Fruit of the Womb
Fruit of the Womb

Misunderstanding Group B Streptococcus (GBS)

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There is not a week that goes by when I don't get a bunch of questions regarding Group B Streptoccus (GBS) infections, either on this site or at the office. GBS is an endless source of stress, misunderstanding, and sometimes over-reaction. For example, when we told one of our patients recently that she had tested positive for GBS at the time of routine screening in third trimester (35-36 weeks) and that we would be treating her with antibiotics prophylactically when she went into labor to prevent transmission to the baby, all she could mutter was "I'm going to kill him." It did no good to explain to her that even though GBS might be passed back and forth by sexual contact, it is not a sexually transmitted disease. Indeed, this issue of transmission, colonization, "How did I get that?" and "How can I get rid of it?" is a recuuring theme as illustrated by the recent comments below from two of our readers...

• Mon Nov 19, 12:07:00 PM 2007, Anonymous said…

I am 23 years old and I just went for my yearly appointment. They told me I was Group B Strep positive. I was wondering how you get this and if you can get rid of it before you decided to have kids? I do know about the risk if you are to get pregnant but I asked my doctor and she said since I wasn't having any problems with the GBS that she wasn't going to treat it. So should I not treat it even if in the future I want to have children?


• Mon Nov 26, 06:17:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Nov 19: Your doctor is absolutely correct under these circumstances. As many as 30-40% of people are GBS positive and are chronic carriers. There is no sense 'treating' it now, or even if you become pregnant unless you have a urinary tract infection with GBS, premature rupture of membranes, or are in labor. Even if you are 'treated' now, there is a very high likelihood that the treatment would be incomplete or that you will become recolonized in a short period of time. Indeed, the risk of complications from the antibiotics are probably greater than the current risk to you from the GBS! Your immune system needs to learn how to keep it in check (although some folks are immunologically hyporesponsive to certain strains of GBS) and both you and your baby (once you get pregnant) are at fairly low risk for complications if the accepted protocols for treatment and prophylaxis are followed. Besides, the next time you are checked, you may be GBS-negative! I am curious though, why were you checked for GBS at your annual exam, or did you have a GBS urinary tract infection? Thanks for reading, and let us know when you get pregnant! Dr T

• At Fri Dec 07, 10:23:00 AM 2007, Anonymous said…
Hi there. I am 32 weeks pregnant and have just tested positive for GBS with profuse growth! Can you tell me how I caught this please and tell me if my baby will be fine?
Thank you

• At Thu Dec 13, 11:43:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Dec 7: As I have pointed out above, 30-40% of folks are simply 'colonized' with GBS. They carry it in their gastrointestinal tracts and can also have colonization of their vagina. So you didn't really "catch it" from anyone. You might have been a carrier since you were very young. Not all women who carry GBS place their babies at risk. However, it does appear that heavier colonization and urinary tract infections with GBS might indicate that your immune system has not responded well to the bacterium and MAY put your baby at greater risk.

If you have GBS at delivery, and are not treated with antibiotics, your baby has about a 50% chance of also becoming colonized, but even then, only a 1-2% chance of developing complications related to GBS. The important thing from your standpoint is that you KNOW you have tested positive for GBS and you should receive antibiotic prophylaxis if you go into labor or rupture your membranes, so that risk is even much lower by about 50-80%. Urinary tract infections with GBS during pregnancy should be TREATED and then you should be rechecked to make sure the infection has been cleared from your bladder. Good luck to you! Chances are that things will turn out just fine for both you and your baby! Let us know how you do!
Dr T
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About the Author

Dr. Trofatter is an expert on maternal-fetal medicine.

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