Most common cause of early, severe infection in newborns.
Also a cause of infection in pregnancy, people with diabetes, immunocompromised people, and older adults.
Presentation depends on the age of the patient and the underlying risk factor.
Diagnosis is confirmed by isolation of group B streptococci (GBS) from usually sterile body fluid.
Targeted antibiotic therapy is the mainstay of therapy in patients with confirmed GBS infection.
Incidence and mortality are highest in older people.
Group B streptococci (GBS), also known as Streptococcus agalactiae, are gram-positive bacteria that normally colonise the gastrointestinal tract, perineum, and vagina. They can cause invasive infections at any age, but infections are most common in the neonatal period, in older people, and in adults with predisposing factors (i.e., pregnancy, diabetes, immunocompromised). GBS can cause a range of infections including sepsis, cellulitis, pneumonia, and meningitis. This monograph deals with confirmed group B streptococcal infection only.
History and exam
- presence of risk factors
- symptoms of meningitis
- signs of meningitis
- symptoms of sepsis
- signs of sepsis
- symptoms of pneumonia
- signs of pneumonia
- symptoms of UTI
- signs of UTI
- symptoms of cellulitis
- signs of cellulitis
- symptoms of septic arthritis
- signs of septic arthritis
- symptoms of conjunctivitis
- symptoms of sinusitis
- signs of sinusitis
- symptoms of otitis media
- signs of otitis media
- symptoms of endometritis
- signs of endometritis
- signs of chorioamnionitis
- 0 to 7 days of age
- maternal fever during labour
- premature rupture of membranes (PROM)
- previous baby with GBS disease
- maternal GBS colonisation
- GBS bacteriuria during pregnancy
- preterm delivery (<37 weeks)
- low birth weight (<2500 g)
- deficient maternal-specific IgG at term
- twin sibling with GBS disease
- maternal age <20 years
- age >60 years
- diabetes mellitus
- advanced hepatic disease
- advanced renal disease
- presence of central venous catheter
- urological disorders
- break in skin integrity or skin ulcers
- neurological disease
- nursing-home resident
- black or Hispanic race
- obstetric manipulation
- presence of urinary catheter
- HIV infection
- consumption of placenta capsules
- serum urea nitrogen and creatinine
- serum electrolytes
- serum glucose
- coagulation studies
- C-reactive protein (CRP)
- blood culture
- cerebrospinal fluid (CSF) Gram stain
- CSF culture
- CSF cell count and differential
- CSF glucose and protein
- antigen detection in CSF
- Gram stain and culture of other sterile body fluids
- chest x-ray
- joint x-ray
- CT head
Brendan Healy, MBChB, BSc (Hons), MRCP, FRCPath
Consultant in Microbiology and Infectious Diseases
University Hospital of Wales
BH has received educational grants and fees for consultancy from a number of pharmaceutical companies, including BMS, Gilead, Jannsenn, Abbvie, ViiV, and MSD. This is principally in work relating to hepatitis C and HIV. BH has carried out consultancy work on some antibiotics, including fidaxomicin, linezolid, tedizolid, ceftobiprole, and ceftaroline. BH declares he has no competing interests in relation to the work carried out for this topic review, Group B streptococcus.
Dr Brendan Healy would like to gratefully acknowledge Dr Susannah Froude and Dr Harriet Hughes, previous contributors to this topic.
SF declares that she has no competing interests. HH declares that she has received funds from Gilead and Biocomposites related to conference registration, travel, accommodation, and speaker fees.
William A. Petri, Jr, MD, PhD, FACP
Chief and Professor of Medicine
Division of Infectious Diseases and International Health
University of Virginia Health System
WAP declares that he has no competing interests.
James R. Hanley, MD, FAAP
Pediatric Emergency Medicine
University of Southern Alabama Children's and Women's Hospital
JRH declares that he has no competing interests.
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