Introduction: Meningitis is known to result in long-term neurological complications. While rigorous vaccination programmed and public health awareness initiatives have been implemented to tackle common pathogens for meningitis such as pneumococcal and Meningitis C, no routine screening has been implemented for Group B streptococcus in Ireland. As neurosurgeons we see gross morbidity occurring from GBS meningitis. There is debate whether routine screening for GBS is indicated.
The aim of our study is to assess the neurosurgical implications resulting from GBS meningitis in a single national paediatric neurosurgical centre.
Methods: Retrospective review of paediatric patients referred with neurosurgical complications of meningitis from January 2007- December 2012
Results: Of 60 patients referred to our service with neurosurgical complications of meningitis, 20% had a diagnosis of Group B streptococcal meningitis. All, except one case, had early onset GBS occurring within the first month of life. The commonest complication in the GBS group was hydrocephalus requiring CSF diversion (75%) . Cerebral palsy, seizure disorder, blindness and developmental delay were the other complications noted. The majority of these children require long-term neurosurgical, medical and allied healthcare input. Only One patient with GBS meningitis referred to us had no long-term sequelae from the meningitis and actually presented at age three with a head injury. The majority of mothers where not screened for GBS antenatally.
Conclusions: Given the gross morbidity and economic implications associated with the sequelae of GBS meningitis it may be prudent to seriously consider routine antenatal screening in our country.
Patient Care: Will provide impetus for introducing antenatal screening for Group B streptococcus and reduce the incidence of early onset neonatal sepsis due to this organism
Learning Objectives: The effects of Group B Streptoccoccal infection
The implications of antenatal screening