Group B Streptococcus (GBS) is a natural bacteria and carried normally by 20 – 30% of UK adults. Most people who carry the infection have no symptoms and carriage can come and go over time. If a mother has tested positive for group B Strep during her pregnancy, antibiotics should be offered when labour starts.
What is group B Strep infection?
Although group B Strep infections are relatively uncommon, they can be very serious. Most babies who develop group B Strep infection recover completely with good medical care however sadly, 1 in 10 of those infection with group B Strep dies and at least 1 in 20 survive and suffer long term problems.
New born babies are most vulnerable to group B Strep infections and it is often the consequences of the infection which causes long term problems; group B Strep infections can cause septicaemia, pneumonia and meningitis.
Whilst group B Strep infection after the age of 3 months is very rare, it is the most common cause of bacterial meningitis in babies younger than 3 months old. Group B Strep is also the most common cause of infection in new born babies.
Without preventative medicine around 1 in 1000 babies a year would develop group B Strep infection. If mum is a carrier of group B Strep this risk increased to 1 in 300.
What treatment should I receive if I have tested positive for group B strep?
The current guidelines provided by the Royal College of Obstetricians and Gynaecologists recommend a prevention strategy based on risks factors. This involves offering women antibiotics at the start of labour when;
• Group B Strep has been detected from a swab or urine sample taken from mum during the current pregnancy.
• Mum has previously had a baby who had a group B Strep infection.
• Mum has a fever in labour.
However, carrying group B Strep has no symptoms so cannot be identified without testing. As a result, if Mum has not had any symptoms because routine testing is not available unless any of the above risk factors apply, many new born babies at risk of group B Strep infection will be unprotected by the current prevention strategy. Whilst most babies born to women carrying group B Strep will not become infected, for those who do, it can be very serious.
Testing for group B Strep
Whilst the current guidelines recommend a prevention strategy based on risk factors, a number of NHS Trusts do offer group B Strep testing to some or all pregnancy women. If you are pregnant and concerned about group B Strep, you should ask your midwife or check the website, www.gbss.org.uk/test for the latest information.
Regrettably however, the NHS uses an all purpose test for group B Strep carriage rather than enriched culture medium (ECM) test which is much more effective at detecting group B Strep carriage and is very good at predicting carriage status for the 5 weeks after the swabs are taken. This means that even when a mother is carrying group B Strep, if the testing is performed on the NHS, she has a 50/50 chance of being told she doesn’t carry group B Strep when an all purpose test is done.
Some NHS Trusts do offer the ECM tests for group B Strep carriage and it simply requires a low vaginal and rectal swab processed in a laboratory using an enrich culture medium.
ECM tests are also available privately and details of the organisations which offer this test can be found at www.gbss.org.uk/test
What are the symptoms?
There are no signs or symptoms of simply carrying group B Strep. Signs of group B Strep infection in a new born baby (0 to 6 days old) include:-
• Poor Feeding;
• Abnormal Drowsiness;
• High/low temperature, heartrate of breathing rate.
Signs of group B Strep infection in babies aged 7 – 90 days old include:-
• High temperature, particularly with cold hands/feet;
• Vomiting and refusing feeding/poor feeding;
• High pitched moaning or whimpering cry;
• Blank, staring or trance like expression;
• Pale, blotchy skin;
• Floppy or dislikes being handled;
• Fretful, lethargic or turning away from bright light;
• Tense or bulging fontanelle;
• Altered breathing pattern and/or involuntary stiff body or jerky movements.
Early diagnosis and treatment of group B Strep infection is essential and if a baby shows any of the above signs, immediate medical advice should be sought. If you would like more information about group B Strep we would suggest you contact your midwife, GP or obstetrician or contact Group B Strep Support.
If you or your baby have experienced medical errors during your pregnancy, labour or shortly after your baby’s birth which may have resulted in serious injury and you would like to discuss this with no obligation, then please contact Elizabeth Smith at Wolferstans, Solicitors on 01752 292309 or firstname.lastname@example.org