Group B streptococcus and pregnancy

Group B strep infection

Group B streptococcus and pregnancy

Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria (tiny organisms that live in and around your body) that can cause infection. Usually GBS is not serious for adults, but it can hurt newborns. Many people carry Group B strep bacteria and don’t know it.

It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, a bladder or urinary tract infection (UTI).

While GBS may not be harmful to you, it can be very harmful to your baby.

If you’re pregnant, you can pass it to your baby during labor and childbirth.

About 1 4 pregnant women (25 percent) carry GBS bacteria. The best way to know if you have GBS is to get tested. If you do have GBS, though, there’s good news: your health care provider can give you treatment during labor and birth that protects your baby from GBS.

How do you get GBS?

GBS bacteria live in the intestines and the urinary and genital tracts. It lives in the body naturally. As an adult, you can’t get it from food, water or things you touch. You can’t catch it from another person, and you can’t get it from having sex.

How do you know if you have GBS?

Your provider tests you for GBS at 35 to 37 weeks of pregnancy. Testing for GBS is simple and painless. Your provider takes a swab of your vagina and rectum and sends the sample to a laboratory.

Your test results are usually available in 1 to 2 days.

Your provider also can use some quick screening tests during labor to test you for GBS.

But these should not replace the regular GBS test that you get at 35 to 37 weeks of pregnancy.

How can you protect your baby from GBS?

If your GBS test at 35 to 37 weeks shows you have the infection, your provider gives you medicine called an antibiotic during labor and birth through an IV (through a needle into a vein).

You also may be treated if you have any risk factors for GBS and you don’t know your GBS test results or you haven’t been tested yet. Treatment with antibiotics helps prevent your baby from getting the infection. Penicillin is the best antibiotic for most women.

Another antibiotic called ampicillin also can be used. These medicines usually are safe for you and your baby. But some women (up to 1 in 25 women, or 4 percent) treated with penicillin have a mild allergic reaction, a rash.

About 1 in 10,000 women have a serious allergic reaction that needs to be treated right away. If you’re allergic to penicillin, your provider can treat you with a different medicine. If your test shows you have GBS, remind your health care providers at the hospital when you go to have your baby.

This way, you can be treated quickly. Treatment works best when it begins at least 4 hours before childbirth.

If you have GBS and you’re having a scheduled cesarean birth (c-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

It’s not helpful to take oral antibiotics before labor to treat GBS. The bacteria can return quickly, so you could have it again by the time you have your baby.

If you have GBS, what are the chances that you can pass it to your baby?

If you have GBS during childbirth and it’s not treated, there is a 1 to 2 in 100 chance (1 to 2 percent) that your baby will get the infection. The chances are higher if you have any of these risk factors:

  • Your baby is premature. This means your baby is born before 37 weeks of pregnancy.
  • Your water breaks (also called ruptured membranes) 18 hours or more before you have your baby.
  • You have a fever (100.4 F or higher) during labor.
  • You’ve already had a baby with a GBS infection.
  • You had a UTI during your pregnancy that was caused by GBS.

If you have GBS and you’re treated during labor and birth, your treatment helps protect your baby from the infection.

If your baby gets GBS, do signs of infection or other problems show up right after birth?

Not always. It depends on the kind of GBS infection your baby has. There are two kinds of GBS infections:

  1. Early-onset GBS: Signs fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby. But treatment with antibiotics during labor and birth can help prevent your baby from getting it. About half of all GBS infections in newborns are early-onset.
  2. Late-onset GBS: Signs coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby during or after birth. Treatment with antibiotics during labor and birth does not prevent late-onset GBS. After birth, your baby also can get GBS from other people who have the infection.

What problems can GBS cause in newborns?

Babies with a GBS infection can have one or more of these illnesses:

  • Meningitis, an infection of the fluid and lining around the brain
  • Pneumonia, a lung infection
  • Sepsis, a blood infection

Pneumonia and sepsis in newborns can be life-threatening. Most babies who are treated for GBS do fine. But even with treatment, about 1 in 20 babies (5 percent) who have GBS die.

Premature babies are more ly to die from GBS than full-term babies (born at 39 to 41 weeks of pregnancy).

GBS infection may lead to health problems later in life.

For example, about 1 in 4 babies (25 percent) who have meningitis caused by GBS develop:

  • Cerebral palsy (A group of disorders that can cause problems with brain development. These problems affect a person's ability to move and keep their balance and posture.)
  • Hearing problems
  • Learning problems
  • Seizures

If your baby has a GBS infection, how is he treated?

It’s important to try and prevent a newborn from getting GBS. But if a baby does get infected with early-onset GBS or late-onset GBS, he is treated with antibiotics through an IV.

