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Awareness weeks guide

International GBS awareness month

International GBS awareness month

July 2024

Fast Facts

  • About 1 in 4 pregnant women "carry" or are "colonized" with group B strep
  • There are three types of perinatal GBS disease, each with their own prevention challenges:

                       Prenatal-onset GBS disease (before birth)
                       Early-onset GBS disease (birth through the first 6 days of life)
                       Late-onset GBS disease  (7 days of age through usually 3 months of age)

  • GBS is a leading cause of sepsis and meningitis in newborns according to the U.S Centers for Disease Control and Prevention (CDC)
  • It is now the standard of care in several countries for all pregnant women to be routinely tested for GBS with a vaginal/rectal swab test during the 36th or 37th week during each pregnancy unless their urine already cultured positive in the current pregnancy
  • GBS colonization is transient which means that a woman could test negative, but be colonized later in pregnancy and vice versa
  • GBS is a fast-acting type of bacteria so it is imperative that everyone who takes care of your baby knows the symptoms of possible GBS infection in babies and how to respond.

Group Strep B International




Society guideline links

Cochrane Library


Patient information



Prevention and screening







Prevention and screening

Should all pregnant women be offered testing for group B streptococcus?
What you need to know

  • Many countries have guidelines that recommend universal testing for group B streptococcus (GBS) in late pregnancy so that women who are colonised with GBS receive intrapartum antibiotic prophylaxis to prevent newborn GBS infection
  • Observational studies suggest that routine testing in pregnancy reduces the risk of early onset GBS in newborns compared with offering antibiotics to women with risk factors for GBS transmission, or no testing. However, those observational studies have a moderate to critical risk of bias, and no randomised trials of routine testing versus a risk factor based approach have taken place
  • Routine testing could result in a large number of women receiving antibiotics unnecessarily, resulting in potential harms of widespread antibiotic use at individual and population levels
  • Offer testing for GBS carriage to pregnant women as per local guidelines, and where that guidance is lacking, discuss with the woman the risks and benefits of testing, as well as how the test result could affect her delivery

BMJ 26 April 2021

Effect of probiotics on mother-to-neonate vertical transmission of group B streptococci: A prospective open-label randomized study
Group B Streptococci (GBS) are common vaginal bacteria found in 20–30% of pregnant women and a significant cause of invasive infections in newborns. Recently, attention has been focused on the efficacy of probiotics during the perinatal period. However, the effect of probiotic intake on the mother-to-child transmission (MTCT) of GBS remains unknown. No statistically significant difference was found; however, the consumption of L. reuteri by women with GBS-positive pregnancies may inhibit the MTCT of GBS. Pediatrics and neonatology 29 August 2023

Women’s knowledge of and attitudes towards group B streptococcus (GBS) testing in pregnancy: a qualitative study
Women need clear, detailed information about GBS and GBS testing, and women’s concerns are important to address if routine GBS testing is implemented. The efficacy of implementing routine universal testing in the UK is currently being investigated in a large multi-centre clinical trial; the GBS3trial, further qualitative research is needed to look at the acceptability of different methods of GBS testing, as well as the acceptability of GBS testing to women in specific groups, such as those planning a home birth or those from different ethnic backgrounds. BMC pregnancy and childbirth 11 May 2023

Preventing Early-Onset Group B Streptococcus neonatal infection and reducing antibiotic exposure using a rapid PCR test in term prelabour rupture of membranes
A hybrid approach involving risk-factor-based intrapartum antibiotic prophylaxis (IAP) and intrapartum GBS PCR screening of non-labouring term prelabour rupture of membranes (TermPROM) women delivers acceptably low rates of EOGBS while minimising and better targeting antibiotic exposure. Australian and New Zealand journal of obstetrics and gynaecology 14 April 2020

Quantitative real-time PCR and magnetic separation strategy for specific detection of group B streptococcus in perinatal Women's urine

  • Group B streptococcus is the main pathogen of infection in perinatal women.
  • Penicillin can serve as a recognition molecule to capture the target bacteria.
  • Magnetic separation combined with quantitative real-time PCR demonstrates a lower detection limit.
  • This method can provide new ideas for the detection of pathogenic bacteria.

Practical laboratory medicine 23 December 2023

Timing and dosage of intrapartum prophylactic penicillin for preventing early-onset group B streptococcal disease: assessing maternal and umbilical cord blood concentration
High concentrations of penicillin G were found in umbilical cord blood of infants born less than 4 hours after intrapartum antibiotic prophylaxis (IAP) administration, well above the minimal inhibitory concentration (MIC) for GBS. ADC fetal and neonatal 10 May 2024

Intrapartum prophylactic efficacy of ampicillin versus clindamycin in preventing vertical transmission of group B Streptococcus
Prophylactic efficacy of clindamycin against the vertical transmission of group B Streptococcus is lower than that of ampicillin. Acta Paediatrica 5 April 2024

Early-onset group B streptococcal infections in five Nordic countries with different prevention policies, 1995 to 2019
Universal screening of pregnant women was initiated solely in Finland in 2012 and this intervention was associated with a marked reduction of 58% in the incidence of early-onset GBS infections. There was no notable change in the frequency of GBS infections in the rest of the Nordic countries using a different strategy for intrapartum antibiotic prophylaxis (IAP). Universal screening of pregnant women appeared to be an effective method to administer intrapartum antibiotic prophylaxis in preventing GBS infections in newborn infants. Eurosurveillance 18 January 2024

Group B Streptococcus screening guidelines in pregnancy: A critical review of compliance
Adhering to Group B Streptococcus screening guidelines to prevent neonatal infection is crucial. Various factors influence compliance rates such as financial aspects and high proportions of caesarean sections. The implementation of strategies and different forms of education can result in improved compliance rates. Maternal and child health journal 4 January 2021



