Group B streptococci (GBS) are gram-positive encapsulated bacteria that comprise the normal flora of the gastrointestinal and urinary tract, but their ability to cause a wide range of infections in humans (S. agalactiae as the main pathogenic species) has been well-documented [1] [2] [3]. Numerous subtypes are mentioned in the literature, but the neonatal disease is perhaps most important. GBS is the causative agent of life-threatening infections in the neonatal population, arising as a result of vertical transmission from the mother (either during delivery or while still being in the uterus) [1] [4]. It is estimated that between 20-40% of women carry GBS [1] [5], and due to the established mortality rate of 12% [6], immense efforts are made toward screening and prophylactic use of antibiotics [4] [7]. Approximately 1-3% of colonized neonates develop systemic signs of infection in the first week (termed early-onset) or within the first three months (late-onset), with sepsis, pneumonia, and less commonly meningitis [1] [4]. In addition to neonates, adults and elderly patients, particularly those having comorbidities (eg. diabetes mellitus, malignancies, liver disease, congestive heart failure, gastrointestinal pathologies, etc.) have been described as a population susceptible to group B streptococcal infections [8] [9] [10] [11]. Cellulitis is the predominant manifestation of skin and soft-tissue infections caused by GBS, and lymphedema, chronic dermatitis, as well as poor vascularity are prominent risk factors [8] [10]. Furthermore, urinary tract infections (pyelonephritis and prostatitis, especially in elderly individuals who reside in nursing homes, have indwelling catheters or suffer from urogenital pathologies), pyogenic arthritis, endocarditis, pneumonia, bacteremia and meningitis are becoming increasingly recognized in the spectrum of group B streptococcal infections [8] [10] [11] [12].

• Sepsis

  Verified cases of sepsis/meningitis and cases with clinical sepsis/pneumonia were documented, as well as risk factors in case mothers and timeliness of intrapartum antibiotic prophylaxis administration. [ncbi.nlm.nih.gov]

• Fever

  Maternal intrapartum fever was the most frequent risk factor associated with failure of chemoprophylaxis. [ncbi.nlm.nih.gov]

  Bacteremia (bloodstream infection) and sepsis (the body’s extreme response to an infection) symptoms include: Fever Chills Low alertness Pneumonia (lung infection) symptoms include: Fever Chills Cough Rapid breathing or difficulty breathing Chest pain [cdc.gov]

  Pregnant women should call their physician promptly if they have fever or abdominal pain. Newborns and infants should be seen by a medical provider if they have fever, trouble breathing, or appear listless. [emedicinehealth.com]

• Asymptomatic

  In asymptomatic women, a positive urine culture for GBS should be considered clinically equivalent to a positive vaginal or rectal sample for screening. [ncbi.nlm.nih.gov]

• Fatigue

  You may notice that your little one has: Fever Fast, slow, or strained breathing Trouble eating Extreme fatigue Irritability Blue color to the skin Babies with group B strep bacteria could get serious complications like these: Pneumonia -- a lung infection [webmd.com]

• Hypothermia

  Involvement Cerebral Palsy About CP Causes & Risk Factors Signs and Symptoms Diagnosis Treatments and Therapies Assistive Technology Legal Help HIE About HIE Causes & Risk Factors Signs of Fetal Distress Diagnosis Brain Imaging Treatment Therapeutic Hypothermia [abclawcenters.com]

  Your baby may have any of the following signs and symptoms: Eating poorly or vomiting Fast or slow heartbeat and trouble breathing Fever, hypothermia (very low body temperature), or seizures Irritability, drowsiness, or difficulty waking up Sensitivity [drugs.com]

• Pneumonia

  A significant decrease in the number of cases with clinical GBS sepsis/pneumonia was also observed. [ncbi.nlm.nih.gov]

  Approximately 1-3% of colonized neonates develop systemic signs of infection in the first week (termed early-onset) or within the first three months (late-onset), with sepsis, pneumonia, and less commonly meningitis. [symptoma.com]

