Highlights & Basics
- Group B streptococcal infection is the most common cause of early, severe infection in newborns.
- It is 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 demonstrated GBS infection.
Quick Reference
History & Exam
Key Factors
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Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
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.[Abstract][Full Text]
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].[Abstract][Full Text]
Ohlsson A, Shah VS. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev. 2014 Jun 10;(6):CD007467.[Abstract][Full Text]
Puopolo KM, Lynfield R, Cummings JJ, et al. Management of infants at risk for group B streptococcal disease. Pediatrics. 2019 Aug;144(2):e20191881.[Abstract][Full Text]
American Society for Microbiology. Guidelines for the detection and identification of group B streptococcus. 29 July 2021 [internet publication].[Full Text]
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6. 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.[Abstract][Full Text]
7. National Center for Health Statistics. Active bacterial core surveillance (ABCs) report: emerging infections program network - group B streptococcus, 2018 [internet publication].[Full Text]
8. Kadambari S, Trotter CL, Heath PT, et al. Group B streptococcal disease in England (1998-2017): a population-based observational study. Clin Infect Dis. 2021 Jun 1;72(11):e791-8.[Abstract]
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41. Pitts SI, Maruthur NM, Langley GE, et al. Obesity, diabetes, and the risk of invasive group B streptococcal disease in nonpregnant adults in the United States. Open Forum Infect Dis. 2018 Jun;5(6):ofy030.[Abstract][Full Text]
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44. Munoz P, Llancaqueo A, Rodriguez-Creixems M, et al. Group B streptococcus bacteremia in nonpregnant adults. Arch Intern Med. 1997 Jan 27;157(2):213-6.[Abstract]
45. Graux E, Hites M, Martiny D, et al. Invasive group B streptococcus among non-pregnant adults in Brussels - capital region, 2005-2019. Eur J Clin Microbiol Infect Dis. 2021 Mar;40(3):515-23.[Abstract][Full Text]
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47. Sunkara B, Bheemreddy S, Lorber B, et al. Group B streptococcus infections in non-pregnant adults: the role of immunosuppression. Int J Infect Dis. 2012 Mar;16(3):e182-6.[Abstract][Full Text]
48. Henning KJ, Hall EL, Dwyer DM, et al. Invasive group B streptococcal disease in Maryland nursing home residents. J Infect Dis. 2001 Apr 1;183(7):1138-42.[Abstract]
49. Shelburne SA 3rd, Tarrand J, Rolston KV. Review of streptococcal bloodstream infections at a comprehensive cancer care center, 2000-2011. J Infect. 2013 Feb;66(2):136-46.[Abstract]
50. Dauby N, Adler C, Miendje Deyi VY, et al. Prevalence, risk factors, and serotype distribution of group B streptococcus colonization in HIV-infected pregnant women living in Belgium: a prospective cohort study. Open Forum Infect Dis. 2018 Dec;5(12):ofy320.[Abstract][Full Text]
51. Cools P, van de Wijgert JHHM, Jespers V, et al. Role of HIV exposure and infection in relation to neonatal GBS disease and rectovaginal GBS carriage: a systematic review and meta-analysis. Sci Rep. 2017 Oct 23;7(1):13820.[Abstract][Full Text]
52. Dauby N, Chamekh M, Melin P, et al. Increased risk of group B Streptococcuss invasive infection in HIV-exposed but uninfected infants: a review of the evidence and possible mechanisms. Front Immunol. 2016 Nov 16;7:505.[Abstract][Full Text]
53. Perovic O, Crewe-Brown HH, Khoosal M, et al. Invasive group B streptococcal disease in nonpregnant adults. Eur J Clin Microbiol Infect Dis. 1999 May;18(5):362-4.[Abstract]
54. Buser GL, Mató S, Zhang AY, et al. Notes from the field: late-onset infant group B Streptococcus infection associated with maternal consumption of capsules containing dehydrated placenta - Oregon, 2016. MMWR Morb Mortal Wkly Rep. 2017 Jun 30;66(25):677-8.[Abstract][Full Text]
55. 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].[Abstract][Full Text]
