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8 : Group B Streptococci: from Emerging Infection to Prevention Success Story

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Abstract:

The inclusion of the group B streptococcus (GBS) in a book on emerging infections published in 2000 may puzzle some readers, since GBS was recognized as a new clinical problem three decades ago. By 1938, however, Fry reported three fatal postpartum maternal infections caused by GBS which presented as pneumonia with multiple liver abscesses and two cases of puerperal sepsis complicated by endocarditis. The responsibility for decisionmaking regarding GBS disease was diffused—therapy for neonatal infections was the province of pediatricians, but interventions to prevent this disease had to be administered by obstetric care givers before delivery. In the screening-based approach, women are screened at 35 to 37 week's gestation, and those who are GBS carriers are offered intrapartum antibiotics. The recommendations appear in the book , published jointly by American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP). While reported practice may be suggestive of increased prevention, the most important benchmark is whether actual disease patterns are altered. Antibiotic prophylaxis was intended to reduce maternal to infant transmission of GBS. Various unintended consequences are potential concerns, and monitoring systems or evaluation projects have been developed to assess some of them. Antibiotic resistance among GBS and other organisms was a major concern. To date, several investigators have evaluated GBS strains from recent patients for susceptibility testing. Clinicians can reduce the chances of serious anaphylaxis by taking very careful histories of penicillin allergy from patients.

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8
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Figures

Image of Figure 1.
Figure 1.

Number of hospitals adopting policies for prevention of group B streptococcal disease by year (bars) and incidence of early-onset group B streptococcal disease by year (line) in four stales (California, Georgia, Maryland, and Tennessee) participating in Active Bacterial Core surveillance from 1993 to 1997. Figure courtesy of CDC.

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8
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Image of Figure 2.
Figure 2.

Incidence of early-onset (solid line) and late-onset (dashed line) group B streptococcal disease in cases per 1,000 births. Inset: incidence of invasive group B streptococcal disease in adults 65 years of age or older, in cases per 100,000. Data are from Active Bacterial Core surveillance for California, Georgia, Maryland, and Tennessee. Adapted from reference . Figure courtesy of CDC.

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8
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Image of Figure 3.
Figure 3.

Incidence of early-onset group B streptococcal disease by geographic area, Active Bacterial Core surveillance, 1993 to 1998. Symbols: ▪, California; □, Georgia; ◊, Maryland; ♦, Tennessee. Figure courtesy of CDC.

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8
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Image of Figure 4.
Figure 4.

Incidence in cases per 100,000 of invasive group B streptococcal disease by race and age group. Active Bacterial Core surveillance in California, Georgia, Maryland, and Tennessee during 1997. Open bars represent nonblacks; filled bars represent blacks. Figure courtesy of CDC.

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8
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References