If you're treated for GBS during labor, does your baby need special treatment?

Probably not. But if you have a uterine infection (an infection in your uterus) during labor and birth, your baby should be tested for GBS. Your baby’s provider can treat your baby with antibiotics while you wait for the test results.

Can GBS cause problems for mom during and after pregnancy?

GBS can cause a uterine infection during and after pregnancy. Symptoms of a uterine infection include:

  • Fever
  • Pain in your belly
  • Increased heart rate (During pregnancy, it also can cause your baby’s heart rate to increase.)

If you have a uterine infection, your provider can give you antibiotics, and the infection usually goes away in a few days. Some women have no symptoms, so they don’t get treatment. Without treatment, infection during pregnancy may increase your chances of:

  • Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts
  • Preterm labor – Labor that happens too early, before 37 weeks of pregnancy
  • Stillbirth – When a baby dies in the womb after 20 weeks of pregnancy

If you’re treated for GBS during labor and birth, you probably won’t get a uterine infection after your baby is born. GBS also can cause a UTI during pregnancy. A UTI can cause fever or pain and burning when you urinate. Sometimes a UTI doesn’t have any symptoms.

If you have a UTI, you may find out about it from a urine test during one of your prenatal visits.

If you have a UTI caused by GBS, your provider gives you antibiotics to take by mouth during pregnancy.

You also get antibiotics through an IV during labor and birth, because you may have high levels of GBS in your body.

Is there a vaccine for GBS?

No. But researchers are making and testing vaccines to prevent GBS infection in mothers and their babies.

More information

Centers for Disease Control and Prevention (CDC)

Last reviewed: November, 2013

Source: https://www.marchofdimes.org/complications/group-b-strep-infection.aspx

Group B Streptococcus And Pregnancy

Group B streptococcus and pregnancy

Group B Streptococcus (GBS) or Streptococcus agalactiae is a gram-positive bacteria which colonizes the gastrointestinal and genitourinary tract[1].

In the United States of America, GBS is known to be the most common infectious cause of morbidity and mortality in neonates[2].

GBS is known to cause both early onset and late onset infections in neonates, but current interventions are only effective in the prevention of early-onset disease[1].

Early onset GBS infections occur within the first week of life, whereas late-onset disease occurs beyond the first week of life[1]. The following chapter will focus on the current guidelines regarding screening of pregnant patients for GBS during prenatal care and intrapartum prophylaxis aimed at the prevention of early-onset GBS infection.

The main risk factor for early-onset GBS infection is colonization of the maternal genital tract with Group B Streptococcus during labor[2]. GBS is a normal flora of the gastrointestinal (GI) tract, which is thought to be the main source for maternal colonization[2]. GBS cultures should be obtained with each pregnancy because colonization may be temporary[2].

Positive GBS urinary tract infection at any time during the pregnancy is a marker of heavy colonization, and these patients should receive prophylaxis even if GBS culture is negative between 35 to 37 weeks[2]. Additional risk factors for early onset GBS disease include young maternal age and black race[2].

Preterm labor (less than 37 weeks), maternal fever during labor (greater than 100.4 F or 36 C), and prolonged rupture of membranes (greater than 18 hours) are also labor characteristics which are risk factors for early-onset GBS disease. GBS colonization is has an incidence of 10-30% in pregnancy[2].

 Without preventative measures, early onset GBS infection occurs in 1% to 2% of neonates born to mothers with GBS colonization[2].

As stated above, GBS colonization has an incidence of 10-30% in pregnancy[2]. Over the last 20 years, developments in screening for GBS colonization, intrapartum prophylaxis, and secondary prevention of early-onset GBS disease have resulted in a significant decrease in the incidence of early-onset GBS infection[2].

In the early 1990s, there were approximately 1.7 cases of early-onset GBS infection per 1000 live births. This has decreased to 0.34 to 0.37 per 1000 live births in recent years[2]. Seventy percent of cases of early-onset GBS infection are in term infants (greater than 37 weeks)[2].

Interestingly, 60% of early-onset infections occur in patients with a negative rectovaginal GBS culture between 35 to 37 weeks[2]. Group B streptococcus colonization in the rectovaginal area is discontinuous. Up to 33% of patients whom have a positive GBS culture at 35-37 weeks, are not colonized at delivery.

On the contrary approximately 10% of women who are colonized at delivery will have a negative culture at 35-37 weeks. [3]

The principal route of neonatal early onset GBS infection is vertical transmission from colonized mothers during passage through the vagina during labor and delivery[4].

