About Group B Strep (GBS) Disease

Overview

Group B Streptococcus (GBS) disease refers to the illness caused by the bacteria known as Group B Streptococcus. GBS is a type of bacteria commonly found in the gastrointestinal and genital tracts of both men and women. While GBS typically does not cause any harm to adults, it can lead to severe infections in newborns and individuals with underlying medical conditions. GBS disease can manifest in various forms, including sepsis (infection in the blood), pneumonia (infection in the lungs), and meningitis (infection of the fluid and lining of the brain and spinal cord). In newborns, GBS infection can occur during the first week of life (early-onset) or between that period and three months of age (late-onset). It is important to note that active surveillance and appropriate medical interventions, such as administering antibiotics during labor for pregnant women with GBS, have significantly reduced the rate of early-onset GBS infection in babies.

Causes and Risk Factors

The disease causes of Group B strep (GBS) disease are as follows:

• Group B Streptococcus (GBS) bacteria, specifically Streptococcus agalactiae, is the main cause of GBS disease.
• GBS bacteria can naturally reside in the intestines, urinary tract, and vagina of healthy adults.
• Invasive GBS disease occurs when the bacteria become overgrown and cause infection in various parts of the body, such as the bloodstream, bones/joints, lungs, and brain/spinal cord.

Non-modifiable risk factors for GBS disease cannot be changed or controlled. These include:

• Age: Increasing age is a non-modifiable risk factor for GBS disease.
• Genetic predispositions: Having a positive family history of GBS or related infections can increase the risk.
• Previous history of polyps: Individuals with a history of polyps are at higher risk.

Modifiable risk factors for GBS disease can be influenced or changed. These include:

• Poor dietary habits and low physical activity: Unhealthy eating patterns and a lack of regular exercise can weaken the immune system, compromising overall health and increasing susceptibility to infections like GBS. These lifestyle factors may also contribute to obesity and diabetes, which are significant risk factors for GBS.
• Obesity and diabetes: These are among the most significant risk factors for GBS, as they can weaken the immune system and make infections more likely.
• Underlying health conditions: Conditions such as HIV, advanced liver disease, kidney disease, and certain malignancies (cancer) can compromise the immune system and increase the likelihood of developing GBS-related complications.

Symptoms

The most common early symptoms of Group B strep (GBS) disease in newborns include fever, lethargy, and feeding difficulties. These symptoms typically appear within the first week of life.

In adults, GBS disease may not cause any symptoms unless the infection is severe. However, when the infection progresses or becomes more severe, the following symptoms may occur:

• Bacteremia (bloodstream infection): Fever, fatigue, body aches, low blood pressure, rapid heart rate, and confusion
• Bone and joint infections: Fever, aches, pain and rashes along specific affected bones and joints
• Meningitis (inflammation around the brain and spine): Sudden headache, fever, and neck stiffness
• Pneumonia (lung infection): Severe cough, excess mucus production, and breathing difficulties
• Sepsis (body's reaction to severe infection): Confusion, rapid heart rate, and breathing changes
• Skin infections: Rashes, swelling, painful areas of skin with pus drainage

It's important to note that these symptoms may vary depending on the part of the body affected by the GBS infection. If you experience any concerning symptoms or suspect you may have GBS disease, it is crucial to seek medical attention promptly.

Diagnosis

To diagnose Group B strep (GBS) disease, health care providers commonly perform the following examinations, tests, and procedures:

• Physical exam: The health care provider will look for physical signs of infection that might indicate GBS, such as fever, swelling, redness, tenderness, or signs of sepsis in newborns or adults. In pregnant women, they may assess for risk factors like premature labor, fever, or signs of infection in the amniotic fluid.
• Lab tests:
  • Vaginal and rectal swabs: Used to screen pregnant women for GBS colonization (typically done at 36-37 weeks of pregnancy). Swabs are cultured to detect the presence of GBS.
  • Blood cultures: Detects GBS in the bloodstream, especially in cases of suspected sepsis or invasive infections. A blood sample is cultured to identify bacterial growth.
  • Urine tests: Identifies GBS bacteria in the urinary tract, particularly in pregnant women with urinary tract infections (UTIs). A urine sample is cultured to confirm bacterial growth.
  • Cerebrospinal fluid (CSF) testing: Used when GBS meningitis is suspected, especially in newborns or individuals with symptoms like confusion or seizures. A sample of fluid from around the spinal cord is taken using a needle to check for infection
  • Polymerase chain reaction (PCR) testing: Provides quick results for detecting GBS, often used during labor if GBS status is unknown. This test identifies the bacteria’s genetic material in a swab or sample.
• Imaging studies: X-rays or MRI (magnetic resonance imaging) scans may be recommended to get a closer look at areas affected by the infection. These tests help check for damage or complications, such as problems in the lungs, bones, joints, or brain.

To determine the severity of GBS disease, additional examinations, tests, and procedures may be performed:

• Clinical procedures: These can vary depending on the body system being evaluated. Examples include an echocardiogram (heart ultrasound) or other specialized tests to assess specific organ function.

It's important to note that the specific examinations, tests, and procedures may vary depending on individual symptoms and the judgment of the health care provider. It's best to consult with your doctor for personalized recommendations.

Treatment Options

The goals of treatment for Group B strep (GBS) disease are to eliminate the infection, prevent complications, and improve overall health. Here are the different treatment approaches and how they work:

• Antibiotics: Antibiotics are the mainstay of treatment for GBS disease. They help eliminate the bacteria causing the infection and reduce the risk of complications. The specific antibiotic prescribed will depend on the location and severity of the infection.
• Hospitalization: In some cases, hospitalization may be necessary, especially for newborns or individuals with underlying medical conditions. Hospitalization allows for close monitoring and administration of intravenous antibiotics if needed.
• Preventive measures: Preventive measures, like giving antibiotics during labor to high-risk mothers (intrapartum antibiotic prophylaxis) and vaccinating pregnant women can help reduce the risk of GBS disease. Intrapartum antibiotic prophylaxis is recommended for pregnant women who are carriers to prevent transmission to their newborns.
• Health behavior changes: Practicing good hygiene, including regular handwashing, can help prevent the spread of GBS bacteria.
• Natural products: Some studies suggest that natural products like garlic may have antimicrobial properties against GBS bacteria. However, further research is needed to establish their effectiveness.

It's important to note that treatment decisions should be made by a healthcare professional based on individual circumstances.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.