GBS Flashcards
The most common GBS
S. Agalactiae
The commonest cause of severe early onset infection in newborns (<7 d)
GBS - Strept agalactiae
Where does GBS commensal
Digestive
Urinary
Reproductive tract
Found in vagina and rectum
Do GBS cause maternal illness
No
Types of GBS infection in newborn
Early onset: <7 d.t. Vertical transmission
Late onset: >7 d contact infection
Incidence of EOGBS in the UK in the abscence of screening
1/2000
22% will be born prematurely
1/3 had one or more RF
Do we give IAP, in case of PREVIOUS INFANT WITH GBS disease
Offer IAP
Do we give IAP, in case of preterm labor
Offer IAP
Do we give IAP, in case of previous +ve GBS swap, yet normal baby
Either give IAP or
Test at 35-37w: +ve give , -ve don’t
Do we give IAP, in case of prelabour rupture of membranes (at term)
- If known carrier: immediate IAP + induction ASAP
- Unkown or negative: no IAP
Do we give IAP, in case of labour at term w/ no risk factors for EOGBS
No IAP
Do we give IAP, in case of labour at term with pyrexia
Broad spectrum AB ( amoxicillin IV)
Do we give IAP, in case of labour at term if GBS +ve
Offer IAP
Do we give IAP, in case of woman has GBS bacteruria
We Treat bacteruria with oral antibiotics + IAP
Do we give IAP, in case of CS not in labor no ROM, regardless of GBS carrier status
NO IAP
CS <36w + ROM= give IAP
Do we do screening for GBS
No
How many women who have GBS +ve testing at 35-37 w will become -ve at delivery
25%
How many women who have GBS -ve testing at 35-37 w will become+ve at delivery
5-7%
First line ttt of GBS
Benzoyl penicillin 3gm then 1.5 g every 4 hours
The first dose should be given at least four hours prior to delivery
GBS bacteriuria during pregnancy may lead to
Chorioamnionitis
If woman is GBS carrier in pvs pregnancy, percentage that she is carrier in this pregnancy is
50%
Is membrane sweeping is allowed in GBS carrier patient
Yes
What to do in women with PPROM +GBS
<34 w-> erythromycin, wait to 34 the. Induce and give IAP
> 34 w -> induce and give IAP
All women with PPROM should be offered oral erythromycin 250 mg 4 times a day for maximum 10 days or until the woman is in established labor
What to give in women with penicillin allergy
If not severe allergy, give cephalosporin IV: ie cefuroxime 1.5g loading then 750mg/8hrs
F severe allergy give vancomycin IV 1g every 12 hr
Monitoring of infants at risk of GBS whose mothers haven’t received adequate IAP
Check vital signs at 0,1,2 and then 2 hourly until 2 hours
What to give babies with clinical signs of GBS
Penicillin and gentamicin within an hour of the decision to treat