The majority of infants exposed to GBS during delivery become colonized with GBS and do not develop signs or symptoms of GBS infection[2].

The fetus is also susceptible to ascending infection into the amniotic fluid, with or without rupture of membranes[2]. 

The principal defense against early-onset GBS infection is the administration of antibiotic prophylaxis to mothers during labor and delivery. Identification of patients who will benefit from intrapartum prophylaxis is an important aspect of routine prenatal care.

The Center for Disease Control and Prevention (CDC) recommends a universal culture-based screening[2]. Obstetrics providers should perform a rectovaginal culture for GBS in all patients between 35 and 37 weeks of gestation[1].

Cultures are performed at this point in gestation because the negative predictive value of the GBS culture is highest (95% to 99%) in the first 5 weeks after collection[2].

Patients who have an indication for preterm or early term induction of labor will benefit from GBS culture at or before 35 weeks, whereas nulliparous patients with unfavorable cervix may benefit from GBS culture collection at 37 weeks[2]. Antibiotic susceptibility testing must be performed on all GBS cultures to guide antibiotic prophylaxis in penicillin-allergic patients[2].

GBS bacteriuria is another marker of genital tract colonization[2]. All pregnant patients should be screened for asymptomatic bacteriuria during pregnancy, and all women with GBS bacteriuria at any point during the pregnancy should receive intrapartum prophylaxis[2]. 

If GBS status is unknown, antibiotic prophylaxis should be initiated in patients with preterm labor (less than 37 weeks gestation), maternal fever during labor (greater than 100.4 F or 38 C), membranes ruptured greater than 18 hours, and/or in patients with a history of a previous child with invasive early-onset GBS infection[1].

Intravenous penicillin G is the treatment of choice for intrapartum antibiotic prophylaxis against Group B Streptococcus[1]. Penicillin G 5 million units intravenous is administered as a loading dose, followed by 2.

5 to 3 million units every 4 hours during labor until delivery[1]. Ampicillin is a reasonable alternative to penicillin G if penicillin G is unavailable[1].

Ampicillin is administered as a 2 gm intravenous loading dose followed by 1 gm intravenous every 4 hours during labor until delivery[1].

Penicillin G and ampicillin should not be used in patients with penicillin allergy. Antibiotic prophylaxis in patients with a history of anaphylaxis, angioedema, respiratory distress, or urticaria following penicillin or cephalosporin is guided by antibiotic susceptibility testing[1].

If GBS is sensitive to both clindamycin and erythromycin, then clindamycin 900 mg intravenous every 8 hours is recommended for GBS prophylaxis during labor until delivery[1]. Occasionally GBS susceptibility testing will return susceptible to clindamycin but resistant to erythromycin.

Resistance to erythromycin can induce resistance to clindamycin even in the presence of a culture that appears sensitive to clindamycin. For this reason, if the culture returns resistant to erythromycin, vancomycin 1 gm intravenously every 12 hours is recommended for GBS prophylaxis[1].

In patients without GBS susceptibility testing with penicillin allergy, vancomycin is recommended for GBS prophylaxis with dosing as described above[1].

Cefazolin 2 gram intravenous loading dose followed by 1 gm every 8 hours may be used in patients without a history of anaphylaxis, angioedema, respiratory distress, or urticaria following penicillin or cephalosporin administration[1].

Initiating antibiotic prophylaxis greater than 4 hours before delivery is considered to be adequate antibiotic prophylaxis and is effective in the prevention of transmission of GBS to the fetus.

However, antibiotic prophylaxis administered at a shorter interval will provide some protection.

If a patient presents in active labor and delivery is expected in less than 4 hours, antibiotic prophylaxis should still be initiated[2].

GBS vaccines show promise to combat early-onset GBS infection, but there are currently no approved GBS vaccines on the market[2].

Since the initiation of universal screening for GBS colonization and intrapartum antibiotic prophylaxis, the incidence of early-onset GBS infection has decreased approximately 80%[2]. Efficacy of intrapartum antibiotic prophylaxis is estimated between 86% to 89%[2].

GBS culture screening during prenatal care will not identify all women with GBS colonization during labor because genital tract colonization can be temporary.

Approximately 60% of cases of early-onset GBS infection occur in neonates born to patients with negative GBS culture at 35 to 37 weeks[2].

Early-onset GBS infection typically presents in the first 24 to 48 hours of life. Symptoms include respiratory distress, apnea, with signs of sepsis[2].

Sepsis and pneumonia commonly result from early-onset GBS infection, but rarely meningitis can occur[2]. Mortality from early-onset GBS infection is much higher in preterm infants than term infants.

