Table 1.
Characteristics of cases of early-onset sepsis caused by S. gallolyticus or S. bovis biotype II.
| First Author, Publication Year | GA | Birth Weight (Grams) | Mode of Delivery | Length of Rupture of Membranes | Maternal Vaginal Cultures | Maternal Peripartum Antibiotics | Symptoms Onset Time (Days) | Clinical Signs and Symptoms | Site of Isolation | Diagnosis | Microorganism | Complications | Definitive Antibiotic Treatment | Patient Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gavin, 2003 [5] | Term | 3.925 | Vaginal delivery | <18 h | GBS (-) | N/A | 3 | Fever, irritability, poor oral intake, decreased urine output | Blood, CSF | Biochemical tests (RapID STR, Vitek 2, API 20 Strep, CFA profile) | S. bovis biotype II/2 | Meningitis, Seizure-like episodes | Penicillin G for 14 days | Full recovery |
| Khan, 2009 [7] | N/A | N/A | N/A | N/A | N/A | N/A | 3 | Apnoeic episodes, lethargy | Blood, CSF | Biochemical tests (API 20 Strep kit) | S. gallolyticus subsp. pasteurianus | Meningitis | Penicillin and gentamicin for 14 days | Recovery |
| Klatte, 2012 [9] | Term | N/A | Vaginal delivery | 3 h | N/A | N/A | 2 | Poor feeding, lethargy, seizure activity | Blood, CSF | Βiochemical tests (Vitek 2), molecular tests (16S rRNA sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | Ampicillin for 16 days, cefotaxime for 6 days | Recovery |
| Thatrimontrichai, 2012 [11] | 39 weeks | 3.188 | Vaginal delivery | <18 h | Gamma Streptococci not in group D (after onset of neonatal symptoms) | N/A | 2 | Fever, lethargy, poor feeding, slightly bulging anterior fontanel | CSF, maternal urine | N/A | S. gallolyticus subsp. pasteurianus | Meningitis, right IVH grade I | Cefotaxime for 14 days and gentamicin for 5 days | Recovery |
| Beneteau, 2015 [16] | 10 preterm and 5 term neonates * | 2.160 (1.860–3.430) for neonates with symptoms onset <4 days, 2.240 (1.480–3.570) for neonates with symptoms onset >4 and ≤28 days | N/A | N/A | N/A | N/A | 3 neonates ≤ 4 days, 12 neonates >4 and ≤28 days | Fever, hypothermia, digestive signs, respiratory signs, irritability, neurologic signs, sepsis | Blood and/or CSF | N/A | S. gallolyticus pasteurianus in 8 cases and S. gallolyticus gallolyticus in 2 cases ** | Meningitis | Amoxicillin and/or 3rd generation cephalosporin and aminoglycocide for 10–25 days | All neonates survived |
| Nguyen, 2019 [20] | 39+1 weeks | 4.195 | Vaginal delivery | 12 h | GBS (-) | N/A | 1 | Respiratory distress | Blood | N/A | S. gallolyticus subsp. pasteurianus | Meningitis, endocarditis | Cefepime for 28 days and gentamicin for 14 days | Recovery without sequelae |
| 40+1 weeks | 3.250 | Vaginal delivery | 4 h | GBS unknown | No | 1 | Poor respiratory effort, irritability | Blood | N/A | S. gallolyticus subsp. pasteurianus | Septic shock, PPHN | Cefepime and clindamycin for 14 days | Recovery without sequelae | |
| Sim, 2021 [21] | 39 weeks | 3.374 | Vaginal delivery | <18 h | GBS (-) | No | 1 | Respiratory distress | Blood, CSF | Βiochemical tests (MALDI-TOF) | S. gallolyticus | Meningitis | Vancomycin | Recovery without sequelae |
| Chen, 2021 [22] | 35+1 weeks | N/A | Cesarean section | N/A | N/A | N/A | 3 | Apnea, desaturation | Blood | Βiochemical tests (MALDI-TOF), molecular tests (16S rRNA and sodA gene sequencing, PCR-RFLP assays of groESL gene) | S. gallolyticus subsp. pasteurianus | None | Ampicillin and cefotaxime for 14 days | Recovery without sequelae |
| 37+3 weeks | N/A | Cesarean section | N/A | GBS (+) | No | 2 | Tachypnea, desaturation, poor activity, fever | Blood, CSF | Βiochemical tests (MALDI-TOF), molecular tests (16S rRNA and sodA gene sequencing, PCR-RFLP assays of groESL gene) | S. gallolyticus subsp. pasteurianus | Meningitis | Ampicillin and cefotaxime for 14 days | Recovery without sequelae | |