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1. American Academy of Pediatrics and American College of Obstetricians and Gynecologists. 1997. Group B streptococcus, p. 227–234. In J. C. Hauth, and G. B. Merenstein (ed.), Guidelines for Perinatal Care, 4th ed. American Academy of Pediatrics, Elk Grove Village, Ill.
2. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. 1997. Revised guidelines for prevention of early-onset group B streptococcal (GBS) infection. Pediatrics 99: 489496.
3. American College of Obstetricians and Gynecologists Committee on Obstetric Practice. 1996. Prevention of early-onset group B streptococcal disease in newborns. ACOG committee opinion (No. 173).
4. Ancona, R. J.,, P. Ferrieri,, and P. P. Williams. 1980. Maternal factors that enhance the acquisition of group B streptococci by newborn infants. J. Med. Microbial. 3: 273 280.
5.Anonymous. 1992. Group B streptococcal infections in pregnancy. ACOG Tech. Bull. 170: 15.
6. Anthony, B. R,, D. M. Okada,, and C. J. Hobel. 1979. Epidemiology of the group B streptococcus: maternal and nosocomial sources for infant acquisitions. J. Pediatr. 95: 431 436.
7. Baker, C. J.,, F. F. Barrett,, R. C. Gordon,, and M. D. Yow. 1973. Suppurative meningitis due to streptococci of Lancefield group B: a study of 33 infants. J. Pediatr. 82: 724 729.
8. Baker, C. J.,, and M. S. Edwards,. 1995. Group B streptococcal infections, p. 980 1054. In J. Remington, and J. O. Klein (ed.), Infectious Diseases of the Fetus and Newborn Infant, 4th ed. The W. B. Saunders Co., Philadelphia, Pa.
9. Barton, L. L.,, R. D. Feigin,, and R. Lins. 1973. Group B beta hemolytic streptococcal meningitis in infants. J. Pediatr. 82: 719 723.
10. Boyer, K. M.,, C. A. Gadzala,, L. I. Burd,, D. E. Fisher,, J. B. Paton,, and S. P. Gotoff. 1983. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. I. Epidemiologic rationale. J. Infect. Dis. 148: 795 801.
11. Boyer, K. M.,, and S. P. Gotoff. 1986. Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N. Engl. J. Med. 314: 1665 1669.
12. Buchanan, R. E.,, J. G. Holt,, and E. F. Lessel (ed.). 1966. Index Bergeyana: An Annotated Alphabetic Listing of Names of the Taxa of the Bacteria. The Williams & Wilkins Co., Baltimore, Md.
13. Centers for Disease Control and Prevention. 1998. Adoption of hospital policies for prevention of perinatal group B streptococcal disease-United States, 1997. Morb. Mortal. Wkly. Rep. 47: 665670.
14. Centers for Disease Control and Prevention. 2000. Adoption of perinatal group B streptococcal disease prevention recommendations by prenatal care providers—Connecticut and Minnesota, 1998. Morb. Mortal. Wkly. Rep., in press.
15. Centers for Disease Control and Prevention. 1999. Shortage of intravenous penicillin G—United States. Morb. Mortal. Wkly. Rep. 48: 974.
16. Charles, D.,, and B. Larsen. 1986. Streptococcal puerperal sepsis and obstetric infections: a historical perspective. Rev. Infect. Dis. 8: 411 422.
17. Committee on Infectious Diseases and Committee on Fetus and Newborn. 1992. Guidelines for prevention of group B streptococcal (GBS) infection by chemoprophylaxis. Pediatrics 90: 775778.
18. Di John, D.,, K. Krasinski,, R. Lawrence,, W. Borkowsky,, J. P. Johnson,, L. S. Schieken,, and M. B. Rennels. 1990. Very late onset of group B streptococcal disease in infants infected with the human immunodeficiency virus. Ped. Infect. Dis. J. 9: 925 928.
19. Eickhoff, T. C.,, J. O. Klein,, A. K. Daly,, D. Ingall,, and M. Finland. 1964. Neonatal sepsis and other infections due to group B beta-hemolytic streptococci. N. Eng. J. Med. 271: 1221 1228.
20. Factor, S. H.,, C. G. Whitney,, S. Zywicki,, A. Schuchat, and the ABC Surveillance Team. Effects of hospital policies on the 1996 group B streptococcal consensus guidelines. Obstet. Gynecol., in press.