Preterm infants with early-onset GBS infection have a case fatality rate between 20% to 30% compared to 2% to 3% in term infants[2].

Pearls and Other Issues

  • In the United States of America, GBS is known to be the most common infectious cause of morbidity and mortality in neonates[2].
  • Intrapartum antibiotic prophylaxis is only effective in the prevention of early-onset GBS infection[2].
  • The CDC recommends universal screening with GBS rectovaginal culture between 35 to 37 weeks in each pregnancy[2]. 
  • Intrapartum antibiotic prophylaxis is recommended with positive GBS rectovaginal culture, GBS bacteriuria at any time during the pregnancy, or a history of delivery of infant affected by early onset GBS infection[2].
  • If GBS status is unknown, antibiotic prophylaxis is recommended during preterm labor and delivery (less than 37 weeks), in the presence of maternal fever during labor, or with prolonged rupture of membranes (greater than 18 hours)[2].
  • Intravenous Penicillin G is the antibiotic of choice for intrapartum prophylaxis[1].
  • Additional options for antibiotic prophylaxis are ampicillin, cefazolin, clindamycin, or vancomycin[1].

Prevention of GBS infection during pregnancy requires an interprofessional team effort. All healthcare workers who look after pregnant women should screen these patients for GBS. This may include physcians, physician's assistants, nurse practioners, midwives and/or nurses.

Since the initiation of universal screening for GBS colonization and intrapartum antibiotic prophylaxis, the incidence of early-onset GBS infection has decreased approximately 80%[2]. Efficacy of intrapartum antibiotic prophylaxis is estimated between 86% to 89%[2].

GBS culture screening during prenatal care will not identify all women with GBS colonization during labor because genital tract colonization can be temporary.

Approximately 60% of cases of early-onset GBS infection occur in neonates born to patients with negative GBS culture at 35 to 37 weeks[2].

To access free multiple choice questions on this topic, click here.

1.American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee Opinion No. 485: Prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol. 2011 Apr;117(4):1019-27. [PubMed: 21422882]2.Verani JR, McGee L, Schrag SJ., Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease–revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010 Nov 19;59(RR-10):1-36. [PubMed: 21088663]3.Regan JA, Klebanoff MA, Nugent RP, Eschenbach DA, Blackwelder WC, Lou Y, Gibbs RS, Rettig PJ, Martin DH, Edelman R. Colonization with group B streptococci in pregnancy and adverse outcome. VIP Study Group. Am. J. Obstet. Gynecol. 1996 Apr;174(4):1354-60. [PubMed: 8623869]4.Schrag SJ, Verani JR. Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease: experience in the United States and implications for a potential group B streptococcal vaccine. Vaccine. 2013 Aug 28;31 Suppl 4:D20-6. [PubMed: 23219695]

Source: https://www.ncbi.nlm.nih.gov/books/NBK482443/

What to Know About Group B Strep and Pregnancy

Group B streptococcus and pregnancy

No mom-to-be wants to find out she has any type of infection while she’s pregnant.

So if you’ve just found out that you’re group B Strep positive, or if you’ve simply heard of this condition and worry you may be at risk, you ly have a slew of questions and concerns about what this diagnosis means and what the risks are for you and your baby.

We have the answers to all of your questions and the information that will put your mind at ease.

What is Group B Strep?

Group B Streptococcus (also called group B strep, or GBS) is a common type of bacteria that lives in the body naturally in the intestines and the urinary and genital tracks of both men and women.

If you’re a healthy adult, you don’t need to worry about GBS—it comes and goes on its own and is usually harmless. However, if you’re pregnant, it can be passed along to your baby, which is why it’s important to get tested for GBS and have the proper treatment plan in place during delivery if you have it.

What Causes Group B Strep?

The bacteria that causes group B strep is naturally occurring in our bodies, and anyone can be a carrier. It’s also very common—about 1 in 4 pregnant women carry the bacteria. And although group B strep can cause minor infections in adults a bladder or urinary tract infection, most carriers don’t even know they have it.

How Do You Get Group B Strep?

Un the flu or even the common cold, group B strep isn’t something you can catch by being around another person who has it—it’s naturally occurring in our bodies. You can’t get it from food or water, and it’s not considered a sexually transmitted disease as it can occur in someone with no prior sexual experience. (It can, however, be passed through sex, including via oral contact.)

Group B strep is something that can be passed from a mother to an infant during childbirth, however. A baby can contract it during a vaginal delivery if they are exposed to or swallow the fluids containing the bacteria.

What is the Group B Strep Test?

Here’s some good news—the group B strep test is a routine test that is quick, easy and painless.

