Difference between revisions of "Group B Strep and Pregnancy"

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<br>By Shawn Ruiz<br>
 
<br>By Shawn Ruiz<br>
  
<br>Group B Strep (GBS), also known as Streptococcus agalactiae, is a Gram-positive, beta-hemolytic, catalase-negative, facultative anaerobe that is a normal component of the gastrointestinal and genitourinary tracts<ref name=aa>[https://en.wikipedia.org/wiki/Streptococcus_agalactiae]</ref>. In fact, GBS colonizes the gastrointestinal and genitourinary tracts of up to 50% of healthy adults<ref name=bb>[https://pubmed.ncbi.nlm.nih.gov/17088932/]</ref>. Most healthy adults who are colonized by GBS will not experience any symptoms or GBS-related infections. While the bacteria is usually harmless in healthy adults, it is a major cause of meningitis, pneumonia, and and sepsis in neonates<ref name=cc>[https://evidencebasedbirth.com/groupbstrep/]</ref>. Moreover, GBS is the leading infectious cause of neonatal mortality and morbidity in the United States; between four and six percent of babies who develop GBS disease die<ref name=dd>[https://www.ncbi.nlm.nih.gov/books/NBK482443/#:~:text=Preterm%20infants%20with%20early%2Donset,in%20term%20infants%5B2%5D.]</ref><ref name=ee>[https://www.cdc.gov/groupbstrep/about/fast-facts.html#references]</ref>. GBS causes both early onset (<7 days old) and late onset (7-90 days old) infections in neonates<ref name=dd/>. The main risk factor for an early-onset GBS infection in a neonate is colonization of a birthing person's genital tract with Group B strep during labor<ref name=dd/>. About one in four pregnant individuals carry GBS in their body<ref name=ee/>. If the bacteria is present in a pregnant person, it can be directly transferred to their baby in a multitude of ways. For example, GBS can travel from the vagina into the amniotic fluid where the baby can ingest it and/or the baby can come into contact with the bacteria as they make their way down the birth canal<ref name=cc/>. In the early 1990s, the early GBS infection rate was 1.7 cases per 1,000 births<ref name=cc/>. In an effort to decrease this infection rate, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics recommended screening pregnant individuals for GBS<ref name=cc/>. As a result, it is now common practice to screen pregnant individuals for GBS at some point between 35 and 37 weeks of pregnancy<ref name=ee/>. Pregnant people who test positive for GBS are treated with intravenous antibiotics during labor<ref name=ee/>. Penicillin and ampicillin are the recommended antibiotics for intrapartum GBS prophylaxis<ref name=ff>[https://www.aafp.org/afp/2011/0501/p1106.html#:~:text=The%20recommended%20antibiotic%20for%20intrapartum,units%20intravenously%20every%20four%20hours.]</ref>. If a pregnant person tests positive for GBS and they are treated with antibiotics during labor, the risk of their neonate developing a serious, life-threatening GBS infection drops by 80%  <ref name=cc/>. GBS infection Early GBS infection rates in the United States have significantly dropped (0.25 cases per 1,000 births) since these preventative measures went into effect around 1995<ref name=cc/>.  
+
<br>Group B Strep (GBS), also known as Streptococcus agalactiae, is a Gram-positive, beta-hemolytic, catalase-negative, facultative anaerobe that is a normal component of the gastrointestinal and genitourinary tracts<ref name=aa>[https://en.wikipedia.org/wiki/Streptococcus_agalactiae]</ref>. In fact, GBS colonizes the gastrointestinal and genitourinary tracts of up to 50% of healthy adults<ref name=bb>[https://pubmed.ncbi.nlm.nih.gov/17088932/]</ref>. Most healthy adults who are colonized by GBS will not experience any symptoms or GBS-related infections. While the bacteria is usually harmless in healthy adults, it is a major cause of meningitis, pneumonia, and and sepsis in neonates<ref name=cc>[https://evidencebasedbirth.com/groupbstrep/]</ref>. Moreover, GBS is the leading infectious cause of neonatal mortality and morbidity in the United States; between four and six percent of babies who develop GBS disease die<ref name=dd>[https://www.ncbi.nlm.nih.gov/books/NBK482443/#:~:text=Preterm%20infants%20with%20early%2Donset,in%20term%20infants%5B2%5D.]</ref><ref name=ee>[https://www.cdc.gov/groupbstrep/about/fast-facts.html#references]</ref>. GBS causes both early onset (<7 days old) and late onset (7-90 days old) infections in neonates<ref name=dd/>. The main risk factor for an early-onset GBS infection in a neonate is colonization of a birthing person's genital tract with Group B strep during labor<ref name=dd/>. About one in four pregnant individuals carry GBS in their body<ref name=ee/>. If the bacteria is present in a pregnant person, it can be directly transferred to their baby in a multitude of ways. For example, GBS can travel from the vagina into the amniotic fluid where the baby can ingest it and/or the baby can come into contact with the bacteria as they make their way down the birth canal<ref name=cc/>. In the early 1990s, the early GBS infection rate was 1.7 cases per 1,000 births<ref name=cc/>. In an effort to decrease this infection rate, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics recommended screening pregnant individuals for GBS<ref name=cc/>. As a result, it is now common practice to screen pregnant individuals for GBS at some point between 35 and 37 weeks of pregnancy<ref name=ee/>. Pregnant people who test positive for GBS are treated with intravenous antibiotics during labor<ref name=ee/>. Penicillin and ampicillin are the recommended antibiotics for intrapartum GBS prophylaxis<ref name=ff>[https://www.aafp.org/afp/2011/0501/p1106.html#:~:text=The%20recommended%20antibiotic%20for%20intrapartum,units%20intravenously%20every%20four%20hours.]</ref>. If a pregnant person tests positive for GBS and they are treated with antibiotics during labor, the risk of their neonate developing a serious, life-threatening GBS infection drops by 80%  <ref name=cc/>. Early GBS infection rates in the United States have significantly dropped (0.25 cases per 1,000 births) since these preventative measures went into effect around 1995<ref name=cc/>.  
  
