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Group B Streptococcus (GBS) Disease: Causes, Symptoms, Diagnosis, Treatment And Prevention

July is International Group B Strep Awareness Month, which is observed to create awareness about group B strep disease to the general public. The theme for this year is '2020 foresight'.

What Is Group B Strep?

Group B Streptococcus (group B strep or GBS), also known as Streptococcus agalactiae, is a gram-positive bacteria that often stay in the body of healthy adults, especially in the gastrointestinal tract and genitourinary tract (urinary and genital organs). This bacteria is usually harmless, however, it can cause serious illness known as group B streptococcal disease in elderly people and people with underlying diseases [1].

According to the American Pregnancy Association, this bacteria is normally present in the vagina or rectum in about 25 per cent of all healthy adult women. In pregnant women, group B strep colonisation (carriers of the bacteria)increases the risk of group B strep disease in newborns [2].

Causes Of Group B Strep Disease [3]

In many healthy adults, group B strep bacteria normally live in the gastrointestinal and genital tracts. But, sometimes the bacteria invade the body and cause certain infections. From the mother, group B strep can spread to a newborn during delivery or while the baby is in the uterus. In this way, the bacterial infection is transmitted from the colonised mother to her newborn. However, not all babies will be affected by the bacteria.

How people get these bacteria and spread to others is not known.

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Symptoms Of Group B Strep Disease

The signs and symptoms of group B strep disease differ from newborns to adults [4].

In newborns and mothers the symptoms are:

• Fever

• Breathing difficulty

• Bluish skin colour

• Difficulty in feeding

• Irritability or fatigue (hard to wake up the baby)

In babies, the early onset of GBS infections occurs within the first week of life and babies who develop the disease later have it after the first week of life.

In adults the symptoms are:

• Fever

• Chills

• Decrease in alertness

• Cough

• Difficulty in breathing

• Chest pain

• Skin and soft tissue infections

• Bone and joint infections

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Risk Factors Of Group B Strep Disease

In pregnant women, the factors that can increase the risk of having her baby to develop GBS disease are: [5]

• If you tested positive for group B strep bacteria during late pregnancy.

• If you have fever during labour.

• The mother's water breaks 18 hours or more before delivery.

• The mother has a urinary tract infection during pregnancy.

• The mother previously delivered a baby with GBS disease.

In adults, the risk factors of GBS disease are:

• Obesity

• Diabetes

• Heart disease

• Cancer or history of cancer

• Congestive heart failure.

• If you are 65 years or older.

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Complications Of Group B Strep Disease

• Babies can become deaf and develop disabilities.

• Miscarriage [6]

• Stillbirths [7]

• Preterm deliveries.

• GBS bacteremia [8]

• Pneumonia [8]

• Meningitis.

• In some cases, death.

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Diagnosis Of Group B Strep Disease

For diagnosing GBS disease, the doctor will collect samples of blood and spinal fluid and then will check the samples to see if the GBS bacteria are growing in it. In addition, the doctor may conduct chest x-ray to help determine if the person has GBS disease. If GBS bacteria caused urinary tract infection, then the doctor will collect samples of urine to check for urinary tract infections [9].

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Treatment Of Group B Strep Disease

Intravenous penicillin G and ampicillin antibiotics are used for the treatment of GBS disease. The dose for penicillin G is 5 million units followed by 2.5 to 3 million units given every four hours during labour until delivery. And the dose for ampicillin is 2 gm followed by 1 gm which is given every four hours during labour until delivery [10].

Antibiotics are given to women who are at an increased risk of having a baby with group B strep disease and aids in protecting the baby from infection, but only if it's given during labour.

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Prevention Of Group B Strep Disease

• Women should get tested for GBS infection between the 35th and 37th week of pregnancy.

• Intravenous antibiotics are recommended for pregnant women during labour to lower the risk of GBS infection [11].

To Conclude...

Although GBS disease is rare, with proper treatment and preventive methods, one can overcome the disease. Currently, there's no vaccine to protect pregnant women and newborns from GBS bacteria, but researchers are working to develop a vaccine.

Common FAQs

Q. What happens if you test positive for group B strep?

A. If you have been tested positive for group B strep, this means that you are a carrier of the bacteria and it may transmit to the baby. However, in some cases a mother who tests positive, her baby might not get affected by the bacteria.

Q. Is group B strep contagious to your partner?

A. No, group B strep is not a sexually transmitted disease.

Q. How can I protect my baby from group B strep?

A. All pregnant women should get tested for group B strep between 35 to 37 weeks of every pregnancy. And if you have been tested positive for group B strep, the doctor will give you intravenous antibiotics to lower the risk of your baby developing early-onset group B strep infection.

Q. Is group B strep and strep throat same?

A. No, Group B Streptococcus (group B strep) should not be confused with group A streptococcus that causes strep throat.

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