Between 35 weeks pregnant and 37 weeks pregnant, your healthcare provider will test you for group B strep by taking a swab of your vagina and your rectum during one of your regular exams. The sample will be sent to a lab, and your results will usually be available in a few days.

In the case of an early or unexpected delivery, it’s also possible to do several quick screening tests while you’re in labor—but this shouldn’t take the place of the standard GBS test if possible.

Group B Strep Symptoms

Most people who test positive for GBS won’t show any symptoms—the positive test simply indicates that you’re a carrier and not that you’ll necessarily pass it along to your baby. But there are some symptoms that may mean you’re at a higher risk of delivering a baby with group B strep. They include:

  • A previous baby with GBS
  • Fever (100.4 F or higher) during labor
  • Urinary tract infection that’s a result of GBS during your pregnancy
  • Labor and/or water breaking (also called ruptured membranes) prior to 37 weeks pregnant
  • Ruptured membranes 18 hours or more before delivery
  • An infection of placental tissues and amniotic fluid

You’re also at an increased risk for group B strep if you have a medical condition that affects your immune system (such as diabetes, HIV, liver disease or cancer).

If you are a carrier for GBS while in labor and you’re not treated, there is a 1-2% chance that your baby will get the infection, and a slightly higher chance if you have the above risk factors.

How to Treat Group B Strep

More good news here—the treatment for group B strep is simple and very effective.

If you’ve tested positive for the bacteria, you’ll need an intravenous (IV) antibiotic during labor and delivery. Penicillin is the best for most women, but if you’re allergic, there are other effective options you can discuss with your healthcare provider.

As soon as your labor has begun and you’ve been checked into the hospital, you’ll be hooked up to an IV to administer the antibiotics. It’s recommended that the antibiotics are given every four hours during active labor until your baby is delivered.

If you’re a group B strep carrier and you’re having a scheduled c-section birth before labor starts and before your water breaks, you most ly won’t need any medication, but you should still discuss your treatment plan with your doctor just to be sure.

How Does Group B Strep Affect Baby?

Before you add this to your list of worries, it’s important to point out that with the right treatment, the statistics around properly treating and preventing your baby from contracting group B strep are very much in your favor.

A pregnant woman who tests positive for GBS and gets antibiotics during delivery has only a 1 in 4,000 chance of delivering a baby who will contract the bacteria. But if baby does get GBS, here’s what to know.

There are two kinds of GBS in babies: early-onset and late-onset.

Early-onset GBS presents within the first seven days of life and accounts for about half of all GBS infections in newborns.

It presents with symptoms such as fever, trouble breathing or drowsiness, and can cause pneumonia (a lung infection), sepsis (a blood infection) or meningitis (an infection of the fluid and lining around the brain).

Babies with GBS that doesn’t develop into other problems are usually treated with IV antibiotics in the newborn intensive care unit.

Signs of late-onset GBS generally will begin between seven days old and three months, and include symptoms coughing and congestion, trouble eating, fever, drowsiness and seizures. It can cause sepsis and pneumonia. Early visits to your pediatrician are important.

Hopefully, this information helps you understand the routine group B test during pregnancy, and the treatments available if you do test positive for GBS.

Source: https://www.babylist.com/hello-baby/group-b-strep-pregnancy

How Did I Get Group B Strep? Test, Treatment, Symptoms, Pregnancy, Baby

Group B streptococcus and pregnancy
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What should I know about group B strep?

Group B strep bacteria can cause infections in a pregnant woman and her baby.

  • Group B Streptococcus (GBS) are bacteria found normally in the intestine, vagina, and rectum in about 25% of all healthy pregnant women.
  • Group B strep infections can affect newborn babies and adults.
  • Most pregnant women who are colonized by the bacteria have no symptoms.
  • The infection can be spread to infants before or during birth.
  • Signs and symptoms of GBS neonatal infection may include fever, breathing problems, seizures, lethargy, and poor feeding.
  • Medical professionals diagnose GBS infection by isolating the organism from body fluids. A positive result means that a person is GBS-positive.
  • The treatment for GBS infection is antibiotics.
  • Complications of GBS infection include sepsis, pneumonia, meningitis, or occasionally death.
  • The prognosis for GBS infection depends on the patient's age and underlying medical conditions.
  • In pregnant women, prevention of transmitting GBS infection is best achieved by routine screening for colonization with GBS.

Group B streptococcus (GBS) is a type of bacteria that can exist in the female reproductive tract without causing symptoms. Up to 30% of healthy women can carry group B strep, and it usually does not cause problems.

