Group B Strep Awareness: Testing, Risks, and Treatment

What is Group B Strep?

Unlike group A strep (GAS), which is responsible for a variety of infections such as strep throat, impetigo, and toxic shock syndrome, group B strep (also called GBS, group B Streptococcus, or Streptococcus agalactiae) is a bacteria that lives in the vagina and rectum. About 1 in 4 pregnant women have this bacterium. However, they are unaware of it because it doesn’t cause any symptoms. 

If you’re pregnant or planning to become pregnant, knowing your GBS status is important since the only known way to pass it to another person is through the birth canal. Not all babies who get group B strep develop an illness. But in a small number of babies exposed to the bacterium, GBS can cause serious, life-threatening complications. 

That is why healthcare providers and organizations like Group B Strep International want to bring awareness. Doctors recommend that pregnant women be tested for GBS before birth to reduce the risk of transmission to newborns.

Signs and Symptoms

You can develop various symptoms or complications of GBS disease depending on the part of your body that’s infected. For example, if you have GBS in your urine, you may develop symptoms of a urinary tract infection. The most common infections caused by group B strep are as follows:

• Newborns: Bacteremia, sepsis, meningitis, and pneumonia.

• Non-Pregnant Adults: Bacteremia, pneumonia, skin and soft tissue infections, bone infections.

• Pregnant Adults: Chorioamnionitis (infection of the amniotic fluid, amniotic sac, and placenta), urinary tract infection (which can increase the risk of preterm labor), and endometritis after birth.

Risk Factors

Approximately 1 in 4 pregnant women are carriers of GBS. Other risk factors include adults with chronic health conditions such as diabetes, heart disease, congestive heart failure, cancer, or a history of cancer, and obesity. There is also a considerably increased risk as adults get older and reach 65 years of age. 

How Common Is Group B Strep?

Globally, approximately 20 million pregnant women are colonized with GBS. More than 390,000 newborn babies worldwide experience perinatal GBS disease each year, resulting in more than 500,000 preterm births (babies born prematurely before they reach full-term), 46,000 stillbirths, and 91,000 infant deaths. 

Each year, about 930 babies in the United States get early-onset GBS, and about 1,050 babies get late-onset GBS disease. 

According to the World Health Organization (WHO), GBS is a leading cause of meningitis and sepsis in newborn babies.

Through proactive prenatal care, these numbers have decreased over the years, but sadly, up to 2 to 3 in every 50 newborns who develop GBS disease die. Other GBS complications may include bloodstream infections (sepsis), GBS meningitis, and lifelong handicaps and disabilities due to neurological damage, including blindness and deafness.

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How Do You Get A Group B Strep Infection?

Transmission of group B strep primarily occurs through the birth canal, where a GBS positive mother can pass on the infection to the infant during vaginal delivery. It is unclear how adults acquire GBS. The infection can come and go or always be present, and people typically aren’t aware of it due to the lack of symptoms. Group B strep infections are not sexually transmitted diseases. 

The spread of GBS among non-pregnant adults is not well known. Older adults (age 65 and older) and those with a weakened immune system are more likely to develop complications from a group B strep infection. While there are currently no vaccines to prevent GBS disease, taking proactive steps to improve your immune system and overall health could help prevent infections in general. 

Since GBS disease is most common in newborns, expecting mothers are tested toward the end of pregnancy so that precautions can be made to prevent transmission to the newborn. 

According to the Centers for Disease Control and Prevention (CDC), there is no evidence that group B strep bacteria can spread through food, water, or any surfaces that people may come into contact with in the U.S.

Group B Strep In Pregnancy  

Risks

GBS pregnancy risks include:

• Late miscarriage (death of the baby between 14 and 24 weeks of gestation).

• Stillbirth (death of the baby between 24 weeks and the end of pregnancy).

• Preterm labor (labor before 37 weeks of pregnancy) leading to a premature birth.

• Maternal infections such as urinary tract infection, chorioamnionitis, and postpartum endometritis.

• Invasive GBS disease in the infant can lead to meningitis and sepsis with a high risk of mortality (death).

Diagnosis During Pregnancy  

A pregnant woman is tested for GBS at 37 weeks. If the mother-to-be tests GBS positive, she is given antibiotics intravenously during labor. This treatment alone brings the likelihood of passing on GBS to the newborn from 1 in 200 to 1 in 4,000.

