Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-06T11:09:17.320Z Has data issue: false hasContentIssue false

Group B Streptococcus

Published online by Cambridge University Press:  02 January 2015

Charles S.F. Easmon*
Affiliation:
Department of Medical Microbiology, Wright-Fleming Institute, St. Mary's Hospital Medical School, London, England
*
Department of Bacteriology, Wright-Fleming Institute, St. Mary's Hospital Medical School, Paddington, London, W2 1PG England

Extract

Over the past 25 years group B streptococci have become established as one of the main bacterial pathogens of the neonate in Western Europe and the United States. The attack rate of 0.25/1,000 live births found by Mayon White in Great Britain1 appears typical of many European countries. However, in some centers in the United States attack rates can be over 10 times higher.

Two types of neonatal group B streptococcus (GBS) diseases exist, “early” and “late” onset. Early onset disease usually presents within the first few days of life. Often the most serious infections are present at birth or seen within a few hours. Early onset disease presents with pneumonia, respiratory distress and shock. Bacteremia is normally present and meningitis may occur. Mortality is high (50% to 75%). The portal of entry is probably the respiratory tract. Infants normally acquire the infecting organism from their mothers. Heavy maternal and infant colonization, prolonged rupture of membranes, prematurity, and obstetric complications are all risk factors.

Delayed onset disease, as its name suggests, presents after the first week of life, primarily with bacteremia and meningitis. Mortality is much lower than for the early onset form, but still appreciable for a bacterial infection (14% to 18%). Its epidemiology is uncertain.

Type
Research Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Mayon White, R: The incidence of GBS disease in neonates in different countries, in Antibiotic Chemotherapy Vol. 35. Christensen, KK, Christensen, P, Kerrien P (eds); Neonatal group B streptococcal infections. Karger, Basel 1985, pp 1727.Google Scholar
2.Baker, CJ, Barrett, FF: Transmission of group B streptococci among parturient women and their neonates. J Pediatr 1973; 83:919.Google Scholar
3.Ferrieri, P: GBS infections in the newborn infant: Diagnosis and treatment, in Christensen, KK, Christensen, P, Ferrieri, P (eds); Antibiotic Chemotherapy Vol. 35 Neonatal group B streptococcal infections. Karger, Basel 1985. pp 211224.Google Scholar
4.Easmon, CSF, Tanna, A, Munday, P, et al: Group B Streptococci—gastrointestinal organisms? J Clin Pathol 1981; 34:921923.Google Scholar
5.Badri, MS, Zawaneh, S, Cruz, AC, et al: Rectal colonization with group B streptococcus: Relation to vaginal colonization. J Infect Dis 1977; 135:308312.CrossRefGoogle ScholarPubMed
6.Dillon, MC, Gray, E, Pass, MA, et al: Anorectal and vaginal carriage of group B streptococci during pregnancy. J Infect Dis 1982; 145:794799.Google Scholar
7.Anthony, BF, Carter, J, Eisenstadt, R, el al: Isolation of group B streptococci from ihe proximal small intestine of adults. J Infect Dis 1983; 147:776.CrossRefGoogle Scholar
8.Barnham, M: The gut as a source of the haemolytic streptococci causing infection in surgery of the intestinal and biliary tracts. J Infect 1983; 6:129139.Google Scholar
9.Kexel, G, Beck, KJ: Untersuchen uber die Haufigkeit der B-Streptokokken in Wochenbatt Geburtschilfe und Frauen heilkunde 1965; 25:10781085.Google Scholar
10.Embil, JA, Martin, TR, Hanset, NH, et al: Group B beta-haemolytic Streptococci in the female genital tract: A study of four clinic populations. Br J Obstet Gynecol 1978; 85:783786.Google Scholar
11.Jackson, DH, Hinder, SM, Stringer, J, et al: Carriage and transmission of group B streptococci among STD clinic patients. Br J Vener Dis 1982; 58:334339.Google Scholar
12.Easmon, CSF, Hastings, MJG, Blowers, A, et al: Epidemiology of group B streptococci: One year's experience in an obstetric and special care baby unit. Br J Obstet Gynecol 1983; 90:241246.Google Scholar
13.Weindling, AM, Hawkins, JM, Coombes, MA, et al: Colonization of babies and their families by group B streptococci. Br Med J 1981; 283:15031505.Google Scholar
14.Steere, AC, Aber, RC, Warford, LR, et al: Possible nosocomial transmission of group B streptococci in a newborn nursery. J Pediatr 1975; 87:784787.CrossRefGoogle Scholar
15.Easmon, CSF, Hastings, MJG, Clare, AJ, et al: Nosocomial transmission of group B streptococci. Br Med J 1981; 283:459461.Google Scholar
16.Boyer, KM, Vogel, LC, Gotoff, SP, et al: Nosocomial transmission of bacteriophage type 7/11/12 group B streptococci in a special care nursery. Am J Dis Child 1980; 134:964966.Google Scholar
17.Hall, RT, Barnes, W, Krishnan, L, et al: Antibiotic treatment of parturient women colonized with group B streptococci. Am J Obstet Gynecol 1976; 124:630634.CrossRefGoogle ScholarPubMed
18.Easmon, CSF, Hastings, MJG, Neill, J, et al: Is group B streptococcal screening during pregnancy justified? Br J Obstet Gynecol 1985; 92:197201.Google Scholar
19.Monif, GRG, Thompson, J, Stephens, HD, et al: Quantitative and qualitative effects of povidone-iodine liquid and gel on the aerobic and anaerobic flora of the female genital tract. Am J Obstet Gynecol 1980; 137:432438.CrossRefGoogle ScholarPubMed
20.Christensen, KK, Christensen, P: Chlorhexidine for prevention of colonization with GBS, in Christensen, KK, Christensen, P, Ferrieri, P (eds). Antibiotics and Chemotherapy Vol. 35. Neonatal group B streptococcal infections. Karger, Basel, 1985, pp 296302.Google Scholar
21.Yow, MD, Mason, EO, Leeds, LJ: Ampicillin prevents intrapartum transmission of group B streptococci. JAMA 1979; 241:12451247.Google Scholar
22.Easmon, CSF, Hastings, MJG, Deeley, J. et al: The effect of intrapartum chemoprophylaxis on the vertical transmission of group B streptococci. Br J Obstet Gynecol 1983; 90:633635.Google Scholar
23.Siegel, JD, McCracken, GH, Threlkeld, N. et al: Single-dose penicillin prophylaxis of neonatal group B streptococcal disease. Conclusion of a 41-month controlled study. Lancet 1982; i: 14261430.Google Scholar
24.Pyati, SP, Pildes, RS, Jacobs, NM, et al: Penicillin in infants weighing two kilograms or less with early-onset group B streptococcal disease. N Engl J Med 1983; 308:13831388.Google Scholar