Infections néonatales tardives à streptocoque du groupe B: quelle contribution des infections nosocomiales ?

Group B Streptococcus late-onset disease, occurring from 7 through 89 days of life, remains an important cause of sepsis and meningitis in infants. The pathogenesis and mode of transmission associated with group B Streptococcus late-onset disease remain unclear. Neonate's digestive tract mucosa colonization may be acquired perinatally or postpartum, from maternal or non-maternal sources. Although maternal sources appear predominant, group B Streptococcus late-onset disease is not influenced by intrapartum antibiotic prophylaxis. Among non-maternal sources of transmission, horizontal nosocomial transmission is possible and may be underestimated in the neonate intensive care unit setting, accounting for about 10% of cases. The origin of transmission may be another patient, a caregiver or the intensive care unit environment. Awaiting for better understanding of transmissions routes and efficient strategies of prevention, clinicians facing such a case in a hospitalized neonate should maintain a high index of suspicion for a nosocomial origin and a potential cluster, ensure routine submission of isolate to a reference laboratory and reinforce infection control precautions. [ABSTRACT FROM AUTHOR]