Overview OF Group B Streptococcal Infections in Newborns
Group B streptococcal (GBS) septicemia is a severe bacterial infection that affects newborn infants.
Commonly Associated With
Group B strep; GBS; Neonatal sepsis; Neonatal sepsis – strep
Causes OF Group B Streptococcal Infections in Newborns
Septicemia is an infection in the bloodstream that may travel to different body organs. GBS septicemia is caused by the bacterium Streptococcus agalactiae, which is commonly called group B strep, or GBS.
GBS is commonly found in adults and older children and usually does not cause infection. But it can make newborn babies very sick. There are two ways in which GBS can be passed to a newborn baby:
The baby can become infected while passing through the birth canal. In this case, babies become ill between birth and 6 days of life (most often in the first 24 hours). This is called early-onset GBS disease.
The infant may also become infected after delivery by coming into contact with people who carry the GBS germ. In this case, symptoms appear later, when the baby is 7 days to 3 months or elder. This is called late-onset GBS disease.
GBS septicemia now occurs less often, because there are methods to screen and treat pregnant women at risk.
The following increase an infant’s risk for GBS septicemia:
- Being born more than 3 weeks before the due date (prematurity), especially if the mother goes into labor early (preterm labor)
- A mother who has already given birth to a baby with GBS sepsis
- A mother who has a fever of 100.4°F (38°C) or higher during labor
- A mother who has group B streptococcus in her gastrointestinal, reproductive, or urinary tract
- Rupture of membranes (water breaks) more than 18 hours before the baby is delivered
- Use of intrauterine fetal monitoring (scalp lead) during labor
Symptoms OF Group B Streptococcal Infections in Newborns
The baby may have any of the following signs and symptoms:
- Anxious or stressed appearance
- Blue appearance (cyanosis)
- Breathing difficulties, such as flaring of the nostrils, grunting noises, rapid breathing, and short periods without breathing
- Irregular or abnormal (fast or very slow) heart rate
- Pale appearance (pallor) with cold skin
- Poor feeding
- Unstable body temperature (low or high)
Exams & Tests
To diagnose GBS septicemia, GBS bacteria must be found in a sample of blood (blood culture) taken from a sick newborn.
Other tests that may be done include:
- Blood clotting tests – prothrombin time (PT) and partial thromboplastin time (PTT)
- Blood gases (to see if the baby needs help with breathing)
- Complete blood count
- CSF culture (to check for meningitis)
- Urine culture
- X-ray of the chest
Treatment OF Group B Streptococcal Infections in Newborns
The baby is given antibiotics through a vein (IV).
Other treatment measures may involve:
- Breathing help (respiratory support)
- Fluids are given through a vein
- Medicines to reverse shock
- Medicines or procedures to correct blood clotting problems
- Oxygen therapy
- A therapy called extracorporeal membrane oxygenation (ECMO) may be used in very severe cases. ECMO involves using a pump to circulate blood through an artificial lung back into the bloodstream of the baby.