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October 1985

Multiple Group B Streptococcal Infections in a Premature Infant: Eradication of Nasal Colonization With Rifampin

Author Affiliations

Division of Neonatology
Division of Infectious Diseases The Children's Memorial Hospital and Northwestern Memorial Hospitals 2300 Children's Plaza Chicago, IL 60614

Am J Dis Child. 1985;139(10):964-965. doi:10.1001/archpedi.1985.02140120010009

Sir.—Although group B streptococci (GBS) are uniformly sensitive to penicillin in vitro, penicillin treatment failures in neonatal GBS infection and recurrent neonatal GBS infection may occur.1 Furthermore, attempts to eradicate GBS from colonized pregnant women or from colonized neonates have had limited success.2,3 There are no published data that address the appropriate management of the infant who is colonized with GBS and who develops recurrent systemic GBS infections. We report the course of a premature infant, colonized with GBS from birth, who experienced multiple infections with GBS type III during his four-month nursery stay.

Patient Report.—Twin A weighed 920 g at birth. The pregnancy was complicated by premature labor two days before delivery at 28 weeks and maternal fever to 38.8 °C (102 °F) shortly before delivery by caesarean section. At birth, twin A was limp and foul-smelling and required vigorous resuscitation (twin B died at