Impact of Group B Streptococcus on Newborns: Risks and Management

The impact of Group B Streptococcus on infants?

Hello Doctor: My wife underwent Group B Streptococcus screening in obstetrics during her pregnancy, and she tested positive for Group B Streptococcus.
The clinic informed us that treatment could be administered during delivery.
After our baby boy was born, he had elevated white blood cell counts, and the hospital administered antibiotics as a precaution to prevent infection.
A few days later, his white blood cell count returned to normal, and the medical staff assured us that there were no adverse effects.
About ten days later, we brought our baby home, and everything has been normal for over two months now.

However, I later learned online that this bacteria could still cause illness within three months, and survivors might experience physical and mental harm (such as complications like meningitis) that could lead to developmental delays.
Recently, our baby has had mild nasal congestion and a fever, and we have sought medical attention and received medication.

Could you please advise whether my child's condition indicates that he is no longer at risk from Group B Streptococcus infection (specifically regarding the delivery), or should we conduct further tests for confirmation? Additionally, our baby often has bloating and does not eat much; would it be appropriate to give him probiotics to help improve this? Thank you.

A Shu, 40~49 year old female. Ask Date: 2011/02/24

Dr. Pei Rensheng reply Pediatrics

Hello, A-Shu.
One quarter of women of childbearing age carry Group B Streptococcus (GBS), and mothers typically do not show symptoms.
About half of newborns can acquire this bacteria during the delivery process as they pass through the birth canal.
The incidence of infection in newborns is approximately 1-2%.
Additionally, a very small number of newborns may become infected in utero via the placental blood flow.

Newborns infected with GBS may experience early-onset infection, which occurs within the first seven days, or late-onset infection, which occurs after seven days.
Symptoms in affected infants can vary in severity and may include respiratory distress, decreased feeding, vomiting, lethargy or irritability, and abnormal body temperature (either hypothermia or hyperthermia).
In severe cases, the infection can progress to respiratory distress, pneumonia, meningitis, or sepsis, with a mortality rate as high as 20-40%.
Among those who survive, nearly half may still experience neurological sequelae.
Your baby is over two months old and has mild nasal congestion and fever.
If the fever exceeds 38 degrees Celsius (100.4 degrees Fahrenheit), hospitalization for blood tests is recommended to check for bacteremia, meningitis, or urinary tract infection.
Probiotics can aid in digestion and absorption, potentially improving symptoms of bloating and poor appetite.
If symptoms persist after one week of probiotic use, it is advisable to seek medical attention to investigate other potential causes.
Wishing you health and happiness!
Sincerely,
Dr.
Pei Ren-Sheng, Head of Pediatrics, Taoyuan Hospital, Department of Health.

Reply Date: 2011/02/24

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 typically harmless in adults, it can pose significant risks to newborns, particularly if the mother is a carrier during labor and delivery. The risk of transmission during childbirth is approximately 50% for infants born to mothers who are colonized with GBS. However, only about 1-2% of these infants will develop an infection, which can manifest as early-onset disease within the first week of life or late-onset disease occurring after the first week.

In your case, it is reassuring that your newborn was monitored closely after birth and received preventive antibiotics due to the elevated white blood cell count, which is a common precautionary measure to prevent potential infections. The normalization of the white blood cell count shortly after treatment is a positive sign, indicating that there was likely no active infection at that time.

Regarding your concerns about the potential for GBS infection within the first three months of life, it is important to note that while the risk exists, the likelihood decreases significantly after the initial weeks following birth, especially if the infant has shown no signs of illness. Symptoms of GBS infection can include difficulty breathing, feeding intolerance, lethargy, temperature instability, and irritability. If your child has been healthy for over two months and has only experienced mild symptoms like a runny nose and fever, it is less likely that these are related to GBS. However, any fever greater than 100.4°F (38°C) in an infant should be evaluated by a healthcare provider to rule out any serious infections, including meningitis or sepsis.

As for your question about probiotics for your infant's gas and appetite issues, probiotics can be beneficial for infants, particularly in improving gut health and digestion. They may help alleviate symptoms of gas and bloating. However, it is crucial to consult your pediatrician before introducing any supplements to ensure they are appropriate for your child's age and health status. If your infant's symptoms persist despite the use of probiotics, further evaluation may be necessary to rule out other underlying conditions.

In summary, while the risk of GBS infection exists, your child's current health status and the management provided at birth suggest that they are likely not at risk from GBS at this time. Regular monitoring and communication with your pediatrician are essential for addressing any new symptoms or concerns as your child continues to grow.

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