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Clinical manifestations of Streptococcus pyogenes infection in postpartum women and neonates in Khyber Pakhtunkhwa_
| Clinical Feature | Postpartum women (n = 32) | Neonates (n = 23) | χ2 Value | p-Value |
|---|---|---|---|---|
| Fever (> 38°C) | 24 (75.0%) | 16 (66.7%) | 0.34 | 0.56 |
| Hypothermia (< 36°C) | 4 (12.5%) | 6 (27.8%) | 1.98 | 0.16 |
| Sepsis | 16 (50.0%) | 12 (55.6%) | 0.16 | 0.69 |
| Meningitis | 6 (16.7%) | 8 (33.3%) | 2.18 | 0.14 |
| Wound infection | 10 (33.3%) | – | – | – |
| Bacteremia | 18 (58.3%) | 16 (66.7%) | 0.37 | 0.54 |
| Respiratory distress | – | 12 (55.6%) | – | – |
| Jaundice | – | 8 (33.3%) | – | – |
| Hypotension | 7 (20.8%) | 5 (22.2%) | 0.01 | 0.92 |
| Tachycardia | 8 (25.0%) | 9 (38.9%) | 1.13 | 0.29 |
| Multi-organ dysfunction | 4 (12.5%) | 3 (11.1%) | 0.02 | 0.88 |
| Vomiting | 8 (25.0%) | 10 (44.4%) | 2.25 | 0.13 |
| Hypoglycemia | 6 (16.7%) | 9 (38.9%) | 3.73 | 0.05 |
| Lethargy | 7 (20.8%) | 12 (50.0%) | 5.46 | 0.02 |
| Rash | 6 (16.7%) | 6 (27.8%) | 0.96 | 0.33 |
| Abdominal pain | 10 (29.2%) | – | – | – |
| Feeding difficulties | – | 8 (33.3%) | – | – |
| Cyanosis | – | 4 (16.7%) | – | – |
Risk factors and laboratory findings associated with Streptococcus pyogenes infection_
| Parameter | Postpartum women (%) (n = 32) | Neonates (%) (n = 23) | Crude OR (95% CI) | Adjusted OR (95% CI) | p-Value |
|---|---|---|---|---|---|
| Risk factors | |||||
| Prolonged labor (> 18h) | 13 (40.6%) | – | 2.9 (1.3–6.4) | 2.6 (1.2–6.0) | 0.030 |
| Premature rupture of membranes | 10 (31.3%) | – | 2.3 (1.1–4.8) | 2.1 (1.0–4.6) | 0.039 |
| Low birth weight (< 2.5 kg) | – | 9 (39.1%) | 1.4 (0.6–3.0) | 1.2 (0.5–2.8) | 0.315 |
| Maternal infection history | 8 (25.0%) | – | 1.8 (0.9–3.5) | 1.6 (0.8–3.2) | 0.092 |
| Maternal malnutrition | 9 (28.1%) | – | 1.4 (0.7–2.8) | 1.3 (0.6–2.7) | 0.256 |
| Poor socioeconomic status | 15 (46.9%) | 12 (52.2%) | 2.6 (1.4–5.1) | 2.3 (1.2–4.6) | 0.027 |
| Home delivery without skilled attendant | 11 (34.4%) | 10 (43.5%) | 3.0 (1.5–6.0) | 2.7 (1.3–5.7) | 0.020 |
| Limited prenatal care (< 3 visits) | 12 (37.5%) | – | 2.7 (1.3–5.5) | 2.4 (1.2–5.0) | 0.036 |
| Preterm birth (< 37 weeks) | – | 10 (43.5%) | 3.3 (1.6–7.1) | 3.0 (1.4–6.7) | 0.013 |
| Neonatal resuscitation at birth | – | 7 (30.4%) | 2.9 (1.4–6.1) | 2.6 (1.2–5.7) | 0.028 |
| Inadequate hand hygiene in hospital | 10 (31.3%) | 8 (34.8%) | 2.8 (1.3–6.0) | 2.4 (1.1–5.2) | 0.034 |
| Laboratory features | |||||
| Elevated CRP (> 10 mg/l) | 20 (62.5%) | 15 (65.2%) | 1.2 (0.6–2.3) | 1.1 (0.5–2.2) | 0.984 |
| Leukocytosis (WBC > 12,000/μl) | 18 (56.3%) | 13 (56.5%) | 1.4 (0.7–2.7) | 1.2 (0.6–2.4) | 0.874 |
| Thrombocytopenia (< 150,000/μl) | 6 (18.8%) | 8 (34.8%) | 1.7 (0.8–3.5) | 1.5 (0.7–3.1) | 0.365 |
| Anemia (Hb < 10 g/dl) | 10 (31.3%) | 9 (39.1%) | 1.5 (0.7–3.1) | 1.4 (0.6–2.9) | 0.710 |
| Positive Blood Culture for S. pyogenes | 18 (56.3%) | 15 (65.2%) | 2.0 (1.1–3.9) | 1.8 (0.9–3.7) | 0.054 |
Prevalence of Streptococcus pyogenes among postpartum women and neonates_
| Group | Total samples | Positive cases | Prevalence (%) | Male cases | Female cases | χ2 Value | p-Value |
|---|---|---|---|---|---|---|---|
| Postpartum women | 192 | 32 | 16.7% | - | 32 | 1.52 | 0.217 |
| Neonates | 192 | 23 | 11.9% | 12 | 11 | ||
| Total | 384 | 55 | 14.3% | 12 | 43 |