Streptococcus Group B Infections Follow-up
- Author: Christian J Woods, MD, FCCP; Chief Editor: Michael Stuart Bronze, MD more...
Both chemoprophylaxis and immunoprophylaxis have been studied as a means to prevent group B streptococcal infection in neonates.
While a group B streptococcal vaccine to prevent infection in women of childbearing age has been studied, an FDA–licensed vaccine in not yet available. Investigational vaccine studies are underway.
Chemoprophylaxis has been shown to be efficacious in neonates. A significant decline in neonatal infections over the past decade may be a result of this national standard.
The only approach for preventing group B streptococcal infection in nonpregnant adults is to adhere to infection control practices, as a significant number of these infections are nosocomial. The percentage of infections that can be prevented is unknown, as single nosocomial cases are common but a clustering of cases is rare.
Group B streptococcal infection in healthy women is usually amenable to therapy without major sequelae.
Neonatal infection, which still results in significant morbidity and mortality, has become less common and is more likely to have a better outcome because of chemoprophylaxis and early recognition of infection in infants.
Group B streptococcal infection in the nonpregnant adult carries a high risk of morbidity and mortality, even with early and appropriate therapy. The prognosis may be improved with a high index of clinical suspicion, initiation of early therapy after cultures are obtained, and procurement of an appropriate surgical opinion and adequate surgical intervention, when necessary.
Group B streptococcal infection in healthy women carries an excellent prognosis. In neonates, the infection carries a better prognosis than it once did but still results in significant morbidity and mortality. Nonpregnant adults with group B streptococcal infection are typically elderly with comorbid conditions. Therefore, high mortality rates are inherent in those who develop infection.
Nonpregnant adults who survive group B streptococcal infection typically retain the underlying risk factor that originally placed them at risk for infection; therefore, the long-term prognosis in these patients is still poor.
Nandyal RR. Update on group B streptococcal infections: perinatal and neonatal periods. J Perinat Neonatal Nurs. 2008 Jul-Sep. 22(3):230-7. [Medline].
Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease: a public health perspective. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1996 May 31. 45:1-24. [Medline].
Huang PY, Lee MH, Yang CC, Leu HS. Group B streptococcal bacteremia in non-pregnant adults. J Microbiol Immunol Infect. 2006 Jun. 39(3):237-41. [Medline].
Sendi P, Johansson L, Norrby-Teglund A. Invasive group B Streptococcal disease in non-pregnant adults : a review with emphasis on skin and soft-tissue infections. Infection. 2008 Mar. 36(2):100-11. [Medline].
Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S, et al. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. JAMA. 2008 May 7. 299(17):2056-65. [Medline].
Gardam MA, Low DE, Saginur R. Group B streptococcal necrotizing fasciitis and streptococcal toxic shock-like syndrome in adults. Arch Intern Med. 1998. 158:1704-8. [Medline].
Daniels J, Gray J, Pattison H, Roberts T, Edwards E, Milner P, et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess. 2009 Sep. 13(42):1-154, iii-iv. [Medline].
Lin FY, Weisman LE, Azimi P, Young AE, Chang K, Cielo M, et al. Assessment of Intrapartum Antibiotic Prophylaxis for the Prevention of Early-onset Group B Streptococcal Disease. Pediatr Infect Dis J. 2011 Sep. 30(9):759-763. [Medline]. [Full Text].
Schwope OI, Chen KT, Mehta I, Re M, Rand L. The effect of a chlorhexidine-based surgical lubricant during pelvic examination on the detection of group B Streptococcus. Am J Obstet Gynecol. 2010 Mar. 202(3):276.e1-3. [Medline].
Wu HM, Janapatla RP, Ho YR, Hung KH, Wu CW, Yan JJ, et al. Emergence of fluoroquinolone resistance in group B streptococcal isolates in Taiwan. Antimicrob Agents Chemother. 2008 May. 52(5):1888-90. [Medline].
Bayer AS, Chow AW, Anthony BF. Serious infections in adults due to group B streptococci. Clinical and serotypic characterization. Am J Med. 1976. 61:498-503. [Medline].
Berardi A, Rossi C, Lugli L, Creti R, Bacchi Reggiani ML, et al. Group B streptococcus late-onset disease: 2003-2010. Pediatrics. 2013 Feb. 131(2):e361-8. [Medline].
Colford JM Jr, Mohle-Boetani J, Vosti KL. Group B streptococcal bacteremia in adults. Five years' experience and a review of the literature. Medicine (Baltimore). 1995 Jul. 74(4):176-90. [Medline].
Dworzack DL, Hodges GR, Barnes WG. Group B streptococcal infections in adult males. Am J Med Sci. 1979. 277:67-73. [Medline].
Farley MM, Harvey RC, Stull T. A population-based assessment of invasive disease due to group B Streptococcus in nonpregnant adults. N Engl J Med. 1993. 328:1807-11. [Medline].
Gallagher PG, Watanakunakorn C. Group B streptococcal bacteremia in a community teaching hospital. Am J Med. 1985 May. 78(5):795-800. [Medline].
Harrison LH, Ali A, Dwyer DM. Relapsing invasive group B streptococcal infection in adults. Ann Intern Med. 1995. 123:421-7. [Medline].
Jackson LA, Hilsdon R, Farley MM. Risk factors for group B streptococcal disease in adults. Ann Intern Med. 1995. 123:415-20. [Medline].
Lerner PI. Meningitis caused by Streptococcus in adults. J Infect Dis. 1975. 131 Suppl:S9-16. [Medline].
Lerner PI, Gopalakrishna KV, Wolinsky E. Group B streptococcus (S. agalactiae) bacteremia in adults: analysis of 32 cases and review of the literature. Medicine (Baltimore). 1977. 56:457-73. [Medline].
Opal SM, Cross A, Palmer M. Group B streptococcal sepsis in adults and infants. Contrasts and comparisons. Arch Intern Med. 1988. 148:641-5. [Medline].
Persson E, Berg S, Bergseng H, Bergh K, Valsö-Lyng R, Trollfors B. Antimicrobial susceptibility of invasive group B streptococcal isolates from south-west Sweden 1988-2001. Scand J Infect Dis. 2008. 40(4):308-13. [Medline].
Pullen LC. Mothers may be key source of LOD Strep in neonates. Medscape Medical News. January 7, 2013. Available at http://www.medscape.com/viewarticle/777188. Accessed: March 4, 2013.
Schuchat A. Group B streptococcus. Lancet. 1999 Jan 2. 353(9146):51-6. [Medline].
Schwartz B, Schuchat A, Oxtoby MJ. Invasive group B streptococcal disease in adults. A population-based study in metropolitan Atlanta. JAMA. 1991. 266:1112-4. [Medline].
Trivalle C, Martin E, Martel P. Group B streptococcal bacteraemia in the elderly. J Med Microbiol. 1998. 47:649-52. [Medline].
Verghese A, Mireault K, Arbeit RD. Group B streptococcal bacteremia in men. Rev Infect Dis. 1986. 8:912-7. [Medline].
Eden PR, Herring CF 3rd. Group B streptococcus testing. MLO Med Lab Obs. 2015 Jul. 47 (7):52. [Medline].