Complement Activation and Group B Streptococcal Infection in the Newborn: Similarities to Endotoxin Shock

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Abstract
Serial measurements of CH50 [total hemolytic complement], C3 [3rd complement component], C4 and factor B were performed on 3 newborn infants with group B streptococcal sepsis. Two of the septic infants had a colonized but noninfected identical twin. All 3 infants with group B streptococcal sepsis had hypotension, prolonged coagulation times, neutropenia and respiratory failure. During the course of the sepsis, factor B was depressed 30-35%, C3 was depressed 40-60% and CH50 was depressed by 100% when compared to their cord blood levels. Two of the infants also had a 50-70% depression of C4. No significant decrease in C levels occurred in the siblings of the twins or in 2 additional control infants. These data are characteristic of older patients with gram-negative sepsis and strongly suggest that the group B Streptococcus has endotoxin-like properties.

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