GBS Positive - Types, Symptoms, Diagnosis, and Treatment

Introduction

Group B streptococcus (GBS), also called Streptococcus agalactiae, is a common bacteria in the body. It colonizes the gastrointestinal, genitourinary, and upper respiratory tract and comes and goes naturally without symptoms. Although the bacteria are harmless in healthy individuals, they can cause severe conditions in people of all ages. In addition, they can cause postpartum infections and blood infections in newborns.

What Causes Group B Streptococcus Infections?

Most healthy individuals carry the group B streptococcus in their bodies. It commonly lives in the vagina, gastrointestinal tract, and upper respiratory tract. The portal of entry of the organism is not identified yet but could include the skin, urinary tract, genital tract, and respiratory tract. They come and go naturally and may not cause any symptoms. However, they may invade the body and cause infections known as GBS disease. In babies, the bacteria is spread during a vaginal delivery, as the baby might get exposed or swallow the fluids containing the bacteria.

What Are the Types of GBS Infections?

The GBS bacteria can cause several types of infections:

• Bacteremia.

• Bone infection.

• Pneumonia.

• Sepsis.

• Skin and soft tissue infections.

• Meningitis.

Who Is at Risk of Developing GBS?

Although many healthy individuals are carriers of the bacteria, some people are at a higher risk of developing the disease.

Newborns are at risk of the disease if:

• The mother tests GBS positive late in pregnancy.

• The mother develops a fever during labor.

• Having a gap of 18 hours or more between the mother’s water breaking and the baby’s birth.

• The baby is born earlier than 37 weeks.

• The mother develops an infection of the amniotic fluid and the placental tissue.

• The mother develops a urinary tract infection during pregnancy.

Adults over the age of 65 or who have an underlying medical condition are at risk of developing the disease. Medical conditions like heart disease, diabetes, cancer, AIDS (acquired immunodeficiency syndrome), liver diseases, and obesity may impair immunity, making them more susceptible to bacteria.

What Are the Signs And Symptoms of GBS Disease?

The signs and symptoms of GBS in adults and infants are different. In newborns, the symptoms caused by GBS can appear within six hours of birth (early onset) or months after birth (late onset).

Symptoms of a GBS infection in newborns include:

• Breathlessness.

• Fever.

• Irritability.

• Difficulty feeding.

• Seizures.

• Jaundice.

• Low body temperature.

• Jitteriness.

• Rash.

• Weak muscle tone.

• Sluggishness.

In adults, the group B streptococcus usually is in the vagina, rectum, bowel, bladder, or throat and may have no symptoms. However, in some cases, it may cause symptoms including:

• Urinary Tract Infections:

  • Pelvic pain.

  • Burning sensation and pain when urinating.

  • Persistent urge to urinate and small amounts of urine.

  • Dark-colored urine - red, bright pink, or cola-colored.

• Bacteremia and Sepsis:

  • Fever.

  • Chills.

  • Confusions.

  • Malaise.

  • Chest pain.

  • Muscle pain

  • Joint pain.

• Pneumonia (Lung Infection):

  • Fever.

  • Cough.

  • Chills.

  • Breathing difficulty.

  • Chest pain.

• Skin and Soft Tissue Infection:

  • A red bump on the skin.

  • Swelling.

  • Warm to touch.

  • Filled with pus or other drainages.

  • Fever.

  • Localized pain.

• Bone and Joint Infections:

  • Fever.

  • Swelling.

  • Chills.

  • Stiffness of the limb.

  • Pain.

  • Inability to move the affected joint.

• Meningitis:

  • Fever.

  • Headache.

  • Neck stiffness.

  • Confusion.

How Is a GBS Disease Diagnosed?

If a GBS infection is suspected, the doctor will take a sample of sterile body fluids, including blood and spinal fluid. The doctor then checks the samples (cultures) for the presence of GBS bacteria. The test may take a few days as the bacteria requires time to grow. The doctor may also advise a chest X-ray and urine test to diagnose a GBS infection.

How Is a GBS Infection Treated?

The treatment for GBS disease would depend on the type of infection by the bacteria. A class of antibiotics called beta-lactams is used to treat GBS diseases, including Penicillin and Ampicillin. Soft tissue and bone infections may require additional treatment, such as surgery. People must consult the doctor for a specific treatment option.

What Are the Complications of GBS Infections?

Group B streptococcus may cause long-term disabilities in newborns, like deafness and developmental disabilities. GBS infection may lead to life-threatening diseases in newborns, including pneumonia, meningitis, and bacteremia.

In pregnant women, GBS infections can cause:

• Miscarriages.

• Stillbirths.

• Preterm delivery.

• Urinary tract infection.

• Infection of the amniotic fluid and placenta

• Endometriosis.

• Bacteremia.

In older adults and people having an underlying medical condition, GBS bacteria can cause:

• Skin infections.

• Urinary tract infections.

• Pneumonia.

• Meningitis.

• Endocarditis.

• Bone infection.

• Sepsis.

Serious GBS infections can be deadly for adults, even with appropriate therapy. One in 20 non-pregnant adults dies from serious GBS infection.

How Is GBS Prevented?

To prevent GBS infection in newborns:

• Test pregnant women for GBS bacteria.

• Antibiotics during labor to women at higher risk of the disease.

The American college of obstetricians and gynecologists recommends a GBS screening test for pregnant women during the 36th to 37th week. A woman can test positive for GBS and show no symptoms; hence a screening test is necessary during pregnancy. The doctor uses a sterile swab and collects a sample from the vagina and the rectum. A positive GBS test may indicate the presence of group B streptococcus bacteria and a probability of passing the bacteria to the baby.

To prevent the bacteria from spreading to the baby, the doctor may give intravenous (IV) antibiotics when the labor begins. However, antibiotics can help protect the baby from infection only if given during labor. The class of antibiotics called beta-lactams, including Penicillin and Ampicillin, are effective against GBS infection. Prior oral antibiotics are ineffective in protecting the baby because the bacteria can return before labor begins. In rare situations, some women may have a severe allergic reaction that needs emergency treatment.

Conclusion

GBS positive test indicates the presence of group B streptococcus in the body. They live in the gastrointestinal tract, genital tract, and upper respiratory tract of healthy individuals with no symptoms. However, these can cause deadly conditions in newborns and adults above the age of 65 or who have underlying medical conditions. The spread of the disease in adults is unknown, but a newborn may acquire the infection during vaginal delivery from their mother. Treatment for GBS infections could be dependent on the type of infection. Antibiotics like Penicillin and Ampicillin are effective in pregnant women in preventing the spread of the bacteria to the baby. There is currently no vaccine against GBS bacteria, but researchers are working on developing a vaccine that could be helpful in the future.