Table 2.
Characteristics of cases of late-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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cheung, 2000 [3] | 32 weeks | 2.340 | Vaginal delivery | N/A | N/A | Prophylactic clindamycin | 28 | Lethargy, possible seizure activity, apnea | Blood, CSF | Biochemical tests (API 20 strep, cellular fatty acid profile) | S. bovis biotype II | Meningitis | Ampicillin and gentamicin changed to penicillin for 18 days | Recovery without sequelae |
| Koh, 2002 [4] | 34 weeks | 1.675 | Cesarean section | N/A | N/A | N/A | 19 | Lethargy, apnea | Blood, CSF | Biochemical tests (API 20 strep test) | S. bovis biotype II | Meningitis | Penicillin G for 14 days | Recovery without sequelae |
| Onoyama, 2009 [6] | Term | 3.192 | Vaginal delivery | <18 h | GBS (-) | N/A | 4 | Fever, poor activity | Blood, CSF | Biochemical tests (API 20 Strep test), molecular tests (16S rRNA and sodA gene sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | Cefotaxime for 14 days | Recovery without sequelae |
| Floret, 2010 [8] | 5 preterm | N/A | 3 vaginal deliveries, 2 cesarean sections | N/A | N/A | N/A | Median age 18 days (13–56) | Abdominal distention, diarrhea, signs of umbilical inflammation | Blood | Molecular tests (sodA gene sequencing, 16S rRNA gene sequencing, PFGE) | S. gallolyticus subsp. pasteurianus | N/A | Cefotaxime for 10 days | All neonates survived |
| Klatte, 2012 [9] | Term | N/A | Vaginal delivery | N/A | N/A | N/A | 12 | Congestion, increased work of breathing, lethargy | CSF | Βiochemical tests (Vitek 2), molecular tests (16S rRNA sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | Cefotaxime for 16 days | Recovery |
| Term | N/A | Vaginal delivery | N/A | N/A | N/A | 4 | Fever, seizure-like activity | Blood, CSF | Βiochemical tests (Vitek 2), molecular tests (16S rRNA sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | Ampicillin for 14 days | Recovery | |
| Post-term | N/A | Vaginal delivery | 13 h | N/A | N/A | 4 | Fever, rhinorrhea, fussiness | Blood, CSF | Βiochemical tests (Vitek 2), molecular tests (16S rRNA sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | Cefotaxime for 14 days | Recovery | |
| Nagamatsu, 2012 [10] | Term | 3.092 | Vaginal delivery | N/A | N/A | N/A | 8 | Superior tonic eye deviation, fever, irritability, decreased oral intake | CSF | Βiochemical tests (API Rapid ID 32 Strep, VITEK 2), molecular tests (16S rRNA gene sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis, seizures | Ampicillin for 20 days and panipenem/ betamipron for 14 days | Recovery without sequelae |
| Tarakci, 2014 [12] | 30 weeks | 1.300 | Cesarean section | N/A | N/A | N/A | 37 | Apnea, lethargy, cyanosis, superficial respiration | Blood | N/A | S. gallolyticus subsp. pasteurianus | None | Meropenem for 14 days | Recovery |
| Hede, 2015 [13] | 32 weeks | 1.474 | Cesarean section | N/A | GBS unknown | No | 24 | Intermittent tachypnea | Blood | Βiochemical tests (Vitek 2), molecular tests (16S rRNA sequencing, PFGE) | S. gallolyticus subsp. pasteurianus | None | Ampicillin for 10 days | Survived |
| 32 weeks | 2.120 | Cesarean section | N/A | GBS unknown | No | 24 | Pale color, loose stools, respiratory distress, hypoxemia, hypothermia | Blood, CSF | Βiochemical tests (Vitek 2), molecular tests (16S rRNA sequencing, PFGE) | S. gallolyticus subsp. pasteurianus | Meningitis, acute respiratory failure, septic shock, seizures, grade III IVH | Ampicillin for 14 days | Survived | |
