GBS

Question 1

what is early onset GBS

Answer 1

infection from the first week of life

Question 2

what is late onset

Answer 2

infection from the first week of life to the first 3 months of life

Question 3

how to teach moms about late onset

Answer 3

ensure the mother has a good knowledge of basic hygiene measures and how to recognize a sick baby

Question 4

understanding late onset GBS

Answer 4

GBS can be transmitted by skin-to-skin contact or via the respiratory system. The risk of a baby developing a GBS infection decreases with age. It is rare after 1 month and virtually unknown after 3 months

Question 5

clinical features of GBS

Answer 5

Streptococci are divided into at least 20 different types, called Lancefield groups. the main Lancefield group types of beta-hematolytic streptococci are group A, group B, and groups C-G

Question 6

how typical is GBS in adults

Answer 6

in both men and women the normal reservoir for GBS is the gastrointestinal tract, and it is carried by up to 30 percent of adults

Question 7

how GBS moves in the body

Answer 7

in women colonization of the gut commonly leads to transient colonization of the vagina and urinary tract. Vaginal–rectal colonization with GBS may be intermittent, transitory, or persistent.

Question 8

what can GBS cause even though is primarily asymptomatic

Answer 8

UTIs, more rarely amnionitis, endometritis, sepsis or meningitis.

Question 9

when can GBS cause the majority of infections

Answer 9

GBS can cross intact membranes, most infections occur during labor and/or after membrane rupture

Question 10

who are most at risk for GBS infection

Answer 10

premature babies most risk of infection and dying or sustaining long-term damage because of their relatively undeveloped immune system

Question 11

prevention and management of GBS for the neonate

Answer 11

begins with the treatment of the GBS-positive mother and may include

• antenatal identification of risk factors
• antenatal screening
• identification of risk factors in labor
• antibiotic treatment in labor
• monitoring and care of the neonate

Question 12

what are some examples of ‘high risk’ when it comes to risk factors for GBS infection

Answer 12

• a woman who has ha a GBS- infected baby previously will usually be offered IV antibiotics in labor, whether or not she has screened positive herself during the current pregnancy
• Urinalysis revels GBS indicating heavy maternal vaginal–rectal colonization

Question 13

what is the importance of screening

Answer 13

many babies who develop early onset- GBS infection are born to women who had no risk factors at delivery apart from carrying GBS and if screening is not undertaken, neither they nor their caregivers will be aware of the risk

Question 14

understanding the swab

Answer 14

both rectal and vaginal swabs are recommended. a rectal swab will be more likely to show the presence of GBS as this is a normal site for colonization. a low vaginal swab is recommended, as a high vaginal swab is likely to test negative, even when there is GBS present in the lower vagina. To maximize the likelihood of GBS recovery, a single swab is used to obtain the culture specimen first from the lower vagina (near the introitus) and then from the rectum (through the anal sphincter) without use of a speculum. A culture of the lower vagina and rectum increases the culture yield substantially compared with either sampling the cervix alone or sampling the vagina without a rectal culture

Question 15

why test if GBS is intermittent

Answer 15

when teste between 35-37 wga it is demonstrated that a positive result will indicate around 87 percent chance she sill be positive at delivery

Question 16

what could a client present with undiagnosed GBS

Answer 16

preterm pre-labor rupture of membranes or pre-labor rupture of membranes

Question 17

what is a potential risk factor for antibiotics in labor

Answer 17

antibiotic use of any kind increase the risk of yeast infection

Question 18

what are possible signs of neonatal GBS infection

Answer 18

• inability to maintain body temperature
• inability to maintain blood sugar
• abnormally high or low temperature, respiratory rate and/or heart rate
• lethargy
• poor feeding
• seizure activity

Question 19

Role of the midwife with GBS

Answer 19

• maintain an up-to-date knowledge of GBS, a frequently changing field to ensure that all questions from clients can be accurately and comprehensively answered
• sustain a good working protocol
• ensure the ability to effectively monitor all newborns, recognize the signs and symptoms of infection, and refer as necessary
  Teach women about general assessment of well-being of newborn

Question 20

which antibiotics for GBS

Answer 20

Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative. First-generation cephalosporins (i.e., cefazolin) are recommended for women whose reported penicillin allergy indicates a low risk of anaphylaxis or is of uncertain severity. For women with a high risk of anaphylaxis, clindamycin is the recommended alternative to penicillin only if the GBS isolate is known to be susceptible to clindamycin.

Question 21

For women who are at high risk of anaphylaxis after exposure to penicillin, what should the laboratory requisitions for ordering antepartum GBS screening cultures (whether on paper or online in electronic medical records) indicate

Answer 21

the presence of penicillin allergy. intended to ensure that the need to test GBS isolates for clindamycin susceptibility is recognized and performed by laboratory personnel, and that the health care provider understands the importance of reviewing such a test result.

Question 22

what important when labeling the sample

Answer 22

incorrect specimen collection—most typically vaginal cultures obtained without concomitant rectal sampling—is the most commonly identified GBS prenatal screening error among health care providers

Question 23

bacteria count for antibiotic and GBS positive

Answer 23

In asymptomatic women, treatment of GBS bacteriuria, as with bacteriuria due to other organisms, is recommended only if test results indicate a level of 105 CFU/mL or higher

Question 24

Intrapartum antibiotic prophylaxis to reduce the risk of GBS EOD is based on what two-pronged approach

Answer 24

1) decreasing the incidence of neonatal GBS colonization, which requires adequate maternal drug levels
2) reducing the risk of neonatal sepsis, which requires adequate antibiotic levels in the fetus and newborn.