Medical Abbreviations: A Closer Look at GBS

GBS or Group B Streptococcus is a bacteria infection, and is one of the leading causes of morbidity and mortality among newborns and the leading cause of neonatal infections. It affects newborns, pregnant women and adults with underlying medical conditions. This pathogen emerged in the 1970’s, and there are two different forms of GBS; early-onset which occurs at seven days or less, and late-onset which occurs between 7 and 90 days of life.

If a mother is GBS positive, then she can pass it on to her baby during delivery. Early and late-onset infections can be very serious and cause inflammation of the newborns blood, lungs, brain or spinal cord. In 1992, the American Academy of Pediatrics established a set of guidelines for prevention of early-onset Group B streptococcus through administration of antibiotics to GBS positive mothers during labor. The guideline established a protocol of screening mothers at 35-37 weeks to see if they have colonized the bacterium. Often times those adults who have colonized the bacteria have had no physical effects from it. By screening expectant mothers before delivery, practitioners can include in their labor protocol the need for antibiotic administration while the woman labors. Of important note is that the guidelines are merely that, so not all obstetrical practitioners have adopted them into their practice. However, for those that have adopted the guidelines there has been a 70% decline in the number of early-onset infection.

Premature infants have a 10 to 15 fold increased risk for early-onset GBS sepsis. For this very specific population, differential diagnoses can be very difficult because of the general presentation of the premature infant. For those infants who are born less than 35 weeks and do not show signs of infection, a 48 hour in hospital observation period is indicated. For those infants who may appear to be symptomatic (breathing issues, difficulty feeding, temperature), a blood culture and complete blood count are obtained to assess for infection. Antibiotic therapy is then initiated. If the blood culture results are negative after 48 to 72 hours then antibiotics are discontinued. If the blood cultures results are positive then antibiotic therapy is extended for at least a seven day course.

References:

Apgar, B.S., Greenburg, G., Yen G. Prevention of Group B Streptococcal Disease in the Newborn. American Family Physician (2005) 71(5): 903-910.

Center for Disease Control and Prevention GBS Disease Program Overview. Retrieved May 2007 from http://www.csc.gov/groupBstrep/doc/GBSoverview.110402.pdf

Center for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective. Morbidity and Mortality Weekly Report 1996; 45(RR -7):1-24.

American College of Obstetricians and Gynecologists. ACOG Committee Opinion: number 279, December 2002. Prevention of early onset group B streptococcal disease in newborns. Obstetrics and Gynecology 2002; 100:1405-12.

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