Group B Streptococcus in Newborns: Causes, Treatment, and Risks

Group B Streptococcus is present in the blood?

Hello, doctor.
My child is three weeks old and started having a fever one night.
We took him to the hospital for a blood test, and the doctor reported the presence of Group B Streptococcus (GBS) in the blood, which caused the fever.
How does GBS enter the baby's body, what should we do about it, how many days of antibiotics are needed for recovery, and will there be any long-term effects?

Xiao Gu, 30~39 year old female. Ask Date: 2002/08/22

Dr. Liang Hongjian reply Pediatrics

Group B Streptococcus (GBS) infection is the leading cause of bacterial infections in neonates, most commonly affecting infants aged 0 to 4 months.
In newborns, infections can be classified into two types: A.
Early-onset, which occurs within three days of birth and presents with symptoms such as respiratory distress, apnea, shock, pneumonia, or meningitis; B.
Late-onset, which occurs approximately 15 to 17 days after birth (ranging from 7 days to 3 months, with an average of 3 to 4 weeks) and is characterized by signs of meningitis, osteomyelitis, and septic shock.
The primary route of infection is typically from the mother to the fetus during delivery.
Other potential transmission routes include 1.
Prolonged pregnancy (>42 weeks), 2.
Premature rupture of membranes (>24 hours), 3.
Maternal infection before or during labor, and 4.
Low levels of specific antibodies in the fetus.
In terms of treatment, antibiotics are generally used based on the clinical situation; for sepsis, a course of 10 to 14 days is recommended, while for meningitis, treatment lasts for 14 days.
Children affected by this condition may experience varying degrees of long-term sequelae, depending on the severity of complications following the infection.

Reply Date: 2002/08/22

More Info

Group B Streptococcus (GBS) is a type of bacteria that can be found in the intestines and the lower genital tract of healthy adults. While it is often harmless in adults, it can pose significant risks to newborns, particularly if they are exposed to it during labor and delivery. Understanding how GBS can affect newborns, the treatment options available, and the potential risks involved is crucial for parents and caregivers.

How GBS Enters the Newborn's Body
Newborns can acquire GBS during the birthing process. If a mother is a carrier of GBS, the bacteria can be transmitted to the baby as they pass through the birth canal. This transmission can occur even if the mother does not show any symptoms of infection. In some cases, GBS can also be transmitted in utero, although this is less common. The risk of infection is higher if the mother has a fever during labor or if the membranes have been ruptured for an extended period before delivery.

Treatment for GBS Infection
If a newborn is diagnosed with a GBS infection, the standard treatment involves intravenous (IV) antibiotics. The choice of antibiotics typically includes penicillin or ampicillin, which are effective against GBS. The duration of antibiotic treatment can vary depending on the severity of the infection. For early-onset GBS disease, which occurs within the first week of life, treatment usually lasts for at least 10 days. If the infection is more severe or if there are complications, the treatment duration may be extended.

Monitoring and Follow-Up
After starting antibiotics, healthcare providers will closely monitor the newborn for signs of improvement or any potential complications. Blood tests may be repeated to ensure that the infection is resolving. In many cases, if treated promptly and appropriately, newborns can recover fully without any long-term complications.

Potential Risks and Long-Term Effects
While many infants recover from GBS infections without any lasting effects, there are still risks involved. Early-onset GBS disease can lead to serious complications, including pneumonia, meningitis, and sepsis. The mortality rate for untreated GBS infections can be significant, and even with treatment, some infants may experience neurological complications or developmental delays.

Conclusion
In your case, since your newborn has been diagnosed with a GBS infection and is receiving antibiotics, it is essential to follow the healthcare provider's recommendations closely. Ensure that the treatment course is completed as prescribed, and keep an eye on any symptoms that may arise. If your child shows signs of worsening condition or if you have concerns about their recovery, do not hesitate to reach out to your pediatrician.

Additionally, it is important to maintain open communication with your healthcare team regarding any follow-up appointments or tests that may be necessary to monitor your child's health after the infection. Early detection and intervention are key to ensuring the best possible outcomes for newborns affected by GBS.

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