Background
Group B Streptococcus (GBS) is the commonest cause of neonatal infection. Incomplete treatment may be associated with worse outcomes and disease recurrence.  Multiple conflicting guidelines exist with resulting confusion around length of treatment and need for lumbar punctures.  We completed a five year retrospective case note review of management and outcomes of invasive GBS presenting to a tertiary paediatric centre.  Results were compared to European Society of Paediatric Infectious Diseases guidelines outlined in The Manual of Childhood infections.
Methods
Any infant aged 0-6 months with positive blood or cerebrospinal fluid cultures identified from microbiology databases between 17/04/2012 - 03/05/2017 at a regional tertiary paediatric hospital was included.  Infants with positive urine cultures representing contamination were excluded.  Data was collected from patient notes and electronic health records.  
Results
46 infants identified, 34 bacteraemia, 12 meningitis.  30(65.2%) male. 31(67.4%) term, 15(32.6%) preterm.  29(63.0%) had early-onset disease, 17(37.0%) had late-onset disease.
32(69.6%) infants presented with breathing difficulties, 16(34.8%) poor feeding, 13(28.2%) irritable, 9(19.5%) drowsy and 11(23.9%) febrile. 
25/34 with bacteraemia had a lumbar puncture (LP), 9 didn’t (5 of these were too sick).  11/12 with meningitis had LP, 1 was too ill.  2 infants had second LP. 
6(13.0%) suffered long-term disability.  3(6.5%) died and 2(4.3%) had GBS recurrence (1 meningitis, 1 bacteraemia).
We completed the first audit of the cycle.

001 / VARIATIONS IN MANAGEMENT OF INVASIVE GROUP B STREPTOCOCCAL DISEASE AT A TERTIARY PAEDIATRIC CENTRE