July is the month of International Group B Strep awareness. Group B Streptococcus (GBS), or Streptococcus agalactiae, is a type of bacteria that is naturally found in the digestive and lower reproductive tracts of both men and women. About 1 in 4 pregnant women "carry" or are "colonized" with GBS.
The infection can be passed to a baby during pregnancy and up to the age of around 6 months old, due to the fact that their immune system is not developed properly yet.
According to the Centers for Disease Control and Prevention (CDC), Group B Strep (GBS) is the leading cause of sepsis and meningitis in a newborn's first week of life. US RNs look after pregnant women and infants, so it is vital that you understand how the infection is transmitted, as well as the signs and symptoms of the infection in an infant.
Who Gets Group B Strep
Anyone can carry Group B Strep. GBS is not considered to be a sexually transmitted infection as it can occur on its own even in someone with no prior sexual experience. However, bacteria can be passed between sexual partners, including through oral contact. Those at most risks for GBS infection are infants, adults with some chronic medical conditions and the elderly due to their weakened immune systems.
For babies, the type of GBS infection they are diagnosed with depends upon when they contracted the infection:
- Prenatal-onset GBS disease (before birth)
- Early-onset GBS disease (birth through the first week of life)
- Late-onset GBS disease (over 1 week of age through several months of age)
Not all babies who are exposed to GBS. However, the infection can cause miscarriages and stillbirths, pre-term labor, and severe illness and death in babies. GBS usually infects the baby’s blood (sepsis), the fluid and lining of the brain (meningitis), and the lungs (pneumonia). It can leave survivors with long-standing medical disabilities such as cerebral palsy and blindness.
It is important to note that GBS disease in babies that have been born (early and late onset) can be caused by infected people other than the mother too.
Screening
In the US all pregnant women are offered routine screening for GBS at 35-37 weeks. GBS colonization can come and go and this is why screening is done later in pregnancy. Screening at 35-37 weeks involves taking vaginal and rectal swabs. If a pregnant woman is found to be infected with GBS, IV antibiotics may be given during labor to prevent the transmission of the infection during birth. If a pregnant woman has previously had a baby with GBS, then she may be given oral antibiotics during pregnancy also.
Group B Strep Infection Disease Symptoms
Pregnant Women:
- May have vaginal irritation and/or discharge – sometimes mistaken for a yeast infection
- It can sometimes cause urinary tract infections
Babies:
- Prenatal-onset GBS
- Decreased or no fetal movement after your 20th week.
- Frenzied movement has also been linked to fetal distress.
- Any unexplained fever
- Early and late onset GBS:
- Sounds - High-pitched cry, shrill moaning, whimpering, inconsolable crying, constant grunting or moaning as if constipated or in distress
- Breathing - Fast, slow, or difficult breathing
- The appearance of skin - Blue, gray, or pale skin, blotchy or red skin, tense or bulging fontanel (soft spot on a baby's head), infection (pus/red skin) at base of the umbilical cord or in puncture on the head from the internal fetal monitor
- Eating and Sleeping Habits - Feeding poorly, refusing to eat, not waking for feedings, sleeping too much, difficulty being aroused
- Behavior- Marked irritability, projectile vomiting, reacting as if the skin is tender when touched, not moving an arm or leg, listless, floppy, blank stare, body stiffening, uncontrollable jerking
- Body Temperature - Fever or low or unstable temperature, hands and feet may feel cold even with a fever
- Early and late onset GBS:
It is important to remember that GBS is a very fast acting bacteria and can cause critical illness in a baby within a couple of hours. If you are dealing with pregnant women, use your communication skills to educate them about health promotion strategies like screening, and about how to recognize the symptoms of an infection (in both herself and her infant).
For more information on Group B Strep please visit https://www.groupbstrepinternational.org