Group B StrepTOCOCCUS  

The most common cause of early-onset severe infection in the neonatal period 

• 20-40% of mothers are 'carriers' and have GBS present in their vaginal, urinary tract, bowel flora which does not cause symptoms  

  • • However, GBS that leads to infection may result in these presentations:

      • • UTI – dysuria, frequency, urgency

        • Chorioamnioitis – fevers, lower abdominal tenderness, foul discharge, maternal and/or foetal tachycardia 

• Infants may be exposed to maternal GBS during labour and develop a serious infection

  • • Symptoms to look out for are pyrexia, respiratory distress, not feeding, floppiness 

Risk factors for infection:

• Prematurity

• Prolonged rupture of the membranes

• Previous sibling GBS infection

A swab is indicated for high risk mothers:

• Symptoms of UTI or chorioamnionitis during pregnancy

• STI symptoms pre-pregnancy

• Previously GBS infected baby.

Offer at 35-37 weeks or 3-5 weeks before anticipated delivery date. 

N.B. Screening is not indicated in all women, even if they request it. 

Management:

Offer/administer IV antibiotic prophylaxis (1st line: benzypenicillin*) to:

• Positive GBS swab 

  • • + Immediate induction after rupture of membranes to reduce exposure as much as possible 

• Women in preterm labour 

• Rupture of membranes without onset of labour >18 hours 

• Women with a fever during labour (>38ºC)

• Women with detected GBS in previous pregnancy (risk of carriage in current pregnancy is 50%) - or can have testing in late pregnancy and antibiotics if still positive.

*If penicillin allergic, give cefuroxime or clindamycin