From the Guidelines
For a female with a urinary tract infection (UTI) growing beta hemolytic strep Group B, the recommended treatment is a 5-7 day course of antibiotics, and she should also receive intrapartum chemoprophylaxis due to the risk of heavy genital tract colonization. The presence of Group B Streptococcus (GBS) in the urine indicates heavy genital tract colonization, which poses a risk to both the mother and the baby, especially if the woman is pregnant 1. When treating the UTI, first-line options include amoxicillin 500mg three times daily or amoxicillin-clavulanate 875/125mg twice daily. For penicillin-allergic patients, alternatives include cephalexin 500mg four times daily (if no anaphylactic reaction history) or trimethoprim-sulfamethoxazole (TMP-SMX) 160/800mg twice daily (after confirming susceptibility). Some key points to consider in the treatment of GBS UTI include:
- The importance of completing the full antibiotic course even if symptoms improve
- Drinking plenty of fluids to help flush out the bacteria
- Seeking follow-up if symptoms persist
- Avoiding certain antibiotics like nitrofurantoin in patients with renal impairment
- Reserving fluoroquinolones like ciprofloxacin for complicated cases due to resistance concerns
- Considering the potential for GBS to cause serious complications in pregnant women, and the need for intrapartum chemoprophylaxis as recommended by the CDC 1.
From the Research
Treatment of UTI caused by Beta Hemolytic Strep Group B
- The treatment of urinary tract infections (UTIs) caused by Streptococcus agalactiae (Group B Streptococcus) is crucial, especially in women of childbearing age, due to the potential risk of life-threatening neonatal infections during pregnancy 2.
- According to various studies, the in vitro sensitivity of Streptococcus agalactiae to antibiotics such as ampicillin, penicillin, and vancomycin is high, ranging from 95% to 100% 3, 4, 2.
- The recommended treatment for serious Group B streptococcal infections includes high doses of benzylpenicillin (penicillin G) 5.
- However, antibiotic resistance is a growing concern, with high resistance rates observed for clindamycin (77.34%) and tetracycline (88.46%) 2.
- Macrolide resistance determinants, such as ermTR, ermB, and mefA/E, have also been identified in some isolates 6.
Antibiotic Susceptibility Patterns
- All Group B Streptococcus strains were found to be susceptible to penicillin, ampicillin, and vancomycin 4, 2.
- Resistance to erythromycin and clindamycin has been reported, with 25% and 13% of strains resistant, respectively 4.
- The emergence of multidrug-resistant Group B Streptococcus is a significant public health concern, highlighting the importance of careful surveillance and appropriate antibiotic management 6.
Importance of Identification and Treatment
- Early identification and treatment of Group B streptococcal infections are crucial, especially in elderly adults and those with chronic diseases, due to the high mortality rate associated with invasive disease 5.
- A thorough examination, identification of infection foci, and choice of adequate individual approach to the patient are essential for successful treatment 3.