• Tachypnea

  […] delivery, it also may occur before rupture of membranes. 11,12 Neonates with early-onset disease commonly present with pneumonia (10%) and sepsis (83%); meningitis is less frequent (7%). 1,6 Respiratory distress, grunting, retractions, hypoxemia, and tachypnea [journals.lww.com]

  Clinical signs of infection including fever, decreased activity level, poor feeding, tachycardia, and tachypnea, were noted for each twin at presentation; both initial CBCs demonstrated a pronounced shift toward immature neutrophil forms. [nature.com]

• Tachycardia

  The extreme tachycardia of twin B at presentation indicated onset of the systemic response syndrome. [nature.com]

• Flushing

  Consumption of large amounts of fluids helps to flush out bacteria from the urinary tract, thereby helping with the treatment. At least eight to 10 glasses of water should be taken per day. [livestrong.com]

• Meningism

  Meningitis results from neonatal infection that occurs when GBS leaves the bloodstream (bacteremia), crosses the blood-brain barrier (BBB), and enters the central nervous system (CNS), where the bacteria contact the meninges. [ncbi.nlm.nih.gov]

  Twin A developed fulminant fatal meningitis, whereas twin B had no CNS involvement. Why some infants develop meningitis as a complication of GBS infection and others do not is poorly understood. [nature.com]

• Seizure

  If treatment is ineffective or delayed, the baby could have developmental delays, pneumonia, blindness, seizures, hearing problems or sepsis (blood poisoning). [birthinjuryjustice.org]

  When GBS infection is present in neonates and young infants, and is treated improperly, it can lead to meningitis, brain damage, cerebral palsy, seizure disorders, developmental disabilities, and other serious complications (1). [abclawcenters.com]

  These symptoms usually develop anywhere within the first 24 hours of life to the first week of life, and may include: fever, breathing problems, grunting sounds, bluish skin, seizures, limpness, stiffness, heart rate and blood pressure abnormalities, [birthinjuryguide.org]

  The signs to look for in babies include fever, breathing problems or grunting sounds, bluish-colored skin, seizures, limpness or stiffness, abnormal heart rate or blood pressure, fussy or poor feeding, vomiting, diarrhea. [metrointegrative.com]

  Your baby has a seizure. Your baby has a tense or bulging soft spot on the top of the head. Your baby has trouble breathing and a very fast or slow heartbeat. Your baby is drowsy or more sleepy than usual. Your baby is vomiting often. [drugs.com]

• Confusion

  These vary according to age and state of health of the person affected but can include: Non-pregnant adults: Fever, headaches, confusion, shortness of breath, a burning sensation when passing urine and frequent visits to the toilet to pass urine. [netdoctor.co.uk]

  Symptoms of group B streptococcal infection The signs and symptoms of GBS vary according to age, but can include: in non-pregnant adults – fever, headache, confusion, shortness of breath or cough (if pneumonia), a burning sensation when passing urine [betterhealth.vic.gov.au]

  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. [rxlist.com]

  But as a mom, it’s a confusing decision – take the chance on the low likelihood of your baby developing a serious GBS infection if you don’t do the antibiotics in labor, or take an antibiotic that can harm baby’s microbiome. [avivaromm.com]

• Headache

  These vary according to age and state of health of the person affected but can include: Non-pregnant adults: Fever, headaches, confusion, shortness of breath, a burning sensation when passing urine and frequent visits to the toilet to pass urine. [netdoctor.co.uk]

  Symptoms of group B streptococcal infection The signs and symptoms of GBS vary according to age, but can include: in non-pregnant adults – fever, headache, confusion, shortness of breath or cough (if pneumonia), a burning sensation when passing urine [betterhealth.vic.gov.au]

  She was drowsy and irritable when aroused, complaining of continued severe headache and neck pain. Neurological exam was significant for photophobia and meningismus. The remainder of the neurological exam and the ocular exam were normal. [f1000research.com]