56. Powers RJ, Wirtschafter D; Perinatal Quality Improvement Panel of the California Perinatal Quality Care Collaborative. Prevention of group B streptococcus early-onset disease: a toolkit by the California Perinatal Quality Care Collaborative. J Perinatol. 2010 Feb;30(2):77-87.[Abstract]
57. Ohlsson A, Shah VS. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev. 2014 Jun 10;(6):CD007467.[Abstract][Full Text]
58. Buetti N, Marschall J, Drees M, et al. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol. 2022 Apr 19;43(5):1-17.[Abstract][Full Text]
59. World Health Organization. Group B streptococcus vaccine: full value vaccine assessment. 2 November 2021 [internet publication].[Full Text]
60. Ohlsson A, Shah VS, Stade BC. Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection. Cochrane Database Syst Rev. 2014 Dec 14;(12):CD003520.[Abstract][Full Text]
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62. Colbourn TE, Asseburg C, Bojke L, et al. Preventive strategies for group B streptococcal and other bacterial infections in early infancy: cost effectiveness and value of information analyses. BMJ. 2007 Sep 29;335(7621):655.[Abstract][Full Text]
63. National Institute for Health and Care Excellence (UK). Neonatal infection: antibiotics for prevention and treatment. April 2021 [internet publication].[Full Text]
64. Puopolo KM, Lynfield R, Cummings JJ, et al. Management of infants at risk for group B streptococcal disease. Pediatrics. 2019 Aug;144(2):e20191881.[Abstract][Full Text]
65. Paredes A, Wong P, Mason EO, et al. Nocosomial transmission of group B streptococci in a newborn nursery. Pediatrics. 1977 May;59(5):679-82.[Abstract]
66. Ray B, Mangalore J, Harikumar C, et al. Is lumbar puncture necessary for the evaluation of early neonatal sepsis? Arch Dis Child. 2006 Dec;91(12):1033-5.[Abstract][Full Text]
67. Nolla JM, Gomez-Vaquero C, Corbella X, et al. Group B streptococcus (Streptococcus agalactiae) pyogenic arthritis in nonpregnant adults. Medicine. 2003 Mar;82(2):119-28.[Abstract]
68. Honest H, Sharma S, Khan KS. Rapid tests for group B streptococcus colonization in laboring women: a systematic review. Pediatrics. 2006 Apr;117(4):1055-66.[Abstract]
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72. Taminato M, Fram D, Torloni MR, et al. Screening for group B streptococcus in pregnant women: a systematic review and meta-analysis. Rev Lat Am Enfermagem. 2011;19(6):1470-8.[Abstract][Full Text]
73. Larsen JW, Serve JL. Group B streptococcus and pregnancy: a review. Am J Obstet Gynecol. 2008 Apr;198(4):440-8.[Abstract]
74. Puopolo KM, Madoff LC, Eichenwald EC. Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics. 2005 May;115(5):1240-6.[Abstract]
75. Yancey MK, Schuchat A, Brown LK, et al. The accuracy of late antenatal screening cultures in predicting genital group B streptococcal colonization at delivery. Obstet Gynecol. 1996 Nov;88(5):811-5.[Abstract]
76. Valkenburg-van den Berg AW, Houtman-Roelofsen RL, Oostvogel PM, et al. Timing of group B streptococcus screening in pregnancy: a systematic review. Gynecol Obstet Invest. 2010;69(3):174-83.[Abstract]
77. Shah V, Ohlsson A; Canadian Task Force on Preventive Health Care. Prevention of early-onset group B streptococcal (GBS) infection in the newborn: systematic review and recommendations CTFPHC technical report 01-6. May 2001 [interent publication].[Full Text]
78. Colbourn T, Asseburg C, Bojke L, et al. Prenatal screening and treatment strategies to prevent group B streptococcal and other bacterial infections in early infancy: cost-effectiveness and expected value of information analyses. Health Technol Assess. 2007 Aug;11(29):1-226.[Abstract]
79. Daniels J, Gray J, Pattison H, et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess. 2007 Aug;11(29):1-226.[Abstract]
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81. Yudin MH, van Schalkwyk J, Van Eyk N, et al. Antibiotic therapy in preterm premature rupture of the membranes. J Obstet Gynaecol Can. 2009 Sep;13(42):1-154.[Abstract]
82. Queensland Health Statewide Maternity and Neonatal Clinical Guidelines Program. Early onset group B streptococcal disease. April 2020 [internet publication].[Full Text]
