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Infecção por estreptococos do grupo B

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 8 Aug 2025
Última atualização: 18 Nov 2022

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • febre
  • sintomas de meningite
  • sinais de meningite
  • sintomas da sepse
  • sinais de sepse
  • sintomas de pneumonia
  • sinais de pneumonia
  • sintomas de infecção do trato urinário
  • sinais de infecção do trato urinário
  • sintomas de celulite
  • sinais de celulite
  • sintomas de artrite séptica
  • sinais de artrite séptica
  • sintomas de conjuntivite
  • sintomas de sinusite
  • sinais de sinusite
  • sintomas de otite média
  • sinais de otite média
  • sintomas de endometrite
  • sinais de endometrite
  • sinais de corioamnionite
Detalhes completos

Outros fatores diagnósticos

  • sinais inespecíficos de infecção em neonatos
  • sinais inespecíficos de infecção em idosos
  • sintomas de infecção intra-abdominal
  • sinais de infecção intra-abdominal
  • aborto na metade da gestação ou trabalho de parto prematuro
Detalhes completos

Fatores de risco

  • 0 a 7 dias de idade
  • febre materna durante o trabalho de parto
  • ruptura prematura de membranas (RPM)
  • bebê prévio com doença por EGB
  • colonização materna por EGB
  • bacteriúria por EGB durante a gestação
  • parto prematuro (<37 semanas)
  • baixo peso ao nascer (<2500 g)
  • IgG materno específico deficiente no nascimento
  • irmão gêmeo com doença por EGB
  • idade materna <20 anos
  • corioamnionite
  • idade >60 anos
  • gestação
  • multiparidade
  • diabetes
  • obesidade
  • doença hepática avançada
  • doença renal
  • presença de cateter venoso central
  • distúrbios urológicos
  • alteração da integridade da pele ou úlceras de pele
  • doença neurológica
  • imunossupressão
  • residentes de casas de repouso
  • raça negra ou hispânicos
  • neoplasia maligna
  • manipulação obstétrica
  • presença de cateter urinário
  • Infecção pelo vírus da imunodeficiência humana (HIV)
  • trauma
  • asma
  • consumo de cápsulas de placenta
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Hemograma completo
  • ureia sérica e creatinina
  • eletrólitos séricos
  • glicose sérica
  • exames de coagulação
  • TFHs
  • proteína C-reativa
  • hemocultura
  • coloração de Gram do líquido cefalorraquidiano (LCR)
  • cultura do LCR
  • celularidade e diferencial do LCR
  • glicose e proteína no LCR
  • detecção de antígeno no LCR
  • coloração de Gram e cultura de outros fluidos corporais estéreis
  • radiografia torácica
  • radiografia simples da articulação e/ou osso
  • tomografia computadorizada (TC) do crânio
Detalhes completos

Investigações a serem consideradas

  • ecocardiografia
  • RNM
Detalhes completos

Algoritmo de tratamento

AGUDA

infecção neonatal por GBS confirmada de início precoce ou tardio (idade de 0-89 dias)

bebês e crianças

adultos: não gestantes

adultos: gestantes e pós-parto

Colaboradores

Autores

Brendan Healy, MBChB, BSc (Hons), MRCP, FRCPath

Consultant in Microbiology and Infectious Diseases

University Hospital of Wales

Cardiff

UK

Declarações

BH has received honorarium and has been reimbursed for attending conferences from AbbVie (hepatitis C), Gilead Sciences (hepatitis C), Bristol Myers Squibb (hepatitis C), and Tillotts Pharma (fidaxomicin). BH declares that he has no competing interests in relation to the work carried out for this topic review, Group B streptococcus.

Agradecimentos

Dr Brendan Healy would like to gratefully acknowledge Dr Susannah Froude and Dr Harriet Hughes, previous contributors to this topic. We would also like to gratefully acknowledge Dr Benjamin D. Lorenz for his contributions to this topic.

Declarações

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.

Revisores

William A. Petri, Jr, MD, PhD, FACP

Chief and Professor of Medicine

Division of Infectious Diseases and International Health

University of Virginia Health System

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

James R. Hanley, MD, FAAP

Attending Physician

Pediatric Emergency Medicine

Ochsner Foundation Hospital

New Orleans

LA

Disclosures

JRH declares that he has ownership of a limited amount of stock in various pharmaceutical companies, although no significant amounts of any company.

Kirsty Le Doare, BA, MBBS, MSc, PhD, FRCPCH

Professor of Vaccinology and Immunology

St George's, University of London

London

UK

Disclosures

KLD declares that their institution has received funds for GBS vaccine clinical trials; she has not received personal funds.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Pediatrics. Group B streptococcal infections. In: Committee on Infectious Diseases, American Academy of Pediatrics, Kimberlin DW, Barnett ED, et al. Red book: 2021-2024 report of the Committee on Infectious Diseases. 32nd ed. Elk Grove Village, IL: AAP; 2021:707-13.

The American College of Obstetricians and Gynecologists. Prevention of group B streptococcal early-onset disease in newborns: ACOG Committee Opinion Summary, Number 797. Obstet Gynecol. 2020 Feb;135(2):489-92.Full text  Abstract

National Center for Health Statistics. Active bacterial core surveillance (ABCs) report: emerging infections program network - group B streptococcus, 2018 [internet publication].Full text

Royal College of Obstetricians and Gynaecologists. The prevention of early onset neonatal group B streptococcal disease. Green-top guideline no. 36. Sep 2017 [internet publication].Full text  Abstract

Ohlsson A, Shah VS. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev. 2014 Jun 10;(6):CD007467.Full text  Abstract

Puopolo KM, Lynfield R, Cummings JJ, et al. Management of infants at risk for group B streptococcal disease. Pediatrics. 2019 Aug;144(2):e20191881.Full text  Abstract

American Society for Microbiology. Guidelines for the detection and identification of group B streptococcus. 29 July 2021 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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