• Stroke

  The bacteria form clumps on the valves which can ‘fly off’ to cause serious problems such as a stroke or damage to other organs, Treatment will involve several weeks of intravenous antibiotics and sometimes surgery is essential to cure the condition. [nfsuk.org.uk]

A thorough clinical and microbiological investigation is necessary in order to make the diagnosis of a group B streptococcal infection. In elderly patients and adults, a detailed patient history that will cover the presence of comorbidities, personal details (eg. residence in nursing homes can be an important piece of information) and assessment of the complaints reported is pivotal. In neonates who present with systemic and severe symptoms, however, group B streptococcal infection must be immediately suspected, in which case mothers should be asked whether they underwent screening for GBS that should be carried out between 35-37 weeks of gestation [4]. Cultivation of previously obtained vaginal or anal swabs for 48 hours is a mandatory step in reducing the number of group B streptococcal infections in neonates [5], but the majority of neonatal infections that are reported today appear in mothers who already tested negative [7]. The recent introduction of polymerase chain reaction (PCR), a molecular method that seems to have superior detection rates compared to cultures, is considered to be the next step in the diagnosis and early identification of group B streptococcal infections [1] [5]. PCR is even more useful for identifying neonatal infections, due to the long turnaround time that is otherwise necessary in the case of cultivation [1].

For the comparison chlorhexidine (vaginal wash or gel) versus placebo or no treatment, two studies (n = 987) were pooled. [ncbi.nlm.nih.gov]

Concerning the prognosis, 22.6% of early onset cases and 38.7% of late onset cases died or had sequelae. [ncbi.nlm.nih.gov]

What is the Prognosis of Group B Streptococcal Infection in Newborns (Outcomes/Resolutions) The prognosis of Group B Streptococcal Infection in Newborns depends on early diagnosis and timely treatment. [dovemed.com]

What is the prognosis of a group B strep infection? The prognosis of a GBS infection varies depending on various factors, including the patient's age and the presence of any underlying medical conditions. [rxlist.com]

Molecular epidemiologic examination may be useful to clarify the transmission route and etiology; culture-based microbiologic screening appears to have limitations for detecting the route of transmission. [ncbi.nlm.nih.gov]

Rebecca Lancefield, who used immunologic typing of carbohydrate antigens as a means to classify streptococci. ( 1 ) Early studies by her group and others indicated that GBS was an uncommon cause of human disease and was more frequently isolated as an etiologic [pedsinreview.aappublications.org]

Pregnancy-related infections include: Bloodstream infections (including sepsis) Amnionitis Urinary tract infection Stillbirth Etiologic Agent Streptococcus agalactiae or group B Streptococcus (group B strep, GBS) cause GBS disease. [cdc.gov]

(Etiology) Group B Streptococcal Infection in Newborns is a serious infection in the bloodstream caused by Streptococcus agalactiae, a Gram-positive bacterium. [dovemed.com]

Bacterial etiology of serious infections in young infants in developing countries: results of a multicenter study. The Pediatric Infectious Disease Journal. 1999; 18(Supplement):S17-S22. [panafrican-med-journal.com]

An understanding of GBS epidemiology, clinical presentation, and prevention strategies enhances the PNP's decision-making skills in the nursery and strengthens the PNP's ability to evaluate and compare new approaches to GBS prevention. [ncbi.nlm.nih.gov]

Epidemiology of group B streptococcal disease in the United States: Shifting Paradigms. Clin Microbiol Rev 1998;11:497-513. [ PUBMED ] 11. Regan JA, Klebanoff MA, Nugent RP. The epidemiology of group B streptococcal colonization in pregnancy. [ijmm.org]

An understanding of GBS epidemiology, clinical presentation, and prevention strategies enhances the PNP's decision-making skills in the nursery and strengthens the PNP's ability to evaluate and compare new approaches to GBS prevention. [ncbi.nlm.nih.gov]

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