Late-onset Streptococcus agalactiae associated meningitis in neonatal practice: clinical cases

Khokhrina E.S, Sarkisyan H.A., Zhirkova Y.V., Mitina Y.Y., Novichkova M.A., Mironova V.A., Solntseva S.N., Khokhrina E.S., Shatalov V.G.

1) Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; 2) Speransky Children’s City Clinical Hospital No. 9, Moscow, Russia

Objective: To describe the clinical course of purulent meningitis with late-onset neonatal sepsis caused by Streptococcus agalactiae, including cases in combination with herpesvirus infection.
Key points: The incidence of purulent meningitis in newborns is 0.1–0.5 per 1,000 infants. In approximately 50% of confirmed cases during the late neonatal period, Streptococcus agalactiae is the causative agent of meningitis. Despite intrapartum prophylaxis, there are cases of late-onset infection. The case-fatality rate can reach 9%. The combination of meningitis caused by Streptococcus agalactiae and the chromosomally integrated form of type 6 herpes in a newborn is very rare and has sparked discussions in the scientific literature.
Materials and methods: This article presents clinical observations of two newborns with purulent meningitis caused by Streptococcus agalactiae, presenting as late-neonatal sepsis, and the presence of a chromosomally integrated form of herpes virus type 6 in the second infant.
Conclusion: Given the high incidence of long-term neurological complications following meningitis caused by Streptococcus agalactiae, close follow-up of patients after hospital discharge is essential. If high levels of herpes virus type 6 are detected in whole blood, an active infection must be ruled out to prevent the unnecessary use of antiviral medications.

For citations: Khokhrina E.S, Sarkisyan H.A., Zhirkova Y.V., Mitina Y.Y., Novichkova M.A., Mironova V.A., Solntseva S.N., Khokhrina E.S., Shatalov V.G. Late-onset Streptococcus agalactiae associated meningitis in neonatal practice: clinical cases. Pharmateca. 2026;33(7):120-128. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.7.120-128

Authors’ contribution: The concept and design of the article – Sarkisyan H.A., Zhirkova Y.V. Data analysis and preparation, text writing – Khokhrina E.S., Solntseva S.N., Novichkova M.A., Mironova V.A., Khokhrina E.S. Scientific editing – Sarkisyan Н.A., Zhirkova Y.V., Mitina Y.Y., Shatalov V.G. 
Conflict of interest: The authors of this article confirmed that the lack of conflict of interest and financial support, which should be to reported.
Funding: Financing of this work was not carried out.
Consent for publication: The authors have received informed consent from the legal representative of patient for publish of the data in a medical publication. 
Use of artificial intelligence tools: No artificial intelligence tools have been used in the research and article preparatione.

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About the Authors

Ekaterina S. Khokhrina, Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; ORCID: https://orcid.org/0009-0008-7597-9707
Heghine A. Sarkisyan, Cand. Sci. (Med.), Associate professor, Academician V.A. Tabolin Department of Hospital Pediatrics, Institute of Maternity and Childhood, Pirogov Russian National Research Medical University (Pirogov University), Moscow; Speransky Children’s City Clinical Hospital No. 9, Moscow, Russia; sarkisian_ea@rsmu.ru (heghinesarg@gmail.com), ORCID: https://orcid.org/0000-0001-7305-9036 (corresponding author)
Yulia V. Zhirkova, Pirogov Russian National Research Medical University (Pirogov University), Moscow; Speransky Children’s City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0000-0001-7861-6778
Yilia Y. Mitina, Speransky Children’s City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0009-0002-1820-9956
Marina A. Novichkova, Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; ORCID: https://orcid.org/0009-0009-7038-762X
Veronika A. Mironova, Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; ORCID: https://orcid.org/0009-0001-0817-4959
Sophia N. Solntseva, Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; ORCID: https://orcid.org/0009-0006-3017-1996
Elizaveta S. Khokhrina, Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; ORCID: https://orcid.org/0009-0009-9315-823X
Vitaly G. Shatalov, Speransky Children’s City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0000-0002-2276-4592