| Park, 2015 [14] | 38+4 weeks | 3.600 | Vaginal delivery | N/A | N/A | N/A | 27 | Fever, lethargy, moaning sounds | Blood, CSF, urine | Μolecular tests (16S rRNA gene sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis, bilateral reduction in visual evoked potentials, subdural effusion and seizures | Ampicillin and cefotaxime for 21 days, ampicillin and cefotaxime for 31 days due to CNS complications | Discharge, improvement of visual evoked potential in follow-up |
| Kennedy, 2015 [15] | 37 weeks | 3.050 | Vaginal delivery | 6 h | GBS (-) | N/A | 4 | Lethargy, irritability, decreased urine output, poor feeding, fever | Blood, CSF | Βiochemical tests (RapID STR), molecular tests (16S rRNA gene sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | Ampicillin for 14 days | Recovery without sequelae |
| 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 |
| Parain, 2016 [17] | Term | N/A | N/A | N/A | N/A | N/A | 28 | Altered consciousness, hypertonic limbs, bulging fontanel | CSF | N/A | S. gallolyticus | Meningitis, hydrocephalus with tetraventricular dilatation requiring external ventricular drainage, recurrence of hydrocephalus requiring ventriculoperitoneal bypass | Cefotaxime for 17 days and amikacin for 2 days | Recovery with neurologic complications (neuromotor delay with poor spontaneous motor mobilization and hypertonia of the limbs at 9 months) |
| Saegeman, 2016 [2] | 30 weeks | N/A | Vaginal delivery | N/A | N/A | N/A | 7 | Hemodynamic instability | Blood | Βiochemical tests (MALDI-TOF mass spectrometry), molecular tests (PFGE, 16S rRNA gene sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis | N/A | Recovery |
| 32 weeks | N/A | N/A | N/A | N/A | N/A | 34 | Septic shock, respiratory failure, pulmonary hemorrhage | Blood | Βiochemical tests (MALDI-TOF mass spectrometry), molecular tests (PFGE, 16S rRNA gene sequencing) | S. gallolyticus subsp. pasteurianus | Septic shock | N/A | Deceased neonate | |
| Yamamura, 2018 [18] | Term | 3.680 | Vaginal delivery | N/A | N/A | N/A | 27 | Fever, lethargy, irritability | Blood, CSF | Βiochemical tests (API 20 Strep test), molecular tests (16s rRNA gene sequencing) | S. gallolyticus subsp. pasteurianus | Meningitis, ventriculitis | Ampicillin for 21 days | Recovery without sequelae |
| Mettananda, 2018 [19] | 34 weeks | 1.680 | Cesarean section | N/A | N/A | N/A | 25 | Fever, poor sucking, reduced activity | Blood | Βiochemical tests | S. bovis biotype II | Meningitis | Penicillin G and cefotaxime for 21 days | Recovery without sequelae |
| Sim, 2021 [21] | 39 weeks | 3.268 | Vaginal delivery | <18 h | GBS (-) | No | 4 | Fever, respiratory distress | Blood, CSF | Βiochemical tests (MALDI-TOF) | S. gallolyticus | Meningitis | Ampicillin | Recovery without sequelae |
| 39 weeks | 3.194 | Vaginal delivery | <18 h | GBS (-) | No | 23 | Fever, lethargy | Blood | Βiochemical tests (MALDI-TOF) | S. gallolyticus | None | Ampicillin | Recovery without sequelae | |
| 34 weeks | 1.812 | Cesarean section | <18 h | GBS (-) | No | 15 | Fever, poor feeding | Blood | Βiochemical tests (MALDI-TOF) | S. gallolyticus | None | Clindamycin | Recovery without sequelae | |
| Chen, 2021 [22] | 37+3 weeks | N/A | Cesarean section | N/A | GBS (+) | No | 5 | Fever, tachypnea | 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 |
| 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 |
Abbreviations: 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; 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.