Group B

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Group B Streptococcus (GBS), also known as Streptococcus agalactiae, is a type of bacterial infection that can be found in the digestive and lower reproductive tracts of both men and women. It is particularly notable for its role in neonatal infections, where it can lead to serious conditions such as meningitis, sepsis, and pneumonia in newborns. The bacteria are categorized as part of the Lancefield group B streptococci, a classification system based on the bacteria's cell wall composition.

Overview

Group B Streptococcus is a leading cause of neonatal morbidity and mortality worldwide. While it is a normal part of the flora in the gastrointestinal and genitourinary tracts of a significant portion of the population, it can become pathogenic under certain conditions. Pregnant women can transmit the bacteria to their babies during childbirth, leading to early-onset disease in newborns, which occurs within the first week of life. Late-onset disease can also occur, typically from one week to a few months after birth.

Symptoms and Risks

In adults, GBS infection may present with no symptoms or mild symptoms related to urinary tract infections or skin infections. However, in newborns, GBS can cause more severe conditions such as sepsis, pneumonia, and meningitis. The risk factors for neonatal GBS infection include preterm delivery, rupture of membranes 18 hours or more before delivery, and a high level of GBS colonization in the mother.

Prevention and Treatment

Prevention strategies focus on screening pregnant women for GBS colonization through rectal and vaginal swabs at 35 to 37 weeks of gestation. Those found to be carriers are offered intrapartum antibiotic prophylaxis, typically with penicillin or ampicillin, to reduce the risk of transmitting the bacteria to the newborn. This approach has significantly decreased the incidence of early-onset GBS disease.

Treatment for infants and adults with GBS infection includes antibiotics, such as penicillin or ampicillin, often in combination with an aminoglycoside if sepsis is suspected or confirmed.

Vaccination

Research is ongoing into the development of a vaccine against GBS, which would offer a preventive strategy to protect newborns from GBS disease. Such a vaccine would be particularly beneficial in low-resource settings where access to screening and intrapartum antibiotics may be limited.

Epidemiology

Group B Streptococcus colonization rates in adults vary globally but can be found in 10% to 30% of pregnant women. The implementation of screening and prophylaxis programs in many countries has led to a significant reduction in the incidence of early-onset GBS disease, although it remains a leading cause of neonatal infection worldwide.