83. Money D, Allen VM. No. 298 - The prevention of early-onset neonatal group B streptococcal disease. J Obstet Gynaecol Can. 2018 Aug;40(8):e665-74.[Abstract]
84. Van Dyke MK, Phares CR, Lynfield R, et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009 Jun 18;360(25):2626-36.[Abstract][Full Text]
85. Society for Maternal-Fetal Medicine. Eighteen things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2022 [internet publication].[Full Text]
86. American Society for Microbiology. Guidelines for the detection and identification of group B streptococcus. 29 July 2021 [internet publication].[Full Text]
87. Price D, Shaw E, Howard M, et al. Self-sampling for group B streptococcus in women 35 to 37 weeks pregnant is accurate and acceptable: a randomized cross-over trial. J Obstet Gynaecol Can. 2006 Dec;28(12):1083-8.[Abstract]
88. Bergeron MG, Danbing KE, Menard C, et al. Rapid detection of group B streptococci in pregnant women at delivery. N Engl J Med. 2000 Jul 20;343(3):175-9.[Abstract][Full Text]
89. Daniels R, Nutbeam T, McNamara G, et al. The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study. Emerg Med J. 2011 Jun;28(6):507-12.[Abstract][Full Text]
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91. US Food & Drug Administration. FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects. Mar 2018 [internet publication][Full Text]
92. European Medicines Agency. Quinolone- and fluoroquinolone-containing medicinal products. 19 March 2019 [internet publication].[Full Text]
93. US Food & Drug Administration. FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Jul 2018 [internet publication].[Full Text]
94. US Food & Drug Administration. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Dec 2018 [internet publication].[Full Text]
95. Baecher L, Grobman W. Prenatal antibiotic treatment does not decrease group B streptococcus colonization at delivery. Int J Gynaecol Obstet. 2008 May;101(2):125-8.[Abstract]
96. Absalon J, Segall N, Block SL, et al. Safety and immunogenicity of a novel hexavalent group B streptococcus conjugate vaccine in healthy, non-pregnant adults: a phase 1/2, randomised, placebo-controlled, observer-blinded, dose-escalation trial. Lancet Infect Dis. 2021 Feb;21(2):263-74.[Abstract]
97. ClinicalTrials.gov. Trial to evaluate the safety, tolerability, and immunogenicity of a multivalent group B streptococcus vaccine in healthy nonpregnant women and pregnant women and their infants. 15 April 2022 [internet publication].[Full Text]
98. ClinicalTrials.gov. Study of a group B streptococcus vaccine in pregnant women living with HIV and in pregnant women who do not have HIV. 2 March 2022 [internet publication].[Full Text]
99. Allen VM, Yudin MH. No. 276 - Management of group B streptococcal bacteriuria in pregnancy. J Obstet Gynaecol Can. 2018 Feb;40(2):e181-6.[Abstract]
100. Sambola A, Miro JM, Tornos MP, et al. Streptococcus agalactiae infective endocarditis: analysis of 30 cases and review of the literature. Clin Infect Dis. 2002 Jun 15;34(12):1576-84.[Abstract]
101. Harrison LH, Ali A, Dwyer DM, et al. Relapsing invasive group B streptococcal Infection in adults. Ann Intern Med. 1995 Sep 15;123(6):421-7.[Abstract]
102. Kohli-Lynch M, Russell NJ, Seale AC, et al. Neurodevelopmental impairment in children after group B streptococcal disease worldwide: systematic review and meta-analyses. Clin Infect Dis. 2017 Nov 6;65(suppl_2):S190-S9.[Abstract][Full Text]
103. Horváth-Puhó E, van Kassel MN, Gonçalves BP, et al. Mortality, neurodevelopmental impairments, and economic outcomes after invasive group B streptococcal disease in early infancy in Denmark and the Netherlands: a national matched cohort study. Lancet Child Adolesc Health. 2021 Jun;5(6):398-407.[Abstract][Full Text]
104. Holmstrom B, Grimsley EW. Necrotizing fasciitis and toxic shock-like syndrome caused by group B streptococcus. South Med J. 2000 Nov;93(11):1096-8.[Abstract]
105. Sarani B, Strong M, Pascual J, et al. Necrotizing fasciitis: current concepts and review of the literature. Am Coll Surg. 2009 Feb;208(2):279-88.[Abstract]
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