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What is Group B streptococcus infection?
Group B streptococci is a bacteria that is found in the vagina or lower intestine of 10-30% of pregnant women. While Group B strep does not usually cause problems for most women it can occasionally cause infections in them or their newborn babies. Approximately 1% of babies born to women with this bacteria develop symptoms. The risk of serious disease appears to be greatest among premature infants.
What complications does Group B streptococcus cause for the baby?
Newborn babies can acquire Group B strep infection when the bacteria enters the amniotic cavity after the membranes have ruptured or when there are small tears in the amniotic sac. Having a caesarian section does not eliminate the risk of infection. Group B strep infection can also be acquired when the baby passes through the mother's vagina (birth canal) during delivery. In either case, the baby may inhale or swallow the bacteria. The bacteria makes its way into the baby's blood stream where toxins may be released. These toxins may cause infection in the baby's heart, lungs and brain.
Early Onset disease (from less than seven days) is characterized by bacterial infection in the baby's bloodstream, that often leads to respiratory distress, periods of irregular breathing shock, pneumonia and meningitis. Early Onset disease has a death rate of about 50%. It is acquired before or during delivery, and occurs more frequently in low birth weight infants.
Late Onset disease (from 7 days to several months) is characterized by bacterial infection in the baby's bloodstream that often leads to meningitis. Late Onset disease has a death rate of about 25% and is acquired by person-to-person contact and occurs in full-term infants.
How do you prevent/treat Group B streptococcus of the newborn?
To prevent early onset of Group B streptococcal disease (GBS) of the newborn there are currently two protocols in use by physicians:
- Screening by cultures of all pregnant women at 35-37 weeks of pregnancy. Women who screen positive would receive antibiotic treatment during labour.
- Antibiotic treatment for all women with the following high risk criteria:
• preterm labour, (less than 37 weeks gestation),
• prolonged rupture of membranes, (greater than 18 hours),
• maternal fever during labour, (greater than 38° C orally),
• previous delivery of a newborn with GBS or evidence of GBS bacteria during pregnancy.
Pregnant women should discuss any concerns they have about this disease with their physician.
Adapted from the former Muskoka- Parry Sound Health Unit. July 2005
14 Mar 2008 15:05:24 -0500
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