Group-B Strep

Group B Strep (GBS) is a bacterium that is the most common cause of life-threatening infections in newborns. Of the 8,000 babies born in the United States with GBS disease, nearly 400 will die. Many of those who survive have permanent brain damage, resulting in hearing or vision loss, learning disabilities, or cerebral palsy.

How do babies acquire GBS?

GBS is found in the vagina and/or lower intestine of 10 to 35 percent of all healthy adult women. Normally, GBS does not cause active infection, and is not contagious. However, during labor and delivery, babies can be exposed to GBS in several different ways. Bacteria traveling upward from the mother's vagina into the uterus once the membranes (bag of waters) rupture. In addition, babies can be exposed to GBS while passing down through the birth canal. The bacteria can be swallowed or inhaled by the baby during this time.

 

 

In some of these babies, the GBS gets into the bloodstream, which can result in sepsis (overwhelming infection throughout the body), pneumonia, or meningitis, potentially leading to lifelong disability or, in some cases, death.

Approximately 75 percent of cases of GBS disease in newborns occur during the first week of life, and most appear within a few hours after birth. This is referred to as "early onset" disease. Although premature babies are at higher risk for GBS disease, and, if infected, are at higher risk for serious long term complications or death, full term babies account for 70 to 75 percent of GBS disease in newborns.

Some infants develop GBS one week to several months after birth. This is referred to as "late onset" disease. Approximately one-half of these cases are related to the baby's mother being colonized with GBS. The source of GBS in the remaining one-half of late onset disease is unknown.

How is GBS disease diagnosed and treated?

GBS disease must be considered in any newborn baby who demonstrates sign or symptoms of infection at birth or during the first week of life. These signs or symptoms may include fever, breathing difficulties, grunting sounds, increased (stiff or decreased) limp, muscle tone, seizures, or markedly unusual behavior.

If any of those are present, blood tests and cultures of bodily fluids such as urine, sputum, or cerebrospinal fluid are performed to check for the presence of GBS. It generally takes several days to obtain the final results of these tests. However, intravenous antibiotics would routinely be started immediately once GBS disease is suspected.

Can GBS in newborns be prevented?

Research studies have shown that 70 to 80 percent of cases of GBS disease in newborns can be prevented by administration of intravenous antibiotics to the mother at the onset of labor in those cases in which one or more risk factors are present. These include the following:

  • Positive culture of the mother for GBS colonization at 35-37 weeks
  • Previous baby with GBS disease Urinary tract infection due to GBS
  • Fever (temperature higher than 100.4 degrees F) during labor
  • Rupture of membranes (breaking of the bag of waters) 18 hours or more before delivery
  • Labor or rupture of membranes before 37 weeks

If one or more of the risk factors listed above are identified, intravenous antibiotics should be offered to the mother as early in labor as possible. It is medically appropriate to perform cultures of the mother's vagina and rectum between 35 and 37 weeks to check for GBS colonization. If a culture has not been done, or the results are not known, antibiotics should still be offered to the mother if her membranes rupture 18 hours or more before delivery, or if she has the onset of labor and/or rupture of membranes before 37 weeks. The antibiotics most commonly given are Penicillin or Ampicillin.

What are the long term effects of GBS disease?

A child with GBS disease may suffer permanent brain damage, leading to hearing or vision problems, learning disabilities, or motor deficits. For a more detailed discussion, visit our page on cerebral palsy.

The websites listed below contain information which may be useful to people interested in learning more about GBS disease, including resources which are available to help children with GBS disease and their families. Kenneth M. Sigelman & Associates is not affiliated with any of these other sites, and cannot be responsible for content. Please feel free to contact us if you are aware of other helpful links to include in this site.

 

What resources are available to help children with GBS disease and their families?

Group B Strep Association (GBSA)

Centers for Disease Control (CDC)

Disease Information Re: GBS

The National Information Center for Children and Youth with Disabilities (NICHCY)

National Institutes of Health (NIH)

News Release Re: Group B Strep Vaccine

AB Center: Prenatal Health-Group B Streptococcus

March of Dimes: Group B Strep Infection

Medscape Resource Center: Group B Streptococcal Disease

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