Impact on Pregnancy Outcomes  

As mentioned, about 1 in 4 pregnant women have GBS. In pregnant adults, GBS can cause infections of the urinary tract, reproductive organs, placenta, amniotic sac, and amniotic fluid. Even if a pregnant woman does not have any symptoms of GBS infection, she can pass the infection to her baby during labor and delivery.

Group B Strep In Newborns  

Types of GBS Disease in Newborns 

There are two main types of GBS in newborns: early-onset and late-onset. Early onset occurs during the first week of life, and late onset occurs within the first three months of life. 

Risks and Complications For Babies  

GBS bacteria commonly cause bacteremia (bloodstream infections), sepsis (a life-threatening condition in which the body’s immune system has an extreme response to an infection), meningitis (infection of the membranes covering the brain and spinal cord), and pneumonia (infection of the lungs). These infections can be fatal. Even babies who survive can be left with lifelong handicaps due to neurological damage, including blindness and deafness.

Symptoms In Newborns  

Symptoms of GBS in newborns will depend on the part of the baby’s body that is infected. Common symptoms include fever, irritability or fussiness, breathing problems, feeding problems, and limpness.

Preventative Measures and Treatment  

Group B Strep awareness advocates recommend that all pregnant adults get tested and receive intravenous antibiotics during labor if they are GBS positive.

Diagnosis, Treatment, and Prevention  

Diagnosis

A healthcare provider can take a swab from the vagina and rectum and send the sample to the lab for testing for GBS. Pregnant adults are routinely tested for GBS at the end of the pregnancy (around 37 weeks). 

If the test is positive for the GBS bacterium:

• Non-pregnant adults who have symptoms are treated with oral antibiotics. 

• Pregnant women receive IV antibiotics during labor to lower the risk of passing Group B Strep to the baby during vaginal delivery. 

The success of treatment often depends on early diagnosis for both infants and elderly adults. Unfortunately, Group B streptococcal disease often goes unnoticed in adults, living in the bowel, vagina, rectum, bladder, and throat with no signs whatsoever. In some cases, GBS disease is diagnosed in adults who have recurring urinary tract infections or blood infections. This is one reason why adults, especially those over 65 years old, should see a doctor regularly to diagnose and treat serious conditions that would otherwise go unnoticed.

Antibiotics 

Penicillin or ampicillin is commonly used to treat Group B Strep. The antibiotics work best if they are given intravenously at least 4 hours before vaginal delivery. Around 90% of GBS infections in newborns can be prevented with antibiotic therapy. 

Managing Recurrence and Long-Term Effects  

If a pregnant woman tests GBS positive in a urine sample during pregnancy, she will receive oral antibiotic treatment right away and IV antibiotics during labor. 

If a pregnant woman has previously given birth to a baby who developed a Group B streptococcal infection, she must receive IV antibiotics during labor, regardless of her current GBS status. 

Babies who get infected with GBS in the birth canal are given IV antibiotics to treat the infection and lower the risk of long-term health consequences.

Can My Baby Get Group B Strep from a C-Section?

The likelihood of your baby getting Group B Streptococcus if you have a cesarean section (C-section) is much lower than a vaginal delivery. If you are GBS positive and are having a planned C-section (for other reasons) before your waters break and labor starts, you will not need IV antibiotics specifically against Group B Strep. This is because the risk of transmitting GBS to your infant is very low with a C-section, and you will, in any case, receive broad-spectrum antibiotics for the operation that are effective against Group B Strep. 

It is worth noting that obstetricians and gynecologists do not recommend a planned cesarean birth only for the purpose of preventing Group B Strep transmission from mother to child, as it comes with its own risks.

Prevention Strategies For Expectant Mothers  

Getting screened for GBS and taking antibiotics during labor if you are GBS positive is the best way for expecting mothers to protect their baby from Group B streptococcal disease.

Research and Vaccine Development

Like many diseases, Group B streptococcal infection is being researched in hopes of developing a vaccine for future generations. Group B Strep Awareness Month is not only a good time to raise awareness about the existence of GBS, but also to inform pregnant and non-pregnant adults about the global threat of GBS. A vaccine may be especially useful in countries with their own prevention challenges and less-advanced medical technologies to manage the complications of Group B streptococcal disease. To find out more about Group B Strep, visit Group B Strep International.

Will Group B Strep Ever Go Away?

Group B strep can come and go, or you can always have it. Testing GBS positive does not mean you will have it all the time. But once you test positive, you are considered a GBS carrier lifelong.