Group B Streptococcus (group B strep) is a type of bacteria that causes illness in people of all ages. Also known as GBS or baby strep, group B strep disease in newborns most commonly causes sepsis (infection of the blood), pneumonia (infection in the lungs), and sometimes meningitis (infection of the fluid and lining around the brain). The most common problems caused by group B strep in adults are bloodstream infections, pneumonia, skin and soft-tissue infections, and bone and joint infections.
Centers for Disease Control and Prevention: http://www.cdc.gov/groupbstrep/about/index.html
http://www.fitango.com/categories.php?id=513Fitango EducationHealth TopicsGroup B strep
1OverviewGroup B Streptococcus (group B strep) is a type ofbacteria that causes illness in people of all ages.Also known as GBS or baby strep, group B strepdisease in newborns most commonly causes sepsis(infection of the blood), pneumonia (infection inthe lungs), and sometimes meningitis (infection ofthe fluid and lining around the brain). The mostcommon problems caused by group B strep inadults are bloodstream infections, pneumonia,skin and soft-tissue infections, and bone and jointinfections.
2OverviewCenters for Disease Control and Prevention:http://www.cdc.gov/groupbstrep/about/index.html
3SymptomsThe symptoms of group B strep disease can seemlike other health problems in newborns andinfants. Most newborns with early-onset diseasehave symptoms on the day of birth. Babies whodevelop late-onset disease may appear healthy atbirth and develop symptoms of group B strepdisease after the first week of life.Some symptoms are:
4Symptoms-- Fever-- Difficulty feeding-- Irritability, or lethargy (limpness or hard to wakeup the baby)-- Difficulty breathing-- Blue-ish color to skin
5SymptomsCenters for Disease Control and Prevention:
6DiagnosisGroup B strep disease is diagnosed when thebacteria are grown from samples of a baby’s sterilebody fluids, such as blood or spinal fluid. Culturescan take a few days to grow.
7DiagnosisTypically, if a mother who tested positive for groupB strep received antibiotics during labor, the babywill be observed to see if he or she should getextra testing or treatment because of concernsabout early-onset disease. (See the secondaryprevention of early-onset GBS among infantssection of the CDC’s prevention guidelines to learnmore.)
8DiagnosisFor both early-onset and late-onset disease, if thedoctors suspect that a baby has group B strepinfection, they will take a sample of the baby’sblood and spinal fluid to confirm the diagnosis.Centers for Disease Control and Prevention:http://www.cdc.gov/groupbstrep/about/index.html
9TreatmentGroup B strep infections in newborns and olderbabies are treated with antibiotics (e.g., penicillinor ampicillin) given through a vein (IV). For babieswith severe illness, other procedures in addition toantibiotics may be needed.Centers for Disease Control and Prevention:
10TreatmentGroup B strep infections in newborns and olderbabies are treated with antibiotics (e.g., penicillinor ampicillin) given through a vein (IV). For babieswith severe illness, other procedures in addition toantibiotics may be needed.Centers for Disease Control and Prevention:
11Risks**Transmission**For early-onset disease, the group B strep bacteriaare passed from the mother to the baby, mostoften during labor and birth. Antibiotics givenduring labor can be very effective at preventingthis transmission.
12Risks**Transmission**Late-onset disease is sometimes due to passing ofthe bacteria from mother to newborn, butsometimes the bacteria come from anothersource. For a baby whose mother does not testpositive for group B strep, the source of infectionfor late-onset disease can be hard to figure out andis often unknown. CDC collects information onbabies with late-onset disease in 10 states tobetter understand transmission.
13Risks**Transmission**Women who are group B strep positive canbreastfeed safely. There are many benefits for boththe mother and child.**Risk Factors**Some pregnant women are at higher risk of havinga baby with early-onset disease. The factors thatincrease risk include:
14Risks**Transmission**Testing positive for group B strep late in thecurrent pregnancy (35-37 weeks gestation)Detecting group B strep in urine during the currentpregnancyDelivering early (before 37 weeks gestation)Developing fever during labor
15Risks**Transmission**Having a long period between water breaking anddeliveringHaving a previous infant with early-onset diseaseThese risk factors guided the early-onset diseaseprevention strategy used today.
16Risks**Transmission**Late-onset disease is more common among babieswho are born prematurely (< 37 weeks). This isthe strongest risk. Babies whose mothers testedgroup B strep positive also have a higher risk oflate onset disease. The risk factors for late onsetdisease are not as well understood as for early-onset disease.Centers for Disease Control and Prevention:
18PreventionPreventing Early-Onset GBSThere are 2 cornerstones to preventing newbornearly-onset disease: testing all pregnant womenfor group B strep bacteria late in pregnancy, andgiving antibiotics during labor to women who testpositive for the bacteria.1. Testing Pregnant Women
19PreventionCDC’s guidelines recommend that a pregnantwoman be tested, or screened, for group B strep inher vagina and rectum when she is 35 to 37 weekspregnant. The test is simple and does not hurt. Asterile swab (“Q-tip”) is used to collect a samplefrom the vagina and the rectum. This is sent to alaboratory for testing.
