Group B Streptococcus

Question 1

What is GBS?

Answer 1

most common cause of early-onset severe infection in the neonatal period

Question 2

How are infants exposed to GBS?

Answer 2

20-40% of mothers have GBS present in their bowel flora and may therefore be thought of as ‘carriers’ of GBS.

Infants may be exposed to maternal GBS during labour and subsequently develop potentially serious infections.

Question 3

What are RFs for GBS?

Answer 3

prematurity
prolonged rupture of the membranes
previous sibling GBS infection
maternal pyrexia e.g. secondary to chorioamnionitis

Question 4

How is GBS managed?

Answer 4

Universal GBS screening
If GBS present in previous pregnancy, mother should be informed chance in current is 50%. Offer intrapartum antibiotic prophylaxis (IAP) or testing in late pregnancy and antibiotics if positive.
Swabs should be offered at 35-37 weeks or 3-5 weeks prior to the anticipated delivery date

Question 5

Who should IAP be offered to and what is the antibiotic of choice?

Answer 5

women with a previous baby with early- or late-onset GBS disease
women in preterm labour regardless of their GBS status
women with a pyrexia during labour (>38ºC)

Benzylpenicillin