eMedicine Specialties > Infectious Diseases > Bacterial Infections

Streptococcus Group B Infections: Follow-up

Author: Christian J Woods, MD, Fellow, Infectious Diseases Program, Department of Pulmonary Critical Care, Georgetown University Hospital, Washington Hospital Center
Coauthor(s): Charles S Levy, MD, Associate Professor, Department of Medicine, Section of Infectious Disease, George Washington University School of Medicine
Contributor Information and Disclosures

Updated: Nov 11, 2009

Follow-up

Deterrence/Prevention

  • 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.

Complications

  • 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.

Prognosis

  • 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.

Miscellaneous

Medicolegal Pitfalls

  • Early clinical suspicion for group B streptococcal infection is important.
  • Early and appropriate long-term parenteral antibiotic therapy and surgical intervention adequate to cure the infection are critical.
    • Inadequate antibiotic or inadequate surgery can result in relapse.
    • Recurrent infection can be observed, even with satisfactory medical and surgical care.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Mohamad Ossiani, MD, to the development and writing of this article.



More on Streptococcus Group B Infections

Overview: Streptococcus Group B Infections
Differential Diagnoses & Workup: Streptococcus Group B Infections
Treatment & Medication: Streptococcus Group B Infections
Follow-up: Streptococcus Group B Infections
References
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Further Reading

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Keywords

Streptococcus agalactiae, S agalactiae, neonatal sepsis, postpartum infection, group B streptococci, group B Streptococcus, group B strep, GBS, group B streptococcal disease, streptococcal disease, coccus, cocci, group B bacteremia, bacteremia, bacterial pneumonia, group B streptococcal infection, beta-hemolytic streptococci, beta-hemolytic Streptococcus, beta-hemolytic strep

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Contributor Information and Disclosures

Author

Christian J Woods, MD, Fellow, Infectious Diseases Program, Department of Pulmonary Critical Care, Georgetown University Hospital, Washington Hospital Center
Christian J Woods, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Charles S Levy, MD, Associate Professor, Department of Medicine, Section of Infectious Disease, George Washington University School of Medicine
Charles S Levy, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, and Medical Society of the District of Columbia
Disclosure: Nothing to disclose.

Medical Editor

Pranatharthi Haran Chandrasekar, MD, Director of Infectious Disease Fellowship, Professor, Department of Internal Medicine, Harper Hospital, Wayne State University School of Medicine
Pranatharthi Haran Chandrasekar, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

John L Brusch, MD, FACP, Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance
John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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