Gbs and what does this mean?
what is Gbs or Group b strep it is an organism that lives on another without harming it.
what can this do to you. well nothing to the host but if you are a woman who is pregnant
this can mean a lot to you. GBS can do a lot to a newborn baby if you have this.
First, there are two types of Gbs and they are Early onset and late onset. How do I know so much
about this you are probably wondering well my daughter after being born contracted the late onset
of this illness. The early onset can occur anytime between the birth and the first two days of life.
If your baby contracts this he/she will have a 65% chance of death compared to the late onset which
only has a death chance of 25%. Of the survivors of GBS meningitis, up to a third suffer long-term mental and/or physical handicaps, from mild learning disabilities to
severe mental retardation, loss of sight, loss of hearing and lung damage(in around 12% of the survivors,
the disabilities may be severe). The great majority of survivors of early-onset disease do so with no
long-term damage.
GBS is also a recognised cause of preterm delivery, maternal infections, stillbirths and late miscarriages.
GBS infections are rare in adults, especially so for men and women who are not pregnant.
Woman among child bearing ages. And those who have some or all these symptoms at delivery: where labour is premature(prior to 37 completed weeks of pregnancy); where there is preterm premature rupture of membranes(prior to 37 completed weeks of pregnancy, with or without other signs of labour); where there is prolonged rupture of membranes(more than 18 to 24 hours before delivery, with or without other signs of labour); and where the mother has a raised temperature(37.8 °C or higher) during labour. Mothers who carry GBS: the presence of one or both of these factors multiplies the risk about 4 times: where the pregnant woman is known to carry GBS; and where the mother has GBS bacteria in her urine at any time during the present pregnancy(which should, of course, be treated at the time of diagnosis).
Mother has had a baby infected with GBS: multiplies the risk about 10 times:where the pregnant woman has had a baby who developed a GBS infection. Colonisation combined with one or more clinical risk factor increases the risk at least 12-fold. 75% of early-onset GBS disease and 90% of resultant deaths follow deliveries with one or more of these risk factors. About half of the babies born to mothers colonised with GBS at the time of delivery will become colonised themselves and, of these, only around 1 in 200 will develop GBS disease.
What can be done to prevent this from occuring:To stop as many cases of GBS infection in newborn babies as possible, women with any risk factor would need to be given intravenous antibiotics during labour for ideally at least 4 hours before delivery. Some women will prefer not to receive antibiotics if their risk is only slightly increased since it would inevitably complicate an otherwise natural birth, plus antibiotic therapy is associated with rare but significant complications. The risk of a GBS infection in the baby must be balanced against the wishes and beliefs of the woman in labour and against her risk of an adverse reaction to the antibiotics.
Medical research shows the chance of a baby developing early-onset GBS infection can be reduced by over 70%(and the number of fatalities by 75-80%) by adopting the following measures. for preventing GBS infection in newborn babies are: women at increased risk should be offered antibiotics immediately at the onset of labour or rupture of membranes(this includes women known to carry the GBS bacteria where no other risk factors are present, and women not known to carry the GBS bacteria but who have another risk factor present). women at particularly high risk should be strongly advised to accept intravenous antibiotics immediately at the onset of labour or rupture of membranes until delivery(this includes women who are known GBS carriers with one or more clinical risk factors and women who have previously had a baby infected with GBS, regardless of other risk factors. It also includes women who are not known to be GBS carriers but who have multiple risk factors). for women in labour, the recommended doses of penicillin G are 3 g(or 5 mU) intravenously initially and then 1.5 g(or 2.5 mU) at 4-hourly intervals until delivery. For women who are allergic to penicillin, the recommended doses of clindamycin are 900 mg intravenously every 8 hours until delivery. intravenous antibiotics should be given for at least 4 hours prior to delivery where possible. babies born in situations where there is increased risk and the mother has received at least 4 hours of intravenous antibiotics should be assessed carefully by a paediatrician and, if completely healthy, intravenous antibiotics should not be given to them(see paediatric prevention). With any policy that involves treating certain women with penicillin to prevent the acquisition of GBS infection following rupture of membranes or the start of labour, a strategy for the management of the newborn baby is required. In all cases, the newborn baby should be assessed as soon as possible by a paediatrician and the threshold for giving antibiotics to babies born in the high risk situations should be low.
Typical symptoms of early-onset GBS infection includes: grunting;lethargy;irritability;poor feeding;very high or low heart rate; low blood pressure;abnormal(high or low) temperature; and abnormal(fast or slow) breathing rates with blueness of the skin due to lack of oxygen(cyanosis).
Typical symptoms of late-onset GBS infection are
fever; poor feeding and/or vomiting; and impaired consciousness. Typical symptoms of meningitis in babies, including GBS meningitis(any of these could develop but some may not be present at all) include:fever, which may include the hands and feet feeling cold, and/or diarrhea; refusing feeds or vomiting; shrill or moaning cry or whimpering;dislike of being handled, fretful; tense or bulging fontanelle(soft spot on the head);involuntary body stiffening or jerking movements; floppy body; blank, staring or trance-like expression;abnormally drowsy, difficult to wake or withdrawn; altered breathing patterns; turns away from bright lights; and pale and/or blotchy skin. If a baby shows signs consistent with late-onset GBS infection or meningitis, call your doctor immediately. If your doctor isn’t available, go straight to your nearest Casualty Department. If a baby has late-onset GBS infection or meningitis, early diagnosis and treatment are vital: delay could be fatal. The risk of a baby developing a GBS infection decreases with age - GBS infection in babies is rare after one month of age and virtually unknown after three months.
The flowchart in all of the downloadable documents except. GBS and Pregnancy’ shows our experts’ recommended paediatric prevention strategy to stop GBS infection
The recommended minimum length of in-patient intravenous antibiotic treatment for babies who develop GBS infection is 14 days if the baby has meningitis, otherwise 10 days. Before discharge, a full work up needs to be done on the baby, including a full examination by a paediatrician, review of clinical parameters, FBC and differential and CRP.
Treatment should also be given to an infected baby’s twin, even if that baby appears to be well at the time, since infection of the second twin is common. Reports suggest that a baby who has recovered from a GBS infection is at raised risk of re-infection. For such a baby, it may be worth discussing with the paediatrician whether giving penicillin prophylaxis orally once or twice a day for the first 3 months of life could be beneficial.