Definition of "Group B streptococcal infection"
Group B streptococcal infection (aka strep B, group B strep) is infection with bacteria of group B streptococcus, which only has 1 specie: Streptococcus agalactiae. It can cause serious illness and sometimes death especially in newborns, the elderly, and Pt's with compromised immune systems. It can also cause inflammation of the udder in dairy cows, hence the name "agalactiae" meaning "no milk".
Patient information
What is group B strep?It's infection with Strep agalactiae bacteria.
Wait. That sounds like galactorrhea?
It should, because it's derivation is from the word "no milk". It causes inflammation in the udder of dairy cows.
- Streptococcus agalactiae (aka group B streptococcus, GBS) is a gram-positive coccus (round bacterium) with a tendency to form chains, as reflected by the genus name Streptococcus. It is a beta-hemolytic, catalase-negative, and facultative anaerobe. In general, GBS is a harmless commensal bacterium being part of the human microbiota colonizing the GI and genitourinary tract of up to 30% of healthy human adults (asymptomatic carriers). Streptococcus agalactiae is the species desgination for streptococci belonging to group B of the Lancefield classification. It is surrounded by a bacterial capsule composed of polysaccharides (exopolysaccharide). The species is subclassified into 10 serotypes (Ia, Ib, II-IX) depending on the immunologic reactivity of their polysaccharide capsule
- GBS is apart of normal gut flora, with around 17% in the genital tract, and in 30% of women
- It may be harmful to both mother and baby
- It can result in severel neonatal infection thus death, and also maternal death, as a upper genital tract infection can progress into septicemia
- Since 30% of women are colonized with GBS in the vagina/rectum, and the bacteria can come and go, testing for GBS is recommended at the 36th week antenatal appointment
Patient information
So why does it matter if you get this "no dairy milk" bacteria, if you're a human mom?It can be harmful to both mom and bub. In both mom and bub, it can cause death. Just remember that as with all infections, they can be deadly if they make their way into blood.
Where does this no dairy milk bacteria, come from?
You find it normally in the tummy tract. We have concern if we find it in the genital tract.
You give birth usually at 39-40 weeks. Why wait until the 36th week to test for GBS?
Remember that it's normally found in the human body. It comes and go. That's why we wait until that date.
- CAMP test, uses the characteristic that GBS is characterized by the presence of group B Lancefield antigen, and its ability to hydrolyze sodium hippurate
- Check for PROM (Pooling test, Nitrazine paper test, Ferning test) → if PROM (however early) and cultured for GBS, give abx
Patient information
How do you test for it?CAMP test.
I'm just thinking Demi Lovato and Camp Rock here. What's camp 
?
It's just a particular test we use to identify group B strep.
What else can we do?
We should also check for whether there has been breaking of the amniotic sac >1 hour before the onset of labor, which we call PROM. For that, we can observe for fluid, or do a test on that fluid. If there has been a breakage, and the fluid there has group B strep bacteria, we want to fix that with antibiotics.
- Prevention, w/ a vaginal swab done at 36 weeks gestation
- For GBS +ve women, IV benpen or ampicillin at the onset of labor, and again every 4 hours. Where there is a pencillin allergy, IV clindamycin can be used instead
- For PROM that is at term, if GBS is +ve, offer IOL
Source: QLD Health
Patient information
What can you do if you have an infection with this no dairy milk, bacteria?We try to prevent it, by identifying the problem early with a vaginal swab, at 36 weeks, at a time early enough to start antibiotics, but not too early that it unnecessary detects this very common bacteria.
And since it's a bacteria, we give antibiotics. When do we do this?
So if the woman comes back GBS positive, we give penicillin. We give it on the onset of labor, and again every 4 hours. If the patient has a penicillin allergy, we can give clindamycin. And as mentioned before, we also give it whenever a mother has PROM, when we'd also start speeding up the labor, which we call induction.
How's it given?
Because we want quick action 
we give it IV.
- Guillain-Barre Syndrome (also abbreviation for GBS)
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