-Throughout pregnancy, is isolated in a transient, intermittent, or chronic fashion.

-is most likely always present in these same women

I. Maternal and Perinatal Infection

-asymptomatic colonization to septicemia.

- Streptococcus agalactiae has been implicated in adverse pregnancy outcomes, including preterm labor,
prematurely ruptured membranes, clinical and subclinical chorioamnionitis, and fetal infections.
- cause maternal bacteriuria, pyelonephritis, osteomyelitis, postpartum mastitis, and puerperal
infections.

It remains the leading infectious cause of morbidity and mortality among infants in the United States

Neonatal sepsis has received the most attention due to its devastating consequences and available
effective preventative measures.

Infection < 7 days after birth is defined as early-onset disease and is seen in 0.24/1000 live births

Many investigators use a threshold of < 72 hours of life as most compatible with intrapartum acquisition
of disease .

septicemia involves signs of serious illness that usually develop within 6 to 12 hours of birth
>include respiratory distress, apnea, and hypotension

Late-onset disease caused by GBS is noted in 0.32 per 1000 live births and usually manifests as
meningitis 1 week to 3 months after birth.
II. Prophylaxis for Perinatal Infections

As GBS neonatal infections evolved beginning in the 1970s and before widespread intrapartum
chemoprophylaxis, rates of early-onset sepsis ranged from 2 to 3 per 1000 live births.

In 2002, the Centers for Disease Control and Prevention, the American College of Obstetricians and
Gynecologists, and the American Academy of Pediatrics revised guidelines for perinatal prevention of
GBS disease.

They recommended universal rectovaginal culture screening for GBS at 35 to 37 weeks’ gestation
followed by intrapartum antibiotic prophylaxis for women identified to be carriers.

They expanded laboratory identification criteria for GBS; updated algorithms for screening and
intrapartum chemoprophylaxis for women with preterm prematurely ruptured membranes, preterm
labor, or penicillin allergy; and described new dosing for penicillin G chemoprophylaxis.

Culture-Based Prevention.

The 2010 Centers for Disease Control and Prevention GBS Guidelines recommend a culture-based.
Such a protocol was also adopted by the American College of Obstetricians and Gynecologists (2013c).
This approach is designed to identify women who should be given intrapartum antimicrobial
prophylaxis.

Women are screened for GBS colonization at 35 to 37 weeks’ gestation, and intrapartum antimicrobials
are given to women with rectovaginal GBS-positive culture

more rapid techniques such as DNA probes and nucleic acid amplification tests are being developed
(Chan, 2006; Helali, 2012).

A previous sibling with GBS invasive disease and identification of GBS bacteriuria in the