GBS infection is diagnosed when the bacteria are grown from body fluids that are usually sterile, such as blood or spinal fluid. These are known as cultures and normally take one to two days to complete.
Most GBS in babies show in the first hours and days of life. However, GBS can more rarely cause infection in a baby during pregnancy, and is a rare though acknowledged cause of stillbirth. There is some evidence to suggest that GBS may be a rare cause of late miscarriage.
GBS infection in newborn babies is usually described as early or late-onset. Early onset is classed as GBS infection which presents within the first 6 days of life. Late onset is GBS infection which shows symptoms after the first week (but before 3 months) of life. The risk of a baby developing a GBS infection decreases with age – GBS infection in babies is rare after one month of age and very rare after three months.
Early-onset GBS infection in babies (0-6 days of life)
In the UK, up to two-thirds of GBS disease is early onset (apparent within the first week), although assuming that current risk-based prevention prevents some infections, then without preventative medicine, the figure would be nearer 90%. Most early-onset GBS infections are potentially preventable when Mum is given intravenous antibiotics in labour.
The rate of early-onset GBS infection in the UK and Republic of Ireland increased from 0.48 per 1,000 live births in 2000, to 0.57 per 1,000 live births in 2014/5 (click here for more info). Risk-based prevention guidelines were introduced in the UK in November 2003 which had been expected to bring about a fall in early-onset GBS infections of between 50-60%.
Early onset GBS infection usually presents as sepsis with pneumonia. These “early-onset” infections are usually apparent at or soon after birth, with the typical symptoms of early-onset GBS infection including:
- Poor feeding;
- Very high or low heart rate;
- Low blood pressure;
- Low blood sugar;
- Abnormal (high or low) temperature; and/or
- Abnormal (fast or slow) breathing rates with blueness of the skin due to lack of oxygen (cyanosis).
Late onset GBS infection in babies age 6 days to 3 months
Up to one third of GBS infections are late-onset, occurring after the baby’s first 6 days, usually as meningitis with sepsis. It is uncommon after a baby reaches one month old and very rare after age three months. Currently there are no known ways of preventing late-onset GBS infections so identifying signs and symptoms of these infections is vital for early diagnosis and treatment.
The rate of late-onset GBS infection in the UK and Republic of Ireland increased from 0.24 per 1,000 live births in 2000, to 0.37 per 1,000 live births in 2014/5 (click here for more info).
Late onset GBS infection usually presents as sepsis, pneumonia and/or meningitis, but can also present as osteomyelitis (bone infection) and septic arthritis (joint infection). Typical signs of late-onset group B Strep infection are similar to those associated with early onset infection and also include signs associated with meningitis such as:
- Being irritable with high pitched or whimpering cry, or moaning;
- Blank, staring or trance-like expression;
- Floppy, may dislike being handled, be fretful;
- Tense or bulging fontanelle (soft spot on babies’ heads);
- Turns away from bright light;
- Involuntary stiff body or jerking movements; and/or
- Pale, blotchy skin.
If a baby shows signs consistent with GBS infection or meningitis, call your doctor immediately. If your doctor isn’t available, go straight to your nearest Paediatric Casualty Department. If a baby has late-onset GBS infection or meningitis, early diagnosis and treatment are vital: delay could be fatal.
Your baby’s GBS infection is not your fault
When a baby develops a GBS infection, Mums are sometimes told that ‘you passed it on to your baby’ (particularly when a newborn baby develops GBS infection) – this can make it sound as though it is somehow her fault. This is NOT the case. Up to 25% of adults carry GBS quite normally. The bacteria live quite harmlessly in our bowel and, in women, in the vagina. Many babies born to carrier mothers become colonised and a small proportion of babies – for reasons that we don’t currently understand – are susceptible to GBS and, when exposed to it, develop infection rather than being able to cope with it normally. That’s not the fault of the mother (or father) in any way, and there is absolutely no reason to feel guilty about it.
*Image from Wikimedia Commons