However, sometimes it can lead to serious infection of the bloodstream, infection of the placenta, or urinary tract infection. Group B strep can also have serious consequences for the baby, causing potentially life-threatening infections in the newborn, including meningitis, pneumonia, and sepsis.

The test is usually done between the 35th and 37th weeks of pregnancy and should be done in subsequent pregnancies even if you test negative in your first pregnancy.

Read about other tests performed during the third trimester of pregnancy »

What is group B strep?

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Group B Streptococcus (GBS) is a type of gram-positive streptococcal bacteria also known as Streptococcus agalactiae. This type of bacteria (not to be confused with group A strep, which causes strep throat) is commonly found in the human body (this is termed colonization), and it usually does not cause any symptoms.

However, in certain cases, it can be a dangerous cause of various infections that can affect nonpregnant adults, pregnant women, and their newborn infants. In the United States, approximately 30,800 cases of invasive GBS disease occur annually across all age groups.

Group B strep disease is the most common cause of neonatal sepsis and meningitis in the United States.

Group B streptococcal infection can also afflict nonpregnant adults with certain chronic medical conditions, such as diabetes, cardiovascular disease, obesity, and cancer.

The incidence of group B streptococcal disease in adults increases with age, with the highest rate in adults 65 years of age and older (25 cases per 100,000).

Although the incidence of neonatal group B strep infection has been decreasing, the incidence of GBS infection in nonpregnant adults has been increasing.

Group B Strep See pictures of a growing fetus through the 3 stages of pregnancy See Images

What causes group B strep infection?

Group B strep bacteria can normally be found in about 25%-30% of all healthy pregnant women. Group B strep is commonly found in the intestine, vagina, and rectal area.

Most women who are carriers of the bacteria (colonized) will not have any symptoms; however, under certain circumstances, perinatal group B strep infection of both the mother and/or the newborn can develop.

In newborns, if the GBS infection develops in the first week of life, it is termed early onset disease. If the GBS infection develops from 1 week to 3 months of age, it is referred to as late onset disease.

On average, approximately 1,000 babies in the United States develop early onset disease each year, with similar rates for late onset disease. According to the U.S. Centers for Disease Control and Prevention (CDC), the rate of early onset infections decreased from 1.7 per 1,000 live births in 1993 to 0.22 cases per 1,000 births in 2016.

How do people get group B strep?

In newborns, group B Streptococcus infection is acquired through direct contact with the bacteria while in the uterus or during birth; thus, the gestational bacterial infection is transmitted from the colonized mother to her newborn.

Approximately 50% of colonized mothers will pass the bacteria to their babies during pregnancy and vaginal birth.

However, not all babies will be affected by the bacteria, and statistics show that about only one of every 200 babies born to a GBS-colonized mother will actually go on to develop GBS infection.

Group B strep infection is more common in African Americans than in whites. There are also maternal risk factors that increase the chance of transmitting group B Streptococcus to the newborn leading to early onset disease:

  • Labor or membrane rupture before 37 weeks gestation
  • Membrane rupture more than 18 hours before delivery
  • Urinary tract infection with GBS during pregnancy
  • Previous baby with GBS infection
  • Fever during labor
  • Positive culture for GBS colonization at 35-37 weeks

Late onset GBS infection occurs more commonly in babies who are born prematurely (.

Source: https://www.medicinenet.com/group_b_strep/article.htm

Group B Strep and pregnancy – Group B Strep Support

Group B streptococcus and pregnancy

Group B Streptococcus (Group B Strep, Strep B, Beta Strep, or GBS) is a type of bacteria which lives in the intestines, rectum and vagina or around 2-4 in every 10 women in the UK (20-40%). This is often referred to as ‘carrying’ or being ‘colonised with’ GBS.

Group B Strep is not a sexually transmitted disease. Most women carrying GBS will have no symptoms. Carrying GBS is not harmful to you, but it can affect your baby around the time of birth.

GBS can occasionally cause serious infection in young babies and, very rarely, during pregnancy before labour.

  • Group B Strep is one of the many bacteria that normally live in our bodies and which usually cause no harm
  • Testing for GBS is not routinely offered to all pregnant women in the UK
  • If you carry GBS, most of the time your baby will be born safely and will not develop an infection. However, it can rarely cause serious infection such as sepsis, pneumonia or meningitis
  • Most early-onset GBS infections (those developing in the first week of life) are preventable
  • If GBS is found in your urine, vagina or rectum (bowel) during your current pregnancy, or if you have previously had a baby affected by GBS infection, you should be offered antibiotics in labour to reduce the small risk of this infection to your baby.
  • The risk of your baby becoming unwell with GBS infection is increased if your baby is born preterm, if you have a temperature while you are in labour, or if your waters break before you go into labour
  • If your newborn baby develops signs of GBS infection, they should be treated with antibiotics straight away

The information below is for you, a friend or a relative who is expecting a baby, planning to become pregnant or has recently had a baby. 

