Saleh Manar, Abuqura Wesam, Abounahia Fouad, Gad Ashraf
Neonatal Intensive Care Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar.
Pediatric Department, Weill Cornell Medicine-Qatar, Doha, Qatar*Correspondence: Manar Saleh. Email:
Qatar Med J. 2025 Jan 27;2025(1):25. doi: 10.5339/qmj.2025.25. eCollection 2025.
Late-onset group B (LOGBS) sepsis is a notable cause of morbidity and mortality in preterm neonates. While the vertical transmission of group B (GBS) during delivery is well established, the potential role of breast milk in the transmission of LOGBS is not as clearly understood. This case report examines a unique instance of preterm triplets developing LOGBS sepsis following maternal GBS mastitis, with the aim of investigating the possible association between breast milk and LOGBS infection in preterm infants.
A set of preterm male triplets born at 30 weeks of gestation were admitted to the neonatal intensive care unit. At two weeks of age, the infants showed clinical manifestations of LOGBS sepsis, including septicemia. Additionally, one of the triplets developed meningitis complicated by hydrocephalus, while another developed necrotizing enterocolitis (NEC). Concurrently, their mother was diagnosed with mastitis and her breast milk cultures tested positive for GBS. The triplets were treated with systemic antibiotics. However, triplet B subsequently required a ventriculoperitoneal shunt for hydrocephalus management, and triplet C underwent laparotomy for NEC treatment.
The occurrence of LOGBS sepsis in these preterm triplets, coupled with maternal GBS mastitis and positive breast milk cultures, raises critical questions regarding breast milk as a possible route of transmission for LOGBS. Understanding this relationship is vital for improving clinical practice, particularly in the management of recurrent infections in this vulnerable population.
晚发型B族链球菌（LOGBS）败血症是早产新生儿发病和死亡的一个重要原因。虽然分娩期间B族链球菌（GBS）的垂直传播已得到充分证实，但母乳在LOGBS传播中的潜在作用尚不清楚。本病例报告研究了一例早产三胞胎在母亲患GBS乳腺炎后发生LOGBS败血症的独特病例，旨在调查母乳与早产婴儿LOGBS感染之间的可能关联。
一组孕30周出生的早产男三胞胎被收治入新生儿重症监护病房。在两周大时，婴儿出现了LOGBS败血症的临床表现，包括败血症。此外，其中一个三胞胎患了脑膜炎并并发脑积水，另一个则患了坏死性小肠结肠炎（NEC）。与此同时，他们的母亲被诊断出患有乳腺炎，她的母乳培养物GBS检测呈阳性。三胞胎接受了全身抗生素治疗。然而，三胞胎B随后因脑积水需要进行脑室腹腔分流术，三胞胎C因NEC接受了剖腹手术。
这些早产三胞胎发生LOGBS败血症，加上母亲GBS乳腺炎和母乳培养物呈阳性，引发了关于母乳作为LOGBS可能传播途径的关键问题。了解这种关系对于改善临床实践至关重要，尤其是在管理这一脆弱人群的反复感染方面。
