Strep B in newborns?

Ingvar.Eliasson at Ingvar.Eliasson at
Tue Mar 14 15:38:42 EST 1995

>I have a friend who just before giving birth was diagnosed with 
>a Streptococcal type b infection. She was told at the time that
>this could have killed her baby if they hadn't caught it in time, and 
>I thought this was somewhat unusual. My question to someone is this: 
>Have you heard of Streptococcal infections in newborns, and if so 
>what is your experience with them? What are the symptoms and 
>pathogenesis of this sort of infection?

It is not unusual for fertile women to be colonized with Group B 
Streptococci (GBS) in the genitourinary tract. In fact, GBS is to be 
considered as part of the commencal flora of the urethra and cervix.

Thus, the first question is: Was she diagnosed as having a GBS 
infection, or was she just culture positive? Screening for GBS is of 
doubtful value in a general population of pregnant women.

A large number of children are transiently colonized with GBS during 
delivery, and this is usually completely harmless. However, in rare 
instances, GBS have the potenrial to cause neonatal infection, which 
can at worst be fatal to the newborn child. In order for severe 
infection to occur, the mother must be 1) colonized with GBS and 2) 
deficient in producing antibodies towards the type specific 
carbohydrate antigens of the strain she is carrying. Possibly, also 
other factors are of importance. Thus, neonatal GBS infection affects 
children of mothers with a mild immunodeficiency, mainly lacking the 
ability to produce anti-carbohydrate antibodies.

To conclude, a pregnant woman who is GBS-positive in the cervix or 
urethra, and has no history of complications in earlier pregnancies, 
has nothing to worry about.

In cases where there is a history of neonatal GBS infection in the 
past, screening for GBS and profylactic antibiotic is indicated. This 
procedure should be well known by the obstetrician/gynecologist. If a 
method is locally available, determination of antibody levels is also 
of great value.

If anyone is in need for more knowledge in this field, please let me 
know, and I will compile a list of references.

Best regards


************< Ingvar.Eliasson at >************
 Ingvar Eliasson, M.D., Ph.D.
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