ORDER AN ECM TEST FOR GBS ONLINE

many bacteria, GBS may be passed from one person to another through skin-to-skin contact, for example, hand contact, kissing, close physical contact, etc. As GBS is often found in the vagina and rectum of colonised women, it can be passed through sexual contact.

There are no known harmful effects of carriage itself and the GBS bacteria do not cause genital symptoms or discomfort. GBS carriage is not a sexually transmitted disease, nor is GBS carriage a sign of ill health or poor hygiene.

No-one should ever feel guilty or dirty for carrying GBS – it’s normal. Around 20-40% of women carry GBS.

GBS may be passed from one person to another by skin-to-skin contact. Everyone (regardless of whether they know they carry GBS) should wash their hands properly and dry them properly before handling a newborn baby.

Most women carrying GBS have no symptoms, so GBS is often found by chance through a vaginal or rectal swab test or a urine test.

The NHS does not routinely test all pregnant women for group B Strep.

Tests designed specifically to find GBS carriage, known as the Enriched Culture Medium (ECM) test, are increasingly becoming available within the NHS and are widely available privately.

Since September 2017, the Royal College of Obstetricians & Gynaecologists (RCOG) has recommended in their guideline on group B Strep that selected pregnant women should be offered the ECM test. Many maternity units still use a standard test that misses up to half of the women carrying group B Strep, so ask your health professionals what is available locally.

For more information about how you can order a private home ECM testing kit for GBS carriage, click here.

Many babies come into contact with group B Strep during labour, or around or after birth and the vast majority will not become ill.

However, there is a small chance that your newborn baby will develop group B Strep infection and become seriously ill, or even die, and this chance is increased if you are carrying GBS.

The infections that group B Strep most commonly causes in newborn babies are sepsis (infection of the blood), pneumonia (infection in the lungs), and meningitis (infection of the fluid and lining around the brain).

Around 1 in every 1750 babies in the UK and Ireland is diagnosed with early-onset group B Strep infection (developing in babies aged 0-6 days).

Around 1 in every 2700 babies in the UK and Ireland is diagnosed with late-onset group B Strep infection (developing in babies aged 7-90 days).

Although group B Strep infection can make your baby very unwell, with prompt treatment most babies will recover fully.

Of the babies who develop GBS infection, 1 in 19 (5.2%) will die from early-onset GBS infection and 1 in 13 (7.7%) from late-onset GBS infection. Of those who survive their GBS infection, 1 in 14 (7.4%) will have a long-term disability following early-onset GBS infection and 1 in 8 (12.4%) following late-onset GBS infection.

Any baby can develop a group B Strep infection, but early-onset group B Strep infection (developing in the first 6 days of life, and usually on the first day of life) is more ly if:

  • your baby is born preterm (before 37 weeks of pregnancy) – the earlier your baby is born, the greater the risk
  • you have previously had a baby who developed a group B Strep infection
  • you have had a high temperature (or other signs of infection) during labour
  • you have had any group B Strep positive urine or swab test in this pregnancy
  • your waters have broken more than 24 hours before your baby is born

Late-onset group B Strep infection (developing in babies aged 7-90 days) is less common than early-onset GBS infection and is more ly if:

  • your baby is born preterm (before 37 weeks of pregnancy)
  • you have had group B Strep positive test in this pregnancy

How can the risk to my baby be reduced?

Most early-onset group B Strep infection can be prevented by giving intravenous antibiotics in labour to women whose babies are at raised risk of developing the infection. At present, there are no known methods to prevent late-onset GBS infection.

  • A urine infection caused by group B Strep should be treated with antibiotic tablets straight away and you should also be offered intravenous (IV) antibiotics during labour.
  • You should be offered IV antibiotics during labour if you have had a GBS-positive swab or urine test from an NHS or other accredited laboratories (see www.gbss.org.uk/test).
  • If you have previously had a baby who was diagnosed with GBS infection, you should be offered IV antibiotics when you are in labour.
  • If your waters break after 37 weeks of your pregnancy and you are known to carry GBS, you will be offered induction of labour straight away. This is to reduce the time that your baby is exposed to GBS before birth. You should also be offered IV antibiotics.
  • Even if you are not known to carry GBS, if you develop any signs of infection in labour, you will be offered IV antibiotics that will treat a wide range of infections including GBS.
  • If your labour starts before 37 weeks of your pregnancy, your healthcare professional will recommend that you have IV antibiotics even if you are not known to carry GBS.

