Deterrence/Prevention

Both chemoprophylaxis and immunoprophylaxis have been studied as a means to prevent group B streptococcal infection in neonates.

Although a group B streptococcal vaccine to prevent infection in women of childbearing age has been studied, an FDA–licensed vaccine is 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 for 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.

Questions

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Author

Christian J Woods, MD, FACP, FCCP, FIDSA Associate Program Director for Internal Medicine, Program Director for Pulmonary/Critical Care, Associate MICU Director, Attending in Infectious Diseases/Pulmonary/Critical Care, MedStar Washington Hospital Center

Christian J Woods, MD, FACP, FCCP, FIDSA is a member of the following medical societies: American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Ihab Masri, MD Resident Physician, Department of Internal Medicine, Medstar Washington Hospital Center

Ihab Masri, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Cindy McCartney, MD Resident Physician, Department of Internal Medicine, Medstar Georgetown University/Washington Hospital Center

Cindy McCartney, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John L Brusch, MD, FACP Corresponding Faculty Member, Harvard Medical School

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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, Medical Society of the District of Columbia

Disclosure: Nothing to disclose.

Acknowledgements

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

Sections Group B Streptococcus (GBS) Infections
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