Case 32: A sick neonate

Question 1

What is the most common cause of meningitis in neonates?

Answer 1

E. coli

Klebsiella

Pseudomonas

Question 2

What will be the gram stain on a CSF deposit of Strep. agalactiae?

Answer 2

Gram +ve cocci

Question 3

What will colonial morphology on HBA be for Strep. agalactiae?

Answer 3

Small white colonies with beta haemolysis

Question 4

What will colonial morphology on MAC be for Strep. agalactiae?

Answer 4

Small red colonies - lactose fermenting

Question 5

What will colonial morphology on CHA be for Strep. agalactiae?

Answer 5

Small white colonies

Question 6

What will a catalase test for Strep. agalactiae be?

Answer 6

Negative

Question 7

How is strep. agalactiae different from strep. pyogenes diagnostically?

Answer 7

Strep. agalactiae grows on MAC and is resistant to bacitracin

Question 8

Which antimicrobial susceptibilities does Strep. agalacatiae show?

Answer 8

Gentamicin

Cefotaxime

Penicillin

Question 9

What is the best way to prevent strep. agalactiae in neonates?

Answer 9

Treat mother 4 hours before giving birth following screening for carriage of group B strep.

Question 10

What is the prognosis for a neonate with strep. agalactiae meningitis?

Answer 10

Without treatment: 40% mortality

With treatment: 1% mortality