Group B Streptococcus and Pregnancy

Abstract

Group B streptococcus, or Streptococcus agalactiae, is a gram-positive bacterium commonly found in the genital and gastrointestinal tracts of humans and less frequently in the upper respiratory tracts of children and adults, which poses significant health risks, particularly to neonates, young infants, pregnant women, and those with certain medical conditions. Group B streptococcus can colonize the gastrointestinal and vaginal tracts of up to one-third of pregnant individuals and can cause various infections, including asymptomatic bacteriuria, urinary tract infections, chorioamnionitis, postpartum endometritis, pneumonia, puerperal sepsis, and bacteremia. Although group B streptococcus accounts for a small percentage of urinary tract infections and peripartum bacteremia during pregnancy, it can occasionally lead to meningitis and endocarditis. However, vertical transmission of group B streptococcus during vaginal birth can result in early-onset group B streptococcus disease in newborns, posing the most significant risks to the neonate, including bacteremia, sepsis, and death. Universal third-trimester screening and intrapartum antibiotic prophylaxis have significantly reduced neonatal group B streptococcus infections, although these measures may have unintended consequences for mothers and infants. Effective prevention of neonatal group B streptococcus disease depends on proper screening, timely antibiotic administration, and coordination with pediatric care clinicians. Despite CDC recommendations for routine group B streptococcus screening and intrapartum antibiotics, group B streptococcus remains a leading cause of early-onset neonatal sepsis in the India. Up to 40% of individuals who test positive for group B streptococcus during prenatal care may test negative at delivery, leading to significant overtreatment and increasing antibiotic resistance. Therefore, new therapeutics to prevent group B streptococcus colonization at delivery are still being investigated. This activity for healthcare professionals is designed to enhance the learner's competence in recognizing the significance of group B streptococcus in pregnancy, performing the recommended evaluation, and implementing appropriate interprofessional preventive management approaches to improve patient outcomes.

Objectives: •Screen for group B streptococcal infection in pregnancy sing established protocols. •Implement intrapartum antibiotic prophylaxis (IAP) guidelines based on GBS screening results and patient risk factors •Select the appropriate treatment for group B streptococcal infection in pregnancy. •Implement interprofessional team strategies to improve care coordination and outcomes in patients with group B streptococcal infection during pregnancy.