At present, there are no known methods to prevent late-onset GBS infection, so knowledge of the typical signs of infection is vital. Click here for more information.

If you are worried about your baby, you should urgently contact your healthcare professional and mention any history of GBS when you do.

If you have any questions about Group B Strep, please call our helpline

Mon-Fri 9am-5pm

0330 120 0796

Or email us at info@gbss.org.uk

Source: https://gbss.org.uk/info-support/about-group-b-strep/what-is-group-b-strep/

Group B Strep and Pregnancy

Group B streptococcus and pregnancy

Group B Streptococcus (group B strep, GBS) is a type of often found in the urinary tract, digestive system, and reproductive tracts. The bacteria come and go from our bodies, so most people who have it don't know that they do. GBS usually doesn't cause health problems.

What Problems Can Group B Strep Cause?

Health problems from GBS are not common. But it can cause illness in some people, such as the elderly and those with some medical conditions. GBS can cause infections in such areas of the body as the blood, lungs, skin, or bones.

About 1 every 4 women have GBS. In pregnant women, GBS can cause infection of the urinary tract, placenta, womb, and amniotic fluid.

Even if they haven't had any symptoms of infection, pregnant women can pass the infection to their babies during labor and delivery.

How Does Group B Strep Affect Babies?

When women with GBS are treated with antibiotics during labor, most of their babies do not have any problems. But some babies can become very sick from GBS. Premature babies are more ly to be infected with GBS than full-term babies because their bodies and immune systems are less developed.

The two types of GBS disease in babies are:

  1. Early-onset infections, which happen during the first week of life. Babies often have symptoms within 24 hours of birth.
  2. Late-onset infections, which develop weeks to months after birth. This type of GBS disease is not well understood.

What Are the Signs & Symptoms of GBS Disease?

Newborns and infants with GBS disease might show these signs:

  • a fever
  • feeding problems
  • breathing problems
  • irritability or fussiness
  • inactivity or limpness
  • trouble keeping a healthy body temperature

Babies with GBS disease can develop serious problems, such as:

  • pneumonia
  • sepsis
  • meningitis (infection of the fluid and lining around the brain). Meningitis is more common with late-onset GBS disease and, in some cases, can lead to hearing and vision loss, learning disabilities, seizures, and even death.

How Is Group B Strep Diagnosed?

Pregnant women are routinely tested for GBS late in the pregnancy, usually between weeks 35 and 37. The test is simple, inexpensive, and painless. Called a culture, it involves using a large cotton swab to collect samples from the vagina and rectum. These samples are tested in a lab to check for GBS. The results are usually available in 1 to 3 days.

If a test finds GBS, the woman is said to be “GBS positive.” This means only that she has the bacteria in her body — not that she or her baby will become sick from it.

GBS infection in babies is diagnosed by testing a sample of blood or spinal fluid. But not all babies born to GBS-positive mothers need testing. Most healthy babies are simply watched to see if they have signs of infection.

How Is Group B Strep Treated?

Doctors will test a pregnant woman to see if she has GBS. If she does, she will get (IV) antibiotics during labor to kill the bacteria. Doctors usually use penicillin, but can give other medicines if a woman is allergic to it.

It's best for a woman to get antibiotics for at least 4 hours before delivery. This simple step greatly helps to prevent the spread of GBS to the baby.

Doctors also might give antibiotics during labor to a pregnant woman if she:

  • goes into labor prematurely, before being tested for GBS
  • hasn't been tested for GBS and her water breaks 18 or more hours before delivery
  • hasn't been tested for GBS and has a fever during labor
  • had a GBS bladder infection during the pregnancy
  • had a baby before with GBS disease

Giving antibiotics during labor helps to prevent early-onset GBS disease only. The cause of late-onset disease isn't known, so no method has yet been found to prevent it. Researchers are working to develop a vaccine to prevent GBS infection.

Babies who get GBS disease are treated with antibiotics. These are started as soon as possible to help prevent problems. These babies also may need other treatments, breathing help and IV fluids.

How Can I Help Prevent Group B Strep Infection?

Because GBS comes and goes from the body, a woman should have GBS testing during each pregnancy. Women who are GBS-positive and get antibiotics at the right time during labor do well, and most don't pass the infection to their babies.

If you are GBS-positive and begin to go into labor, go to the hospital rather than laboring at home. By getting IV antibiotics for at least 4 hours before delivery, you can help protect your baby against early-onset GBS disease.

Reviewed by: Armando Fuentes, MD

Date reviewed: October 2018

Source: https://kidshealth.org/en/parents/groupb.html

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