STREP B What you need to know

Group B Streptococcus (GBS) is a normal bacterium which is carried by 20-30% of adults, most commonly in the gut, and for up to 25% of women, in the vagina, usually without symptoms or side-effects.

GBS can occasionally cause infection, most commonly in newborn babies, sometimes in adults and, very rarely, during pregnancy and before labour.

GBS is not a sexually transmitted disease. Treatment of a woman and her partner carrying GBS does not prevent recolonisation.

Group B Strep Infection In Newborn Babies

There are two types of GBS infection in newborns: early and late-onset.

Early-onset GBS infection is more common (2/3 of cases in babies) and occurs when the baby is up to 6 days old; a key symptom is the rapid development of breathing problems, associated with blood poisoning.

Late-onset GBS infection – usually presenting as GBS meningitis – occurs between age 6 days and 1 month and, more rarely, up to age 3 months. After 3 months’ old, GBS infection in babies is extremely rare.

GBS is recognised to cause preterm delivery, maternal infections, stillbirths and late miscarriages; and preterm babies are known to be at particular risk of GBS infection as their immune systems are not as well developed.

Overall, approximately one in every 1,000 babies born in the UK develops group B Strep infection.

On average in the UK, at least two babies a day develop a group B Strep infection one baby a week dies from their GBS infection, and one baby a week survives with long-term disabilities –physical, mental or both.

Currently, UK guidelines recommend a ‘risk factor’ approach to determine which women should be offered antibiotics in labour to prevent GBS infection in newborn babies. Testing is the only way to know if you are carrying GBS. If you are, steps can be taken that minimise the risk of your newborn baby developing GBS infection. However, routine screening of all pregnant women for GBS is not currently recommended by the UK National Screening Committee or the Royal College of Obstetricians & Gynaecologists.

Group B Streptococcus (GBS) is a normal bacterium carried by up to a third of adults, most commonly in the gut, and for up to 25% of women in the vagina, usually with no symptoms or side-effects. It is not a sexually transmitted disease.

In the UK, pregnant women are not offered testing routinely for group B Strep carriage, unlike in many other developed countries. Sensitive tests for GBS carriage are not widely available within the NHS, though they are available privately (click here) from less than £40.

If you want to find out whether you carry group B Strep, the sensitive ‘ECM’ (Enriched Culture Medium) test is available from those listed at www.gbss. org.uk/test who follow Public Health England’s guidelines for this test.

Group B Strep carriage may be detected when samples are taken for other reasons – but often it’s not, because the widely used NHS test was not developed to find group B Strep and, unsurprisingly, is not very good at doing so. The standard ‘non-specific’ NHS tests give a high proportion of falsely-negative results, though a positive result is reliable.

It’s good to know if you carry group B Strep during your pregnancy so preventative action can be taken to minimise the chance of your newborn baby developing group B Strep infection.

If group B Strep is detected at any time during your current pregnancy, you should be offered intravenous antibiotics from the start of your labour and regularly until your baby is born.

If GBS has been detected during your current pregnancy from a vaginal or rectal swab If group B Strep has been detected during your current pregnancy from a urine sample If group B Strep was detected during a previous pregnancy If a previous baby developed group B Strep infection.

Not every pregnant Mum who has GBS detected during her pregnancy will want intravenous antibiotics in labour. Many will, but others may decide not to have them unless there are other additional risk factors. Do discuss this with your midwife or doctor, or contact us.

If you decide against antibiotics in labour, it would be prudent for your newborn baby to be observed by trained staff for at least 12 hours.

Risk factors for group B Strep infection Pregnant women carrying group B Strep is perfectly normal. GBS can be present at any time – in a woman’s first pregnancy, or in one or more subsequent pregnancies. It can be a threat during pregnancy, around delivery and afterwards. There are certain situations which increase the chance a newborn baby may develop GBS infection.

THESE INCLUDE:

Mothers who have previously had a baby infected with GBS – risk is increased 10 times.

Mothers where GBS has been found in the urine at any time in this pregnancy –risk is increased 4 times.

Mothers who have been shown to carry GBS in this pregnancy – risk is increased 3 times.

The following clinical risk factors also increase the chance of a baby developing a GBS infection Mothers who have a raised temperature* during labour of 37.8°C or higher – risk is increased 4 times Labour starts or waters break before 37 weeks of pregnancy (i.e. preterm) – risk is increased 3 times Waters break more than 18 hours before delivery – risk is increased 3 times *A slightly raised temperature may be of less significance in a woman who has an epidural than in a woman who hasn’t.

Q: CAN I BREASTFEED IF I HAVE GBS?

Our medical advisory panel strongly recommends you should be encouraged to breastfeed your baby. Although there have been isolated cases describing GBS infection possibly related to breast milk contamination, the advantages of breast feeding will, in our medical advisory panel’s opinion, greatly outweigh the remote risk of transmitting GBS via breast feeding. High hygiene standards need to be maintained for all breastfeeding mothers, with the hands and nipple areas being kept clean.

July Is Group B Strep Awareness Month

Group B Strep is the UK’s most common cause of life-threatening infection in newborn babies.

Strepelle is a home-to-laboratory Group B Streptococcus (GBS) test which can be bought at www.strepelle.com or at independent pharmacies from £39.99, it simply allows pregnant women the opportunity to test for this devastating infection from 35 weeks, with the highest accuracy ECM testing. If positive they are sent a letter to give them access to the potentially life-saving antibiotics during labour.

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