Streptococcal Group B invasive disease

Bacteria called group B Streptococcus (group B strep, GBS) commonly live in people’s gastrointestinal and genital tracts. The gastrointestinal tract is the part of the body that digests food and includes the stomach and intestines. The genital tract is the part of the body involved in reproduction and includes the vagina in women. Most of the time the bacteria are not harmful and do not make people feel sick or have any symptoms. Sometimes the bacteria invade the body and cause certain infections, which are known as GBS disease.

Types of Infections

GBS bacteria can cause many types of infections:

• Bacteremia (bloodstream infection) and sepsis (the body’s extreme response to an infection)
• Bone and joint infections
• Meningitis (infection of the tissue covering the brain and spinal cord)
• Pneumonia (lung infection)
• Skin and soft-tissue infections

GBS most commonly causes bacteremia, sepsis, pneumonia, and meningitis in newborns. It is very uncommon for GBS to cause meningitis in adults.

Riskfactors

GBS disease is most common in newborns. There are factors that can increase a pregnant woman’s risk of having a baby who will develop GBS disease, including:

• Testing positive for GBS bacteria late in pregnancy
• Developing a fever during labor
• Having 18 hours or more pass between when their water breaks and when their baby is born.

In adults, most cases of GBS disease are among those who have other medical conditions. Other medical conditions that put adults at increased risk include:

• Diabetes
• Heart disease
• Congestive heart failure
• Cancer or history of cancer
• Obesity

Risk for serious GBS disease increases as people get older. Adults 65 years or older are at increased risk compared to adults younger than 65 years old.

Transmission

The bacteria do not spread through food, water, or anything that people might have come into contact with. How people get these bacteria or spread them to others is generally unknown. However, experts know that pregnant women can pass the bacteria to their babies during delivery.

Signs and Symptoms

Symptoms of group B strep (GBS) disease are different in newborns compared to people of other ages who get GBS disease. The symptoms of GBS disease can seem like other health problems in newborns and babies. Symptoms include:

• Fever
• Difficulty feeding
• Irritability or lethargy (limpness or hard to wake up the baby)
• Difficulty breathing
• Blue-ish color to skin

Symptoms depend on the part of the body that is infected. Listed below are symptoms associated with the most common infections caused by GBS bacteria.

Symptoms of bacteremia (blood stream infection) and sepsis (the body’s extreme response to an infection) include:

• Fever
• Chills
• Low alertness

Symptoms of pneumonia (lung infection) include:

• Fever
• Chills
• Cough
• Rapid breathing or difficulty breathing
• Chest pain

Skin and soft-tissue infections often appear as a bump or infected area on the skin that may be:

• Red
• Swollen or painful
• Warm to the touch
• Full of pus or other drainage
• People with skin infections may also have a fever.

Bone and joint infections often appear as pain in the infected area and might also include:

• Fever
• Chills
• Swelling
• Stiffness or inability to use the affected limb or joint

Diagnosis

If doctors suspect someone has GBS disease, they will take samples of sterile body fluids. Examples of sterile body fluids are blood and spinal fluid. Doctors look to see if GBS bacteria grow from the samples (culture). It can take a few days to get these results since the bacteria need time to grow. Doctors may also order a chest x-ray to help determine if someone has GBS disease.

Sometimes GBS bacteria can cause urinary tract infections (UTIs or bladder infections). Doctors use a sample of urine to diagnose urinary tract infections.

Treatment

Doctors usually treat GBS disease with a type of antibiotic called beta-lactams, which includes penicillin and [ampicillin]]. Sometimes people with soft tissue and bone infections may need additional treatment, such as surgery. Treatment will depend on the kind of infection caused by GBS bacteria. Patients should ask their or their child’s doctor about specific treatment options.

Prevention

The two best ways to prevent group B strep (GBS) disease during the first week of a newborn’s life are:

• Testing pregnant women for GBS bacteria
• Giving antibiotics, during labor, to women at increased risk
• Unfortunately, experts have not identified effective ways to prevent GBS disease in people older than one week old.

Vaccination

Currently, there is no vaccine to help pregnant women protect their newborns from GBS bacteria and disease. Researchers are working on developing a vaccine, which may become available in the future.

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