21. Fernandez, M.,, M. E. Hickman,, and C. J. Baker. 1998. Antimicrobial susceptibilities of group B streptococci isolated between 1992 and 1996 from patients with bacteremia or meningitis. Antimicrab. Agents Chenwther. 42: 1517 1519.
22. Franciosi, R. A.,, J. D. Knostman,, and R. A. Zimmerman. 1973. Group B streptococcal neonatal and infant infections. J. Pedlatr. 82: 707 718.
23. Freedman, R. A.,, D. L. Ingram,, I. Gross,, P. A. Ehrenkranz,, J. B. Warshaw,, and R. S. Baltimore. 1981. A half century of neonatal sepsis at Yale, 1928 to 1978. Am. J. Dis. Child. 135: 140 144.
24. Fry, R. M. 1938. Fatal infections by haemolytic streptococcus group B. Lancet i: 199 201.
25. Gardner, S. E.,, E. O. Mason,, and M. D. Yow. 1980. Community acquisition of group B streptococcus by infants of colonized mothers. Pediatrics 66: 873 875.
26. Garland, S. M.,, and J. R. Fliegner. 1991. Group B streptococcus and neonatal infections: the case for intrapartum chemoprophylaxis. Aust. N. Z. J. Obstet. Gynaecol. 31: 119 122.
27. Hill, A. M.,, and H. M. Butler. 1940. Haemolytic streptococcal infections following childbirth and abortion: clinical features, with special reference to infections due to Streptococci of groups other than A. Med. J. Aust. 1: 293 299.
28. Hood, M.,, A. Janney,, and G. Dameron. 1961. Beta hemolytic streptococcus group B associated with problems of perinatal period. Am. J. Obst. Gynecol. 82: 809 818.
29. Isaacs, D.,, J. A. Royle, and Australasian Study Group for Neonatal Infections. 1999. Intrapartum antibiotics and early onset neonatal sepsis caused by group B Streptococcus and by other organisms in Australia. Pediatr. Infect. Dis. J. 18: 524 528.
30. Jafari, H. S.,, A. Schucbat,, R. Hilsdon,, C. Whitney,, K. Toomey,, and J. Wenger. 1995. Barriers to prevention of perinatal group B streptococcal disease. Pediatr. Infect. Dis. J. 14: 662 667.
31. Lancefield, R. C. 1933. A serological differentiation of human and other groups of hemolytic streptococci. J. Exp. Med. 57: 571 595.
32. Lancefield, R. C.,, and R. Hare. 1935. The serological differentiation of pathogenic and nonpathogenic strains of hemolytic streptococci from parturient women. J. Exp. Med. 61: 335 349.
33. Lieu, T. A.,, J. C. Mohle-Boetani,, G. T. Ray,, L. M. Ackerson,, and D. L. Walton. 1998. Neonatal group B streptococcal infection in a managed care population. Obstet. Gynecol. 92: 21 27.
34. McCracken, G. H. 1973. Group B streptococci: the new challenge in neonatal infections. J. Pediatr. 82: 703 706.
35. McLaughlin, G. E. 1998. Investigating the group B strep case. Trial (May): 42 45.
36. Mercer, B. M.,, M. Miodovnik,, G. R. Thurnau,, R. L. Goldenberg,, A. F. Das,, R. D. Ramsey, et al. 1997. Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. JAMA 278: 989 995.
37. Mohle-Boetani, J.,, A. Schuchat,, B. D. Plikaytis,, D. Smith,, and C. V. Broome. 1993. Comparison of prevention strategies for neonatal group B streptococcal infection: a population-based economic analysis. JAMA 270: 1442 1448.
38. Morales, W. J.,, S. S. Dickey,, P. Bornick,, and D. V. Lim. 1999. Change in antibiotic resistance of group B streptococcus: impact on intrapartum management. Am. J. Obstet. Gynecol. 181: 310 314.
39. Morales, W. J.,, and D. Lim. 1987. Reduction of group B streptococcal maternal and neonatal infections in preterm pregnancies with premature rupture of membranes through a rapid identification test. Am. J. Obstet. Gynecol. 157: 13 16.
40.Nocard and Mollereau. 1887. Sur une mammite contagieuse des vaches laitieres. Ann. Inst. Pasteur 1: 109126.
41. Pearlman, M. D.,, C. L. Pierson,, and R. G. Faix. 1998. Frequent resistance of clinical group B streptococci isolates to clindamycin and erythromycin. Obstet. Gynecol. 92: 258 261.
