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Group - B Streptococcal Infection
Group - B Streptococcal Infection
Group - B Streptococcal Infection
STREPTOCOCCAL
INFECTION
INTRODUCTION
Group B streptococci-Streptococcus agalactiae is a gram positive
encapsulated coccus
Important cause of perinatal morbidity and mortality .
20% and 30% of pregnant women are colonized with GBS in the
vagina or rectum .
Gram positive cocci colonizes in the gastrointestinal tract with
secondary to genito urinary tract.
Invasive group B streptococcal disease in the newborn: can cause
early & late neonanatal sepsis..
EPIDEMIOLOGY
PREVELENCE: 0.5 per 1000 live birth
Attack rate in colonized patients with
risk factor : 40 to 50%
absence of risk factors
< 5%
Neonatal mortality rate if
RISK FACTORS PRESENT: 35%
NO RISK FACTORS : <5%
CLINICAL
INFECTION
Maternal
Neonatal
NEONATAL INFECTION
Early Onset
Neonatal
onset
neonatal
Early
Onset Neonatal Late
Late
onset
neonatal
outcome outcome
outcomes
outcome
Vertical transmission during
labour from mother to the baby
Menigitis , pneumonia
RECOMMENDED PREVENTION
STRATEGIES
CULTURE BASED SCREENING APPROACH
Recommended universal screening for GBS
is between
Table 2.Indications and Nonindications for Intrapartum Antibiotic Prophylaxis to Prevent Early-Onset Group B Streptococcal Disease
EVALUATION
Laboratory testing with culture media, which typically requires 36 to 72
hours of incubation time,
Blood agar
selective enrichment broth (that is, Lim Broth, TransVag Broth or
Carrot Broth)
latex agglutination methods
Optical immunoassay, enzyme immunoassay, and DNA hybridization
polymerase chain reaction (PCR) or nucleic acid amplification tests
(NAAT)
CARROT
BROTH
Xpert GBS
assay
PARTUM
Penicillin remains the agentINTRA
of choice
for intrapartum
PROPHYLAXSIS
prophylaxis.
REGIMEN
TREATMENT
RECOMMENDED
ALTERNtive
Penicillin allergic
NEONATAL GROUP B
SEPTIECEMIA
The infant's risk for
group B streptococcal septicemia:
prematurity, preterm labor
Mother who has already given birth to a baby with GBS sepsis
SYMPTOMS
Anxious or stressed appearance
cyanosis
Breathing difficulties such as:
Flaring of the nostrils
Grunting noises
Rapid breathing
Apnea
Tachycardia/ bradicardia
Pallor with cold skin
Poor feeding
Unstable body temperature (low or high)
Investigations::
Blood clotting tests - prothrombin time (PT) and
partial thromboplastin time (PTT)
Blood gases (to see if the baby needs help with
breathing)
Complete blood count
CSF culture (to check for meningitis)
Urine culture
X-ray of the chest
Complications:
DIC
Pneumonia
Hypoglycemia
Respiratory distress
Meningitis
TREATMENT:
IV Antibiotics: inj. Penicillin/ ampicillin
PREVENTION:
GBS screening during 35-37weeks
Teatment with iv antibiotic during labour.
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