What
is group B streptococcus (group B strep)?
Group B
streptococcus (group B strep) is a bacterium that causes
life-threatening infections in newborn infants. Group B strep can also
cause serious diseases in pregnant women, the elderly, and adults with
other illnesses. The letter "B" refers to a classification
of bacteria in the genus Streptococcus according to the makeup
of the organism's cell wall.
What
kind of illnesses does group B strep cause?
In newborns, group B
strep is the most common cause of sepsis (infection of the
bloodstream) and meningitis (infection of the lining and fluid
surrounding the brain) and a common cause of pneumonia. Group B strep
disease in newborns usually occurs in the first week of life
("early- onset"). Babies can also get a slightly less
serious "late-onset" form of group B strep disease that
develops a week to a few months after birth.
In adults, group
B strep usually causes no symptoms. However, in rare cases, it can
lead to serious bloodstream infections, urinary tract infections, skin
infections, and pneumonia, especially in people with weakened immune
systems and other health problems, such as diabetes.
How
do people get infected with group B strep?
Group B strep
bacteria are different from many other types of bacteria that can
cause disease. People can be "colonized" with group B strep.
This means that they carry the bacteria in their bodies but are not
infected and do not become sick. Adults can carry the bacteria in the
gastrointestinal tract, genital tract, or urinary tract. About 10% to
30% of pregnant women are colonized with group B strep in the genital
tract.
Colonization with
group B strep is usually harmless. The bacteria can become deadly,
though, if something happens that allows them to invade the
bloodstream. In adults, weakened immunity resulting from cancer
treatment or a chronic illness can prompt an infection. More often,
pregnant women who carry the bacteria can unknowingly transmit group B
strep to their newborns at birth. Newborns can acquire early-onset
group B strep disease either before or during delivery. The cause of
late-onset disease in babies is not well understood.
How
is group B strep infection diagnosed?
Group B strep
infection is diagnosed by a laboratory test of blood or spinal fluid.
Who
is at risk for group B strep infection?
Adults with
illnesses that weaken the immune system, such as diabetes or cancer,
are at risk of infection with group B strep.
An infant born to
a woman who is carrying the bacteria can also be at risk. Some
pregnant women are at more risk than others of having a baby who
develops group B strep disease. A pregnant woman is at high risk if
she:
- Has
already had a baby with group B strep infection
- Has
a urinary tract infection caused by group B strep
- Becomes
colonized with group B strep late in pregnancy
- Develops
a fever during labor
- Has
rupture of membranes 18 hours or more before delivery
- Begins
labor or has rupture of membranes before 37 weeks ("preterm")
What
complications can result from group B strep infection?
Group B strep
infection is fatal in about 20% of infected men and non-pregnant women
and about 5% to 15% of infected newborns. Babies who survive can be
left with speech, hearing, and vision problems as well as mental
retardation.
What
is the treatment for group B strep infection?
Group B strep
infections in both newborns and adults are usually treated with
antibiotics given intravenously (through a vein).
How
common is group B strep infection?
Group B strep causes
disease in about 18,000 people in the United States each year. Of
these, about 8,000 are newborns. Group B strep is the most common
cause of blood infections and meningitis in newborns and is a frequent
cause of newborn pneumonia.
How
can group B strep infection be prevented?
Most cases of group
B strep infection in newborns can be prevented by giving certain
pregnant women antibiotics during labor. Antibiotic treatment before
labor does not prevent group B strep infection in newborns.
Any pregnant
woman who has already had a baby with group B strep infection or who
has a urinary tract infection caused by group B strep should be given
antibiotics during labor. Pregnant women who are colonized with group
B strep should be offered antibiotics at the time of labor or rupture
of the membranes. Colonization with group B strep can be detected late
in pregnancy (35-37 weeks' gestation) by a special test of secretions
from the vagina and rectum.
Unfortunately,
some babies still get group B strep infection despite testing and
antibiotic treatment. Vaccines to prevent group B strep infection are
being developed.
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