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Group B Streptococcal Infection in Newborns

Last updated Sept. 18, 2018

Approved by: Maulik P. Purohit MD, MPH

Group B Streptococcal Infection in Newborns is a severe bacterial infection affecting a newborn child. It is a bloodstream infection caused by the bacterium Streptococcus agalactiae, commonly known as “Group B strep” or GBS.


What are the other Names for this Condition? (Also known as/Synonyms)

  • GBS Infection in Newborns
  • Group B Streptococcal Septicemia of the Newborn
  • Neonatal Group B Streptococcus Agalactiae Infection

What is Group B Streptococcal Infection in Newborns? (Definition/Background information)

  • Group B Streptococcal Infection in Newborns is a severe bacterial infection affecting the newborn child. It is a bloodstream infection caused by the bacterium Streptococcus agalactiae, commonly known as “Group B strep” or GBS
  • There are two types of GBS infection in newborns, early onset GBS disease that occurs during birth (until 6 days of age) and late onset GBS disease, which occurs in infants who are 7 days to 3 months old
  • A newborn baby’s vulnerability increases owing to many risk factors, some of which are pre-term delivery, the mother being infected in her gastrointestinal or urinary tract with the causative bacterium, having siblings born with infection, and mother having fever during delivery
  • Streptococcus agalactiae, a Gram-positive bacterium, is the causative organism of GBS infection in post-partum women and newborns. In adults, infection due to group B streptococcus is not usually life-threatening; in newborns though, the condition can be fatal
  • Common signs and symptoms associated with this infection in newborns include weakness, lethargy, fever, refusal to feed, pale skin and breathing problems
  • Intravenous antibiotic therapy is the mainstay of treatment for Group B Streptococcal Infection in Newborns. If treatment is delayed or is not made available, there can be serious complications from the infection, such as a drop in blood sugar levels (hypoglycemia), meningitis, respiratory failure, or an abnormal clotting of blood resulting in a condition called disseminated intravascular coagulation (DIC)
  • Testing a pregnant woman in her 35th-37th week of pregnancy for group B Streptococcs agalactiae infection, checking the newborn for infection even in the absence of symptoms, washing hands before handling a newborn, and starting treatment promptly after diagnosis are some known preventive methods for this disease
  • With proper diagnosis and prompt treatment, the infection resolves within a few weeks in newborns. However, if treatment is delayed or not given, the condition can worsen and even be fatal

Who gets Group B Streptococcal Infection in Newborns? (Age and Sex Distribution)

  • Group B Streptococcal Infection In Newborn affects newborn babies, although the bacterium can affect older children and adults as well
  • There is no gender, racial or ethnic predilection for the occurrence of this infection

What are the Risk Factors for Group B Streptococcal Infection in Newborns? (Predisposing Factors)

Risk factors associated with Group B Streptococcal Infection in Newborns include:

  • Pre-term babies, babies born 3 weeks before due date
  • Mothers who have already given birth to a baby with group B streptococcal sepsis
  • Mothers with fever during labor and delivery
  • A pregnant woman with GBS infection in her gastrointestinal, reproductive, or urinary tract before or at the time of delivery
  • Rupture of membranes more than 18 hours before delivery (premature rupture of membranes)
  • Use of intrauterine fetal monitoring during labor
  • Newborn children of infected mothers

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Group B Streptococcal Infection in Newborns? (Etiology)

Group B Streptococcal Infection in Newborns is a serious infection in the bloodstream caused by Streptococcus agalactiae, a Gram-positive bacterium. There are 2 ways by which a GBS infection can occur in newborns:

  • Early onset GBS disease, in which an infant gets infected as it passes through the birth canal. The infected baby may become ill between birth and first 6 days of life
  • Late onset GBS disease, in which infants become infected after delivery by coming in contact with individuals with GBS disease. Babies may become ill from 7 days to 3 months of life. Infection occurs due to handling of the baby, by individuals carrying Group B Streptococcus bacteria

What are the Signs and Symptoms of Group B Streptococcal Infection in Newborns?

Some signs and symptoms of Group B Streptococcal Infections in Newborns include:

  • Restlessness
  • Cyanosis or bluish color of skin
  • Breathing difficulties as evidenced by
    • Flaring of the nostrils
    • Grunting noises
    • Rapid breathing
    • Apnea: Short time intervals when the child does not breathe
  • Irregular or abnormal heartbeat
  • Pale appearance
  • Poor feeding, lethargy
  • Unstable body temperature, cold skin

How is Group B Streptococcal Infection in Newborns Diagnosed?

For the diagnosis of Group B Streptococcal Infection in Newborns, a healthcare professional would need the following information:

  • Complete evaluation of medical history (prenatal history of the mother), along with a thorough physical exam
  • Tests such as:
    • Complete blood count (CBC)
    • Blood culture - the most important diagnostic test to detect and confirm the presence of bacteria in blood
    • Blood clotting tests that include prothrombin time (PT) and partial thromboplastin time (PTT)
  • Culture of cerebrospinal fluid - to check for meningitis
  • Culture of urine
  • Chest X-ray

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Group B Streptococcal Infection in Newborns?

Some potential complications associated with Group B Streptococcal Infections in Newborns include:

  • Meningitis: Infection of the membrane coverings of the brain and spinal cord, causing inflammation
  • Respiratory failure
  • Disseminated intravascular coagulation (DIC) due to abnormal blood clotting

If the treatment is delayed, the condition can be fatal.

How is Group B Streptococcal Infection in Newborns Treated?

The following are some treatment options for Group B Streptococcal Infection in Newborns:

  • Intravenous antibiotic therapy: It is the mainstay of treatment for GBS infection in newborns
  • Respiratory support, to make breathing easy
  • Intravenous fluids, to rehydrate the baby and combat dehydration
  • Medications, to address blood clotting issues, if any
  • Extracorporeal membrane oxygenation (ECMO) therapy, which is recommended in severe cases. This is a type of supplemental oxygen therapy

How can Group B Streptococcal Infection in Newborns be Prevented?

Preventive measures for Group B Streptococcal Infection in Newborns include:

  • Pregnant women have to get tested for GBS during the 35th-37th week of pregnancy. If test is positive, then antibiotics may be given during labor
  • All newborns have to be tested for Group B streptococcal infection
  • Giving antibiotics to babies during first 48 hours of life till blood culture results are available
  • Proper hand washing by caretakers, visitors, and parents to help control the spread of infection

Early diagnosis and prompt treatment is necessary to prevent complications.

What is the Prognosis of Group B Streptococcal Infection in Newborns (Outcomes/Resolutions)

The prognosis of Group B Streptococcal Infection in Newborns depends on early diagnosis and timely treatment.

  • The disease may become life-threatening, if it is left untreated
  • However, in most of the babies, the prognosis is good with treatment

Additional and Relevant Useful information for Group B Streptococcal Infection in Newborns:

  • A prenatal group B strep screen test is regularly performed on an expectant mother, during late pregnancy. The goal is to determine, if strep B is present and whether it has the ability to infect a newborn child

The following article will help you understand the prenatal group B strep screening test:

http://www.dovemed.com/common-procedures/procedures-laboratory/prenatal-group-b-strep-screening-test/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 27, 2016
Last updated: Sept. 18, 2018