Group B Strep in Infants Katrina Maurath

Group B Strep, or GBS, is a bacterium that is found in the intestines or genital tract of 25% of healthy pregnant women.  The risk of babies getting GBS is lower now than it was years ago because of the tests that can detect GBS during pregnancy.  Women should be tested at 35-37 weeks of pregnancy in case they are carriers of GBS.  A swab is taken from the vagina to test for it.  If the woman tests positive, she should be given intravenous (IV) antibiotics during labor because if GBS is passed to the infant, it could cause serious complications.

Other ways an infant can become infected are if the baby is born before 37 weeks if water is broken more than 18 hours before delivering, or if the mother has a fever of 100.4 or higher.  In these cases, the mother should also be given antibiotics just to be on the safe side.  If antibiotics are not given to the mother, 1 in 400 babies will be infected.  If antibiotics are given to the mother, 1 in 2000 babies are infected.  1200 babies get infected with GBS every year.  4-6% of these babies will die.  Women can also pass GBS to an infant before going into labor.  This is called pre-natal onset GBS.

Most babies are infected while passing through the birth canal and show symptoms within the first week of life.  This is called early-onset GBS.  GBS can also be passed to an infant after birth by coming into contact with someone who carries GBS.  A baby can develop GBS after the first week of life-6 months, this is called late-onset GBS.  The complications are similar in both, but meningitis is more common with late-onset GBS.  GBS can be deadly if not treated promptly.  There are signs to detect early-onset GBS when your infant is born. These include irritability, inconsolable crying, projectile vomiting, poor feeding, unstable temperature, irregular or difficulty breathing, or anxious behavior.  Most of the time, these symptoms are noticed while the baby is still in the hospital.  If you notice any of these symptoms, a physician should be notified immediately.  Prompt treatment can reduce the risk of some of the complications caused by GBS.

The baby will then be tested for GBS.  Some of the tests include a blood culture, blood clotting test, complete blood count, CFS culture (to test for meningitis), urine specimen, and chest X-ray.   If a baby tests positive for GBS, many complications can arise, such as septicemia (infection of the blood), pneumonia (infection of the lungs), meningitis (inflammation of the membranes covering the brain and spinal cord), and/or respiratory failure resulting in death.  Infants are treated for GBS through intravenous (IV) antibiotics.  Depending on the severity, the baby may also need to be treated with other antibiotics, oxygen, or IV fluids.

If any mother has given birth to a baby that was infected with GBS, then they need to take preventative measures by taking intravenous antibiotics each time she goes into labor with any child born after the infected infant.  Effective prevention is the reason why the rates of babies born with GBS have dropped in the past 10 years.

 

References

http://www.nlm.nih.gov/medlineplus/ency/article/001366.htm

http://www.mayoclinic.com/health/group-b-strep/DS01107

http://www.cdc.gov/groupbstrep/about/index.html

http://www.medicinenet.com/group_b_strep/article.htm

http://www.webmd.com/parenting/baby/tc/group-b-streptococcal-infections-in-newborns-topic-overview