Group B Strep

Jonas has Group B Strep, which is very serious in infants. He has the late onset kind and could have contracted it at birth or after birth by someone passing it to him. Luckily, he was already in the hospital when his symptoms presented so they caught it early. He is getting high doses of antibiotics and will have to stay in the hospital for at least 2 more weeks while he compeltes the course of antibiotics. The doctor said that all babies can get GBS, not just preemies and that if he was full term, this probably would have happened at home and we'd have to take him to the ER and he'd be admitted to get the same treatments.

I included some info about GBS below.

pamphlet issued by: The Group B Strep Association

WHAT IS GROUP B STREPTOCOCCUS INFECTION?
Since the early 1970's, the bacteria Group B Streptococcus (GBS) has been identified as the number one cause of life threatening infections in newborn babies.
This bacteria is normally found in the vagina and/or lower intestine of 15% to 40% of all healthy, adult women. Those women who test positive for GBS are said to be colonized.
Group B Streptococcus should not be confused with Group A Streptococcus which causes strep throat.

The vast majority of GBS infections are acquired during childbirth when the baby comes into direct contact with the bacteria carried by the mother.

An estimated 12,000 infants in the United States will become infected with GBS each year. This bacteria will result in the death of an estimated 2,000 infants yearly, while leaving many others mentally and/or physically handicapped.

GBS usually causes infant illness within the first seven days of life, but late onset infections may occur up to three months of age. Performance of a cesarean section will not eliminate the risk of infection.

GBS infections are more common than other illnesses for which pregnant women are screened, such as rubella, Down's Syndrome and spina bifida. Yet, GBS remains generally unknown to the public.

Fortunately, there is testing and a preventative treatment available that can help prevent many of these infections.

GBS AND PREGNANCY
"Do All Women Carry GBS?"

If 1000 women, regardless of race or socioeconomic status, had a vaginal culture taken, 150-350 would test positive for GBS. Because GBS usually does not cause problems for the adult female, most women carry it and do not know it. Yet, GBS can cause serious illness in babies born to women who carry the bacteria.

"Is GBS a Sexually Transmitted Disease?"

Since GBS is normally found in the vagina and/or rectum of colonized women, one way it can colonize another individual is through sexual contact. However, this bacteria usually does not cause genital symptoms or discomfort and is generally not linked with increased sexual activity. Therefore GBS is not considered to be a sexually transmitted disease.

"How Common Are GBS Infections?"

Out of every 1000 births, three babies will become ill with GBS. Why only certain infants fall victim to this infection is not completely known. An estimated 12,000 babies will suffer from GBS infections each year.

"What Complications Does GBS Cause?"

Most often, GBS colonizes the baby during labor either by traveling upward from the mother's vagina into the uterus, or as the infant passes through the birth canal. Illness occurs when the bacteria enters the baby's blood stream. This can then lead to shock, pneumonia, and meningitis (an infection of the baby's spinal fluid and brain tissue). In certain cases, evidence exists that GBS may cross intact membranes to infect the baby in utero. All of these conditions are life threatening. This year alone: an estimated 2000 babies will die; large numbers will suffer permanent handicaps such as braindamage ranging from mild learning disabilities to severe mental retardation, loss of sight and hearing, and lung damage (full statistics do not exist for the total number of surviving babies who will have these permanent handicaps); others will survive with no long-term damage. GBS is also responsible for causing infections in nearly 50,000 pregnant women each year including fever after birth, uterine inflammation, and infections following cesarean sections.

"When is GBS a Threat?"

GBS can be present in a woman's first pregnancy, or in following pregnancies. The bacteria can be a threat both during pregnancy and at the time of delivery. It has been shown that women who carry large amounts of the bacteria are at greatest risk of having a baby infected with GBS. Also, the occurrence of GBS infections are increased in certain high risk situations.

HIGH RISK SITUATIONS:

When labor is premature; When there is premature rupture of the membranes; When there is prolonged rupture of membranes (>12 hours) before the baby is born; If the mother has a fever (>100.4 F) before or during labor; Women who have a history of GBS in previous births.

"Can GBS Infections Be Prevented?"

Yes. There is a fast and effective treatment for many situations. Medical research indicates that giving antibiotics through the vein to the mother during labor can greatly reduce the frequency of GBS infection in the baby immediately after birth or during the first week of life.
Treating the mother with oral antibiotics during the pregnancy may decrease the amount of GBS for a short time, but it will not eliminate the bacteria completely and will leave the baby unprotected at birth. Also, waiting to treat the baby with antibiotics after birth is often too late to prevent illness.

"How Do I Know If I Carry GBS?"

Some doctors routinely screen for GBS by doing cultures on their patients during pregnancy. These cultures must be taken from the lower vagina and rectum, not the cervix.
Women who are found to carry the bacteria can then be treated as potential GBS risk patients. But, just like any other bacteria in the human body, GBS can be present in small amounts on one day which would result in a negative culture. Therefore, one negative culture result does not guarantee that you will be negative on the day you deliver. (Current studies indicate that a lower vaginal AND rectal culture done late in pregnancy is more than 93% accurate in detecting who will not carry the bacteria at delivery.)

"Can I Be Tested Again At The Time Of Delivery?"

A rapid test has been developed that can detect the presence of GBS from a vaginal swab. This test can be completed during labor and will identify women who carry large amounts of GBS.
Infants born to these heavily colonized women are at greatest risk of infection. Women who carry less amounts of the bacteria may not be identified by the test; however, medical research indicates that their babies are at lower risk of becoming infected. Although GBS can strike anyone, infants at greatest risk of infection are those that fall into the HIGH RISK SITUATIONS mentioned previously. It is in these situations that it could be particularly beneficial to perform the rapid test during labor to determine of the mother is carrying GBS.

"What If My Culture Of Rapid Test Is Positive?"

Because so many women carry GBS, and not all of their babies become ill, many physicians believe that antibiotics should not be given to all women who test positive for the bacteria. This would result in the unnecessary treatment of a large number of women. Instead, the focus is on the high risk patients. If a woman is found to carry GBS and falls into one or more of the high risk situations during labor, her doctor can immediately start antibiotic treatment which will help protect the baby and the mother.

"Future Hopes For A Vaccine"

Although the focus of GBS testing and treatment is on high risk infants and mothers, GBS also strikes infants and mothers who do not appear to have any risk factors at birth. As a result, researchers are actively working on the development of a GBS vaccine which would protect infants and mothers in the future. Use of the vaccine in adult women would create an immunity, which during pregnancy could cross the placenta and protect the baby. Although widespread use of a vaccine is still years away, this is the solution that will protect future babies regardless of risk factors.