Group B Strep

Overview

Group B strep (streptococcus) is a common bacterium found in the intestines or lower genital tract, usually harmless in healthy adults. However, it can cause serious illness in newborns and individuals with certain chronic medical conditions. In infants, the illness can manifest with symptoms such as pneumonia, meningitis, or bloodstream infections. Pregnant women may develop urinary tract infections or other infections, while older adults or those with chronic health conditions may experience skin infections, bacteremia, or other infections like pneumonia.

Understanding the disease

Symptoms

The symptoms of group B strep in infants can include pneumonia, meningitis, bacteremia, and infection in the bloodstream. In adults, the symptoms can vary depending on the type of infection. They may include urinary tract infection, fever, chills, confusion or lack of alertness, pneumonia, cough, shortness of breath, chest pain, skin or soft-tissue infection, and swelling, warmth, or redness at the site of the infection.

Risk Factors

Infants are at increased risk of developing group B strep disease if they are exposed to the bacteria during a vaginal delivery and swallow the fluids containing group B strep. Other risk factors include the mother carrying group B strep in her body, the baby being born prematurely (earlier than 37 weeks), the mother's water breaking 18 hours or more before delivery, the mother having an infection of the placental tissues and amniotic fluid (chorioamnionitis), the mother having a urinary tract infection during the pregnancy, the mother's temperature being greater than 100.4 F (38 C) during labor, and the mother previously delivering an infant with group B strep disease. Additionally, adults aged 65 and older or those with chronic health conditions are at increased risk of developing group B strep infections.

Development

Group B strep (streptococcus) can cause different types of infections depending on the host and the stage of life.

1. In newborns: Most newborns who are exposed to group B strep during labor are healthy. However, a few may develop a serious illness called group B strep disease. Symptoms in infants can include pneumonia, meningitis, bacteremia, and other infections.
2. In pregnant individuals: Group B strep can cause urinary tract infections, infection of the placenta and amniotic fluid (chorioamnionitis), infection of the membrane lining the uterus (endometritis), bacteremia, and other complications.
3. In older adults and individuals with chronic health conditions: Group B strep bacteria can lead to skin infections, bacteremia, urinary tract infections, pneumonia, bone and joint infections, infection of the heart valves (endocarditis), and meningitis. The exact mechanisms of how group B strep develops and causes infections vary depending on the host and the stage of life. When group B strep bacteria are carried in the body of a healthy adult, they usually do not cause any harm. However, they can lead to serious infections in certain individuals, such as newborns, pregnant people, older adults, and those with chronic health conditions.

Assessment and Diagnosis

Triage

If you have signs or symptoms of group B strep infection, particularly if you are pregnant, have a chronic medical condition, or are older than 65, you should contact your doctor right away. If you notice your infant has signs or symptoms of group B strep disease, you should contact your baby's doctor immediately.

Diagnosis

To diagnose group B strep disease, your doctor will likely conduct a physical exam and order one or more tests, such as a rapid antigen test, molecular (polymerase chain reaction, or PCR) test, or a throat culture. Urine culture and chest X-ray may also be performed in some cases. In adults with an infection, a blood test can determine if group B strep is the cause.

Management and Treatment

Complications

Group B strep can lead to serious complications in infants, including pneumonia, inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis), and infection in the bloodstream (bacteremia). In adults, complications may include urinary tract infections, skin infections, bacteremia, pneumonia, bone and joint infections, infection of the heart valves (endocarditis), and meningitis. Premature birth, maternal infections, and a history of previous group B strep disease in the mother can increase the risk of complications in newborns.

Prevention

Group B strep can be prevented in newborns through antibiotic treatment during labor if the mother carries the bacteria. Pregnant women are recommended to have a group B strep screening test during their third trimester. If the test is positive, antibiotic treatment during labor can protect the baby from infection. Additionally, oral antibiotics are not recommended as they may not be effective in preventing group B strep transmission during labor.

Home Remedies

If you are a healthy adult, there's nothing you need to do about group B strep. However, if you are pregnant, it's essential to get a group B strep screening test during your third trimester. If you test positive, your doctor will likely prescribe antibiotics during labor to protect your baby. For adults who are not pregnant, the best course of action is to consult a healthcare provider if you experience any signs or symptoms of a group B strep infection, such as fever, difficulty breathing, or skin infections. A healthcare professional will provide appropriate treatment based on your specific situation, which may include antibiotics. Please note that this information is not a substitute for professional medical advice. If you suspect you or your baby may have group B strep, consult a healthcare professional immediately.

Treatment

Treatment for group B strep typically involves antibiotics, especially for pregnant women to prevent transmission to newborns during labor. If you're a healthy adult with no symptoms, no treatment is necessary. If you have symptoms or a positive group B strep screening test, your doctor may prescribe oral antibiotics. However, taking oral antibiotics ahead of time won't help because the bacteria can return before labor begins. If you're allergic to penicillin, alternatives like clindamycin or vancomycin may be recommended, but their effectiveness is not well understood. In some cases, intravenous antibiotics may be given during labor to prevent transmission to the baby. Additionally, if you have a chronic health condition or are an older adult, your doctor may recommend antibiotics to prevent serious infections.

Preparing for medical consultation

To prepare for an appointment regarding Group B Strep, here are some steps you can take:

1. Ask for any pre-appointment restrictions: When scheduling the appointment, inquire if there's anything you need to do in advance, such as fasting before having specific tests.
2. Note symptoms and personal information: Make a list of any symptoms you're experiencing, including those that may seem unrelated to Group B Strep. Also, include key personal information such as major stresses, recent life changes, and family medical history.
3. List medications and supplements: Create a list of all medications, vitamins, or supplements you're currently taking, including doses.
4. Bring a family member or friend: Consider bringing someone along to help remember the information provided during the appointment and act as an advocate.
5. Be prepared for tests: If your healthcare provider suspects Group B Strep, ask about any tests that may be required, such as blood or spinal fluid tests for your baby. By being well-prepared for your appointment, you can ensure that you provide your healthcare provider with the most accurate and comprehensive information.