Group B streptococcal infection natural history
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Group B Streptococcus (GBS) is the leading infectious cause of morbidity and mortality among infants in the United States, particularly among preterm neonates. Most newborns with early-onset disease have symptoms on the day of birth. Babies who develop late-onset disease may appear healthy at birth and develop symptoms of GBS disease after the first week of life.
Natural History, Complications and Prognosis
GBS in Neonates
Most newborns with early-onset disease have symptoms on the day of birth. Babies who develop late-onset disease may appear healthy at birth and develop symptoms of group B strep disease after the first week of life. Infants with early-onset GBS disease generally present with respiratory distress, apnea, or other signs of sepsis within the first 24 to 48 hours of life. The most common clinical syndromes of early-onset disease are sepsis and pneumonia; less frequently, early-onset infections can lead to meningitis.
- Disseminated intravascular coagulation (DIC)
- Respiratory failure
- Neurological complications of meningitis
GBS is the leading infectious cause of morbidity and mortality among infants in the United States. The case-fatality ratio of early-onset disease has declined from as high as 50% in the 1970s to 4%-6% in recent years, primarily because of advances in neonatal care.
GBS in Pregnancy
GBS colonization during pregnancy can be transient, intermittent, or persistent. Although some women with GBS colonization during a pregnancy will be colonized during subsequent pregnancies, a substantial proportion will not. In the absence of any intervention, an estimated 1%-2% of infants born to colonized mothers develop early-onset GBS infections.
Pregnant women who are colonized by GBS are most commonly asymptomatic. Some pregnant women develop serious conditions as a result of the infection, such as endometritis, chorioamnionitis, urinary tract infections, and preterm delivery.
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