Neonatal Group B Streptococcal Infection in Australia: A Case–control study
GBS remains a leading cause of neonatal morbidity and mortality. Adding previous fetal death to GBS screening guidelines would improve GBS prevention. The introduction of maternal GBS vaccination programs should be guided by country-specific disease epidemiology. The pediatric infectious disease journal March 16 2023

Group B streptococcal bacteraemia: changing trends in a tropical region of Australia
GBS bacteraemia is deviating from being primarily a neonatal disease. While the indigenous population of North Queensland are disproportionately affected, the demographics affected differ. GBS appears to target the older non-indigenous patients with greater comorbidities. In the non-indigenous population, invasive GBS disease is an emerging issue. Three-month mortality appears to be increased in males and the immunosuppressed. Internal medicine journal  21 December 2020

Maternal and neonatal group B streptococcus colonisation: A systematic review and the meta-analysis of matched-pair studies
The authors support the implementation of targeted intrapartum antibiotic prophylaxis for all women who are positive for GBS as well as women with risks factors for early onset GBS in their infants regardless of their GBS colonisation status. Acta Paediatrica 13 February 2024

Self-collection of samples for group B streptococcus testing during pregnancy: a systematic review and meta-analysis
Self-collected samples for group B streptococcus detection in pregnancy had high specificity compared to provider-collection, but lower sensitivity, particularly for included trials. Studies investigating the effect of self-collection on health outcomes, and further higher quality trials comparing accuracy of self-collection to provider-collection, are required. BMC medicine 18 December 2023

Antibiotic use in late preterm and full-term newborns
This large nationwide study found that a relatively low exposure to antibiotics is not associated with an increased risk of early-onset sepsis (EOS) or associated mortality. Still, future efforts to reduce unwarranted neonatal antibiotic use are needed. JAMA 22 March 2024

Membrane stripping in group B streptococcus carriers does not impede adequate intrapartum antibiotic prophylaxis: a retrospective study
The provision of membrane stripping did not impede adequate intrapartum antibiotic prophylaxis and was correlated with a higher rate of sufficient prophylaxis in comparison to non-swept patients. These observations suggest that membrane stripping can be considered a safe option for ensuring adequate antibiotic prophylaxis in women colonized with GBS. Frontiers in medicine 5 April 2024

Breastfeeding and risk of late-onset Group B Streptococcal Disease
What’s Known on This Subject:

  • Case reports have described children with late-onset group B Streptococcus disease with group B Streptococcus cultured from breast milk. Although controversial, this has led to concern and to breast milk being implicated as a potential source for disease transmission.

What This Study Adds:

  • Breastfeeding was not associated with an increased likelihood of developing late-onset group B Streptococcus disease in our setting.

Pediatrics 12 August 2021

Novel insights on Group B Streptococcus in Pregnancy
Group B Streptococcus (GBS) is a frequent colonizer of the human genital and gastrointestinal tract. In pregnant or postpartum persons, colonization is often asymptomatic and can contribute to infectious morbidity in both the parturient and the newborn. The prevalence of invasive GBS disease has dramatically decreased over the past 3 decades. However, despite standardized clinical algorithms, GBS disease remains a public health concern. This review summarizes the GBS bacteria pathophysiology, morbidity, management guidelines, and summarizes ongoing research. While novel testing and parturient vaccination are being explored, barriers exist, preventing guideline updates and widespread implementation. Clinical obstetrics and gynecology 21 June 2024



Clinical risk factors associated with late-onset invasive Group B Streptococcal Disease: Systematic review and meta-analyses
Prematurity/low birth weight and maternal colonization are major risk factors for late-onset sepsis and meningitis (LOGBS). Future GBS vaccine studies should try to establish the optimal time for vaccination during pregnancy to protect preterm infants. Clinical infectious diseases 11 March 2022

Long-term risk of Epilepsy following Invasive Group B Streptococcus Disease in neonates in Denmark
In this population-based cohort study of 1432 neonates, iGBS disease was associated with a higher incidence of epilepsy in later childhood, notably after meningitis. Premature birth, sex, and low maternal SEP modified the association. JAMA 21 April 2023

Risk factors for infection and outcomes in infants with neonatal encephalopathy: a cohort study
Infants with NE exposed to risk factors for early-onset infection did not have worse short-term adverse outcomes.

  • Risk factors for early-onset neonatal infection, including rupture of membranes >18 h, maternal group B streptococcus colonization, chorioamnionitis, maternal pyrexia or antepartum antibiotics, were not associated with death or short-term morbidity after cooling for NE.
  • Despite exposure to risk factors for early-onset neonatal infection, infants with NE reached oral feeds earlier and needed fewer anti-seizure medications for a shorter duration than infants with NE but without such risk factors.
  • This study supports current provision of therapeutic hypothermia for infants with NE and any risk factors for early-onset neonatal infection.

Nature 2 April 2024

Understanding factors in Group B Streptococcus late-onset disease
Group B streptococcus (GBS) infection remains a leading cause of sepsis, pneumonia, and meningitis in infants. Rates of GBS early onset disease have declined following the widespread use of intrapartum antibiotic prophylaxis; hence, late-onset infections (LOGBS) are currently a common presentation of neonatal GBS disease. This narrative review discusses current and previous studies that have reported LOGBS. Few well-designed studies have described this condition; therefore, reliable assessment of maternal GBS colonization, breastfeeding, and twin delivery as risk factors for (LOGBS) remains limited. Infection and drug resistance 17 August 2021 



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