Sepsia neonatal e meningite causada pelo Grupo B Streptococcus ou Escherichia coli em gêmeos. Uma revisão sistemática

Resumo original em inglês

O que aconteceu

Neonatal sepsis in one twin poses a dilemma in managing the healthy-appearing sibling. Shared exposures and genetic factors increase risk, and early signs of sepsis can be subtle with rapid deterioration. However, the magnitude of this risk for the healthy twin is unclear, and management strategies vary considerably.

We systematically searched PubMed and EMBASE on June 10th 2025 for multiples in which at least one infant (0-89 days) developed culture-confirmed Group B Streptococcus or Escherichia coli early-onset or late-onset sepsis or meningitis.

O que encontraram

Of 151 sets of multiples from 51 studies, all siblings developed disease in 70 sets (46%). Concordance was 35% in cases described in cohort or surveillance studies and 69% among cases in case reports/series. Median onset interval between siblings was 3 days (IQR 1-7 days). In a small subgroup, pre-emptive antibiotics for the well-appearing twin were associated with lower disease risk (11% vs 56%, p=0.03).

Por que isso importa

Concordance rates of the well-appearing sibling was a third in cohort or surveillance studies and up to half in all identified cases. Even though this can be inflated by reporting bias, cautious management should include strict clinical monitoring, parental education and a low threshold for antibiotics.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.