20PreventionAbout 25% of pregnant women carry group B strepin the rectum or vagina. Those women areconsidered group B strep positive. A woman maytest positive at certain times and not at others.That’s why it’s important for all pregnant womento be tested for group B strep between 35 to 37weeks of every pregnancy.
21PreventionA woman who has the bacteria in her body usuallydoes not feel sick or have any symptoms. However,she is at higher risk for passing group B strep to herbaby during birth.Women should talk to their doctor about theirgroup B strep status.2. Antibiotics During Labor
22PreventionTo help protect their babies frominfection, pregnant women who test positive forgroup B strep in the current pregnancy shouldreceive antibiotics (medicine) through the vein (IV)during labor. Also, pregnant women who havegroup B strep detected in their urine during thecurrent pregnancy or who had a previous infantwith group B strep disease should receiveantibiotics during labor; they do not need to bescreened at 35-37 weeks because they shouldreceive antibiotics regardless of the screen
23PreventionPregnant women who do not know whether or notthey are group B strep positive when labor startsshould be given antibiotics if they have: laborstarting at less than 37 weeks (pretermlabor); prolonged membrane rupture (waterbreaking 18 or more hours before delivery);or fever during labor.
24PreventionAntibiotics help to kill some of the group B strepbacteria that are dangerous to the baby duringbirth. The antibiotics help during labor only — theycan’t be taken before labor, because the bacteriacan grow back quickly. Penicillin is the mostcommon antibiotic that is given. For women whoare severely allergic to penicillin, there are otherantibiotics that can be given. Women should telltheir doctor or nurse about any allergies during acheckup and try to make a plan for delivery. When
25PreventionPenicillin is very safe and effective at preventinggroup B strep disease in newborns. There can beside effects from penicillin for the woman,including a mild reaction to penicillin (about a 10%chance). There is a rare chance (about 1 in 10,000)of the mother having a severe allergic reaction thatrequires emergency treatment.Preventing Late-Onset Disease
26PreventionUnfortunately, the method recommended toprevent early-onset disease (giving women whoare group B strep positive antibiotics through thevein (IV) during labor) does not prevent late-onsetdisease. Although rates of early-onset disease havedeclined, rates of late-onset disease haveremained fairly stable since 1990. At this time, astrategy has not yet been identified for preventinglate-onset group B strep disease.
28PreventionThere is no group B strep vaccine currentlyavailable to help mothers protect their newbornsfrom group B strep disease. Researchers areworking on developing a vaccine, which maybecome available one day in the future. Antibioticstaken by mouth instead of through the vein, andantibiotics taken before labor and delivery are noteffective at preventing newborn group B strepdisease. Birth canal washes with the disinfectantchlorhexidine do not reduce mother to babytransmission of group B stre
29PreventionCenters for Disease Control and Prevention:http://www.cdc.gov/groupbstrep/about/index.html
30Facts-- In the U.S., group B strep is the leading cause ofmeningitis (infection of the fluid and lining aroundthe brain) and sepsis (infection of the blood) in anewborn’s first week of life (early-onset disease).
31Facts-- About 25% of pregnant women carry group Bstrep in the rectum or vagina. Group B strepbacteria may come and go in people’s bodieswithout symptoms.-- CDC’s guidelines recommend that a pregnantwoman be tested for group B strep when she is 35to 37 weeks pregnant.
32Facts-- A pregnant woman who tests positive for groupB strep and gets antibiotics during labor has only a1 in 4,000 chance of delivering a baby with group Bstrep disease, compared to a 1 in 200 chance if shedoes not get antibiotics during labor.
33Facts-- Any pregnant woman who had a baby withgroup B strep disease in the past, or who has had abladder (urinary tract) infection during thispregnancy caused by group B strep should receiveantibiotics during labor.-- Most early-onset group B strep disease innewborns can be prevented by giving pregnantwomen antibiotics (medicine) through the vein (IV)during labor.
34Facts-- Newborns are at increased risk for a group Bstrep infection if their mother tests positive forgroup B strep during pregnancy.-- The antibiotics used to prevent early-onsetgroup B strep disease in newborns only help duringlabor — they can’t be taken before labor, becausethe bacteria can grow back quickly.
35Facts-- The rate of serious group B strep diseaseincreases with age; average age of cases in non-pregnant adults is about 60 years old.Centers for Disease Control and Prevention:http://www.cdc.gov/groupbstrep/about/index.html