| Geetha, 2021 [23] | 36+6 weeks | 3.776 | Vaginal delivery | <18 h | GBS (-) | No | 1 | Respiratory distress | Blood | Biochemical tests (MALDI-TOF, Vitek) | S. gallolyticus subsp. pasteurianus | Liver abscess | Cefotaxime for 5 weeks, co-amoxiclav for 3 weeks | Recovery without sequelae |
| Srour, 2022 [24] | 36+4 weeks | 3.720 | Vaginal delivery | <18 h | GBS (-) | N/A | 1 | Intermittent cyanosis, hypothermia, tachypnea | Blood, CSF | N/A | S. gallolyticus | Meningitis, ventriculitis, seizure-like activity | Penicillin G for 21 days | Recovery without sequelae |
| Williams, 2022 [25] | 26 weeks | 950 | Vaginal delivery | PPROM 12 days | GBS (-) | IV ampicillin for 2 days and pos amoxicillin for 5 days and a single dose of azithromycin | 1 | Poor respiratory effort, metabolic and respiratory acidosis | Blood | Βiochemical tests (MALDI-TOF) | S. gallolyticus | Septic shock | Ampicillin and gentamicin (empirical treatment) | Deceased neonate |
| Orbea, 2022 [26] | N/A (9 neonates) *** | N/A | N/A | N/A | N/A | N/A | Median age 24 days (1–74 days) | Fever, irritability, difficulty feeding, lethargy, respiratory distress, apnea, seizure-like activity, emesis, diarrhea | Blood and/or CSF | Biochemical tests (MALDI-TOF, Vitek) | S. gallolyticus, S. gallolyticus subsp. pasteurianus **** | Meningitis (11 infants), bilateral grade III IVH (1neonate), ventriculitis and subdural collection and/or subarachnoid debris (3 neonates) ***** | Antibiotic therapy for a median of 14 days (9–28 days) | One deceased neonate, one neonate with neurologic complications |
| Sasi, 2022 [27] | 37 weeks | 3.125 | Vaginal delivery | N/A | N/A | N/A | 1 | Tachycardia, tachypnea, poor sucking | Maternal blood cultures, placental tissue culture, no growth in neonatal blood culture | Biochemical tests (MALDI-TOF) | S. gallolyticus subsp. gallolyticus | None | Ampicillin and amikacin for 5 days | Recovery without sequelae |
| 38 weeks | 2.670 | Vaginal delivery | 3 h | N/A | N/A | 1 | Tachycardia, tachypnea | Maternal blood cultures, no growth in neonatal blood culture | Biochemical tests (MALDI-TOF) | S. gallolyticus subsp. gallolyticus | None | Ampicillin and amikacin for 7 days | Recovery without sequelae | |
| 39 weeks | 3.620 | Cesarean section | N/A | N/A | N/A | 1 | Respiratory distress | Maternal blood and urine cultures, no growth in neonatal blood culture | Biochemical tests (MALDI-TOF) | S. gallolyticus subsp. gallolyticus | Meningitis | Ampicillin and amikacin for 10 days | Recovery without sequelae | |
| 41 weeks | 4.170 | Cesarean section | N/A | N/A | N/A | 1 | Fever, tachycardia, respiratory distress | Maternal blood cultures, placental tissue culture, no growth in neonatal blood culture | Biochemical tests (MALDI-TOF) | S. gallolyticus subsp. gallolyticus | Pneumonia | Ampicillin and amikacin for 5 days | Recovery without sequelae | |
| This case | 38+1 weeks | 3.250 | Cesarean section | 10 h | GBS (-) | No | 1 | Respiratory distress, poor feeding, fever | Blood | Biochemical tests (Vitek 2) | S. gallolyticus | PPHN | Ampicillin and cefotaxime for 10 days | Recovery |
Abbreviations: CFA, cellular fatty acid; CSF, cerebrospinal fluid; GBS, group B streptococci; IV, intravenous; IVH, intraventricular hemorrhage; MALDI-TOF, matrix-assisted laser desorption ionization-time of flight mass spectrometry; N/A, not available; PFGE, pulsed-field gel electrophoresis; PCR, polymerase chain reaction; PPHN, persistent pulmonary hypertension of the newborn; RFLP, restriction fragment length polymorphism. * This study included 23 infants, 15 of whom were neonates. ** Subspecies of S. bovis were identified in 10 cases. Not specified if the data of S. gallolyticus identification refers to neonates or to infants. *** This study included 15 infants, 9 of whom were neonates. **** S. bovis was not classified into subspecies in one case. Not specified if the data of S. gallolyticus identification refers to neonates or to infants. ***** Not specified if cases of meningitis refer to neonates or to infants.