>I have a friend who just before giving birth was diagnosed with
>a Streptococcal type b infection. She was told at the time that
>this could have killed her baby if they hadn't caught it in time, and
>I thought this was somewhat unusual. My question to someone is this:
>Have you heard of Streptococcal infections in newborns, and if so
>what is your experience with them? What are the symptoms and
>pathogenesis of this sort of infection?
It is not unusual for fertile women to be colonized with Group B
Streptococci (GBS) in the genitourinary tract. In fact, GBS is to be
considered as part of the commencal flora of the urethra and cervix.
Thus, the first question is: Was she diagnosed as having a GBS
infection, or was she just culture positive? Screening for GBS is of
doubtful value in a general population of pregnant women.
A large number of children are transiently colonized with GBS during
delivery, and this is usually completely harmless. However, in rare
instances, GBS have the potenrial to cause neonatal infection, which
can at worst be fatal to the newborn child. In order for severe
infection to occur, the mother must be 1) colonized with GBS and 2)
deficient in producing antibodies towards the type specific
carbohydrate antigens of the strain she is carrying. Possibly, also
other factors are of importance. Thus, neonatal GBS infection affects
children of mothers with a mild immunodeficiency, mainly lacking the
ability to produce anti-carbohydrate antibodies.
To conclude, a pregnant woman who is GBS-positive in the cervix or
urethra, and has no history of complications in earlier pregnancies,
has nothing to worry about.
In cases where there is a history of neonatal GBS infection in the
past, screening for GBS and profylactic antibiotic is indicated. This
procedure should be well known by the obstetrician/gynecologist. If a
method is locally available, determination of antibody levels is also
of great value.
If anyone is in need for more knowledge in this field, please let me
know, and I will compile a list of references.
Best regards
Ingvar
************< Ingvar.Eliasson at alinks.se >************
Ingvar Eliasson, M.D., Ph.D.
Academic Links HB
Muraregatan 15
S-392 36 Kalmar, Sweden
Voice: +46-480-20100 Fax: +46-480-20022
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