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Answer
Group B Strep[tococcus] is a bacterium which normally lives in the
gastrointestinal tract of humans. Occasionally, because of the proximity of
the rectum, vagina, and urinary tract in women, this bacterium invades the
vagina and/or urinary tract in 5-40% of women. While this does not pose a
problem for the woman, and is frequently asymptomatic, it can be very
dangerous if her baby catches it.
Not every baby catches GBS; 40-75% are colonized but only 1-2% will
develop disease. The disease presents as either early-onset disease,
which occurs in the first 5-7 days of life, or late-onset disease,
which occurs after 7 days of age. Early-onset disease is usually the
worst form, and frequently is associated with obstetric complications
and prematurity. Lung problems, meningitis, and bacteremia (blood
infection) can occur. Mortality rates of 50% in the 1960s and 1970s
have declined to 10-20% with newer, more aggressive management, but it
can still be very dangerous.
New prevention guidelines from the Centers for Disease Control,
American Academy of Pediatrics, and American College of Obstetrics and
Gynecology recommend either 1) screening by culture for GBS carriage at
35 to 37 weeks' gestation followed by penicillin during labor for all
carriers, or 2) no screening but penicillin based on defined risk
factors (a previous delivery of an infant with GBS sepsis, GBS in the
mother's urine during pregnancy, delivery prior to 37 weeks' gestation,
maternal temperature over 100.4 during labor, or ruptured membranes
>18 hours). Not all women need antibiotics during labor just because
of carrying GBS, but many times it will help prevent early-onset
disease. Antibiotics during labor have not been found to affect the
occurrence of late-onset disease.
For more information, see the Group B Strep Association Website at
http://www.groupbstrep.org.
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