  

Revision as of 02:38, 15 March 2021

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Introduction

This artistic recreation, based on scanning electron microscopy (SEM), depicts a three-dimensional (3D), computer-generated image, of a group of Gram-positive, Streptococcus agalactiae (group B Streptococcus) bacteria. Photo Credit: Alissa Eckert, who is a medical illustrator at the CDC.


By Shawn Ruiz


Group B Strep (GBS), also known as Streptococcus agalactiae, is a Gram-positive, beta-hemolytic, catalase-negative, facultative anaerobe that is a normal component of the gastrointestinal and genitourinary tracts[1]. In fact, GBS colonizes the gastrointestinal and genitourinary tracts of up to 50% of healthy adults[2]. Most healthy adults who are colonized by GBS will not experience any symptoms or GBS-related infections. While the bacteria is usually harmless in healthy adults, it is a major cause of meningitis, pneumonia, and and sepsis in neonates[3]. Moreover, GBS is the leading infectious cause of neonatal mortality and morbidity in the United States; between four and six percent of babies who develop GBS disease die[4][5]. GBS causes both early onset (<7 days old) and late onset (7-90 days old) infections in neonates[4]. The main risk factor for an early-onset GBS infection in a neonate is colonization of a birthing person's genital tract with Group B strep during labor[4]. About one in four pregnant individuals carry GBS in their body[5]. If the bacteria is present in a pregnant person, it can be directly transferred to their baby in a multitude of ways. For example, GBS can travel from the vagina into the amniotic fluid where the baby can ingest it and/or the baby can come into contact with the bacteria as they make their way down the birth canal[3]. In the early 1990s, the early GBS infection rate was 1.7 cases per 1,000 births[3]. In an effort to decrease this infection rate, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics recommended screening pregnant individuals for GBS[3]. As a result, it is now common practice to screen pregnant individuals for GBS at some point between 35 and 37 weeks of pregnancy[5]. Pregnant people who test positive for GBS are treated with intravenous antibiotics during labor[5]. Penicillin and ampicillin are the recommended antibiotics for intrapartum GBS prophylaxis[6]. If a pregnant person tests positive for GBS and they are treated with antibiotics during labor, the risk of their neonate developing a serious, life-threatening GBS infection drops by 80% [3]. Early GBS infection rates in the United States have significantly dropped (0.25 cases per 1,000 births) since these preventative measures went into effect around 1995[3].




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Authored for BIOL 238 Microbiology, taught by Joan Slonczewski, 2021, Kenyon College.