Perinatal group B streptococcal infections

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Abstract
Predisposing factors and clinical presentations associated with early-onset group B streptococcal (GBS) infections in 60 infants were reviewed. Over a three-year period, the incidence of these infections in The Royal Women's Hospital, Melbourne, was 2.0 per 1000 births. The clinical presentation ranged from fulminating sepsis to asymptomatic bacteraemia. In some cases, there was evidence of intrauterine fetal infection, despite intact membranes and a lack of clinical evidence of maternal infection. However, the over-all incidence of fever, before and after delivery, among the mothers of these babies was high. Early, or prophylactic, antibiotic therapy was generally associated with a favourable outcome. None of the infants who died from GBS infections had received antibiotic therapy before the onset of symptoms. The value of routine antenatal screening for vaginal carriage of group B streptococci, and the place of antibiotic prophylaxis, or immunoprophylaxis, are not yet established. However, prophylactic antibiotic therapy in mothers and babies considered to be at risk from GBS infection is recommended.