42. Rantz, L. A.,, and W. M. M. Kirby. 1942. Hemolytic streptococcus bacteremia: report of thirteen cases with special reference to serologic groups of etiologic organisms. N. Engl. J. Med. 227: 730 733.
43. Regan, J. A.,, M. A. Klebanoff,, R. P. Nugent,, D. A. Eschenbach,, W. C. Blackwelder,, Y. Lou,, R. S. Gibbs,, P. J. Rettig,, D. H. Martin,, and R. Edelman. 1996. Colonization with group B streptococci in pregnancy and adverse outcome. Am. J. Obstet. Gynecol. 174: 1354 1360.
44. Rouse, D. J.,, W. W. Andrews,, F. Y. Lin,, C. W. Molt,, J. C. Ware,, and J. B. Philips. 1998. Antibiotic susceptibility profile of group B streptococcus acquired vertically. Obstet. Gynecol. 92: 931 934.
45. Rouse, D. J.,, R. L. Goldenberg,, S. P. Cliver,, G. R. Cutter,, S. T. Mennemeyer,, and C. A. Fargason. 1994. Strategies for the prevention of early-onset neonatal group B streptococcal sepsis: a decision analysis. Obstet. Gynecol. 83: 483 494.
46. Schrag, S.,, S. ZywiCki,, M. M. Farley,, A. L. Reingold,, L. H. Harrison,, L. B. Lefkowitz,, J. L. Hadler,, R. Danila,, P. R. Cieslak,, and A. Schuchat. 2000. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis, 1993-1998. N. Engl. J. Med. 342: 15 20.
47. Schuchat, A.,, and J. D. Wenger. 1994. Epidemiology of group B streptococcal disease: risk factors, prevention strategies and vaccine development. Epidemiol. Rev. 16: 374 402.
48. Schuchat, A.,, C. Whitney,, and K. Zangwill. 1996. Prevention of perinatal group B streptococcal disease: a public health perspective. Morbid. Mortal. Wkly. Rep . 45(RR-7): 1 24.
49. Schuchat, A.,, S. Zywicki,, M. J. Dinsmoor,, B. Mercer,, J. Romaguera,, M. J. O'Sullivan,, D. Patel,, M. T. Peters,, B. Stoll,, and O. S. Levine. 2000. Risk factors and opportunities for prevention of early-onset neonatal sepsis: a multicenter case-control study. Pediatrics 105: 21 26.
50. Towers, C. V.,, M. H. Carr,, G. Padilla,, and T. Asrat. 1998. Potential consequences of widespread antepartal use of ampicillin. Am. J. Obstet. Gynecol. 179: 879 883.
51. Towers, C. V.,, P. J. Rumney,, S. F. Minkiewicz,, and T. Asrat. 1999. Incidence of intrapartum maternal risk factors for identifying neonates at risk for early-onset group B streptococcal sepsis: a prospective study. Am. J. Obstet. Gynecol. 181: 1197 1202.
52. Tuppurainen, N.,, and M. Hallman. 1989. Prevention of neonatal group B streptococcal disease: intrapartum detection and chemoprophylaxis of heavily colonized parturients. Obstet. and Gynecol. 73: 583 587.
53. Whitney, C. G.,, B. D. Plikaytis,, W. S. Gozansky,, J. D. Wenger,, and A. Schuchat. 1997. Prevention practices for perinatal group B streptococcal disease: a multi-state surveillance analysis. Obstet. and Gynecol. 89: 28 32.
54. Yancey, M. K.,, and P. Duff. 1994. An analysis of the cost-effectiveness of selected protocols for the prevention of neonatal group B streptococcal infection. Obstet. Gynecol. 83: 367 371.
55. Zangwill, K. M.,, A. Schuchat,, and J. D. Wenger. 1992. Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. CDC Surveillance Summaries. Morb. Mortal. Wkly. Rep. 41: 25 32.

Tables

Generic image for table
Table 1.

Screening-based and risk-based strategies for prevention of early-onset group B streptococcal disease

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8
Generic image for table
Table 2.

Antimicrobial susceptibility testing of group B streptococcus from invasive and genital tract isolates

Citation: Schuchat A, Schrag S. 2000. Group B Streptococci: from Emerging Infection to Prevention Success Story, p 107-120. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch8

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