

23.05.2017 | Life Sciences

Medical gamma-ray camera is now palm-sized

23.05.2017 | Medical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>