Remote Primary Health Care Manuals

Group B Streptococcus infection

  • Group B Streptococcus (GBS) bacteria found in rectum, vagina, urinary tract of healthy women
  • Asymptomatic and only detected by screening tests
  • If GBS present in vagina during labour and birth — baby at risk of infection
    • Leading cause of sickness and death in newborn babies
    • Infection in babies can cause pneumonia, meningitis, sepsis
    • Preterm babies most at risk

All women with history of previous GBS infected baby are given antibiotics in labour for all future births even if negative swab results

Do during pregnancy

At first antenatal visit

  • Check file notes
  • Ask woman if baby infected with GBS in previous pregnancy or if GBS detected in current pregnancy

If GBS positive urine anytime during pregnancy

  • Must treat immediately — give amoxicillin oral — adult 500mg, 3 times a day (tds) for 5 days
    • If allergy to penicillin — medical consult
  • See — Urine infections in pregnancy for follow-up
  • Will need antibiotics in labour if GBS positive urine at any point in pregnancy even if previously treated

GBS swab — 35-37 weeks pregnant

  • Take combined vaginal (first) and anal swab (second) at 35–37 weeks pregnancy — can be self-collected by woman
  • If swab GBS positive
    • Record in file notes
    • No antenatal treatment needed
    • Explain meaning of positive result — will need antibiotics in labour
    • Advise woman to report signs of labour or rupture of membranes early so antibiotics can be started before baby is born
Do in labour

If woman GBS positive at any time during pregnancy

  • Plan for birth in hospital
  • If not possible to send to hospital before birth
    • Give antibiotics
    • Transfer mother and baby after birth
    • See Newborn care

Treat for GBS

  • Woman with GBS positive swab or urine in this pregnancy
  • Woman with previous baby infected with GBS
  • If GBS status unknown or no GBS swab in last 5 weeks — give antibiotics if
    • Preterm labour
    • Premature rupture of membranes (37 or more weeks pregnant)
    • Prolonged rupture of membranes — more than 18 hours or unknown time since membranes ruptured
  • Give benzylpenicillin IV — adult 3g, single dose straight away
  • THEN benzylpenicillin IV — adult 1.8g, every 4 hours until birth
    • If allergy to penicillin — medical consult
  • Stop treatment immediately after birth