Similar mortality rates for early and late group B streptococcal disease among newborns at Groote Schuur Hospital in Cape Town

Background. Invasive group B streptococcal disease (iGBS) is an important cause of morbidity and mortality in newborns globally and is more common in Sub-Saharan Africa and South Africa. Few studies describe newborn iGBS cases in the Western Cape, leaving limited data to guide local prevention and treatment strategies. Objective. To describe all cases of newborn iGBS at Groote Schuur Hospital (GSH), Western Cape, between January 2015 and December 2020. Methods. A retrospective review was conducted of all blood or cerebrospinal fluid-positive cases of newborn iGBS between January 2015 and December 2020. Results. Thirty-five cases of iGBS were included in the study, 51% with early-onset disease (EoD) and 49% with late-onset disease (LoD). The median gestational age at birth was 27 and 31.5 weeks in the LoD and EoD groups, respectively. The median birth weight was 900 g and 1 812 g in the LoD and EoD groups, respectively. Meningitis was more common in the LoD group and pneumonia was more common in the EoD group. The overall mortality rate was 23%, with similar mortality rates in the EoD and LoD groups (22% and 24%, respectively). Invasive GBS disease accounted for a cumulative 274 intensive care unit days during the study period. Conclusion. Invasive GBS disease in newborns at GSH is associated with a high mortality rate, with this study showing similar mortality rates between the EoD and LoD groups.