Group B Streptococcus

Joanne N. de Jesus M.D.

GBS
Major cause of neonatal bacterial sepsis  Major pathogen for neonates, pregnant women and immunocompromised nonpregnant adults  Facultative anaerobic gram (+) cocci in chains  Lacefield group B 

GBS neonatal sepsis 

Risk factors:
± PROM ± Intrapartum fever ± Prematurity ± Maternal bacteriuria during

pregnancy ± Prev delivery of an infant with prev GBS infection

GBS transmission in newborn
Vaginal route  Rectal colonization 
 

Serotype I1, Ib,III, II and V
± Neonatal GBS disease

Serotype III
± Late onset disease; meningitis

assoc. with early and late onset sepsis

GBS may cause:
UTI  Bacteriuria  Endometritis  Endocarditis  Pneumonia  meningitis 

Pathogenesis
Type specific capsular polysaccharide  C5A peptidase  Beta-hemolysin  Hyaluronidase  TNF alpha and IL 6 

S/SX GBS infection 

Early onset - <7days
± Sepsis 50% ± Pneumonia 30% ± Meningitis 15% ± Associated with: chorioamnionitis,

PROM, preterm labor

S/SX GBS infection 

Late onset GBS infection
± > 7days ± Bacteremia 45-60% ± Meningitis 25-35% ± Focal infection 20% (bone, skin,

soft tissue, urinary tract, lungs) 

2 common syndromes assoc with childhood GBS disease
± Bacteremia ± Endocarditis ± HIV infection- (?)children with

invasive GBS infection beyond the neonatal period

DDX
HMD  E.coli infecitons  L. Monocytogenes 

Diagnosis 

Isolation and identification of org from sterile site (culture)
± colonization: GI, tracheal aspirate,

skin

Lumbar puncture  WBC count  CRP ± early marker for GBS sepsis  CXR 

Treatment
Penicillin G  Aminoglycoside  Ampicillin  IVIG 

Chemoprophylaxis
Penicillin- DOC  Alternatives: 

± Cefazolin ± Clindamycin ± Erythromycin

Prognosis 

Neurologic sequelae
± Dev¶t delay ± Spastic quadriplegia ± Microcehaly ± Seizure d/o ± Cortical blindness ± deafness 

Mortality ± high in preterm infants

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