GBS (Group B Strep) infections

Group B Streptococcus (GBS, Streptococcus agalactiae) is a common gram positive coccus that colonizes the vaginal and gastrointestinal tracts in 20-40% of healthy women. About half of GBS positive mothers will pass on the bacteria to their newborns but only 1% of these newborns will have a clinical infection. Transmission and clincal GBS disease is more common in premature infants and in women who have prolonged rupture of the membranes.

Neonatal group B streptococcal disease classically presents either as early or late sepsis. Early sepsis typically presents within 24 hours of birth but by definition can be evident up to seventh day of life. With early sepsis bacteremia and pneumonia are classic findings. Late sepsis on the other had can present up to 3 months postpartum and classically has bacteremia and meningitis.

Prevention: Term women with GBS positive cultures are treated with ampicillin intrapartum. Penicillin allergic patients can be treated with clindamycin or erythromycin.

GBS infection is otherwise rare in healthy individuals but the following conditions may predispose to an infection: Diabetes mellitus, malignancy, old age with bedridden state, cirrhosis, steroids, AIDS, renal failure, peripheral vascular disease. Common manifestations in these scenarios are urinary tract infection, pneumonia, and soft-tissue infection.