Can a patient transmit Streptococcal (Streptococcus) infection to their partner through sexual contact and should they undergo testing if their partner has a vaginal Streptococcal infection?

Group B Streptococcus Vaginal Infection and Sexual Transmission

Group B Streptococcus (GBS) vaginal infection can be sexually transmitted, and the patient should be tested and treated if their partner has a confirmed GBS vaginal infection.

Understanding Group B Streptococcus (GBS)

Group B Streptococcus is a bacterium that can colonize the genital and gastrointestinal tracts. While often considered part of normal flora in some individuals, it can cause infections in certain circumstances:

• GBS can be found in approximately 12% of pregnant women 1
• It can be transmitted between sexual partners
• Unlike other STIs like chlamydia or gonorrhea, GBS is not exclusively sexually transmitted
• GBS can also be part of normal gastrointestinal flora in some individuals

Sexual Transmission of GBS

The evidence regarding sexual transmission of GBS indicates:

• GBS can be transmitted between sexual partners during intimate contact
• A study documented cases where healthcare workers with GBS carriage transmitted the infection to patients, suggesting person-to-person transmission is possible 2
• Unlike classic STIs, GBS may be transiently carried by individuals without causing symptoms
• Sexual partners can reinfect each other if both aren't treated simultaneously

Testing Recommendations

For a patient whose partner has GBS vaginal infection:

• Testing is recommended to determine if the patient is also colonized with GBS
• Nucleic acid amplification tests (NAATs) are preferred due to their high sensitivity (>90%) and specificity 3
• Combined vaginal-rectal swabs provide the most comprehensive sampling for GBS detection 1
• Testing should include antimicrobial susceptibility to guide treatment if positive

Treatment Approach

If the patient tests positive for GBS:

• Treatment with appropriate antibiotics is recommended for both partners to prevent reinfection
• All GBS isolates are typically susceptible to penicillin, ceftriaxone, and vancomycin 1
• Over 90% of GBS isolates are susceptible to erythromycin and clindamycin 1
• Treatment of both partners simultaneously is crucial to prevent the "ping-pong effect" of reinfection

Partner Management

The Infectious Diseases Society of America (IDSA) recommends:

• Testing and treatment of sexual partners when one partner has a confirmed infection 4
• Partner referral for evaluation and treatment is essential to prevent reinfection 4
• Both partners should abstain from sexual activity until treatment is completed 4
• Follow-up testing may be warranted if symptoms persist after treatment

Important Considerations

• GBS carriage can be intermittent, meaning negative test results don't guarantee absence of the organism
• Reinfection between partners is possible if both aren't treated simultaneously
• Unlike some STIs, GBS can colonize individuals without causing symptoms
• In pregnant women, GBS screening is particularly important due to risk of neonatal transmission

Prevention Strategies

• Consistent condom use can reduce but not eliminate transmission risk
• Regular STI screening for sexually active individuals
• Open communication between partners about STI status
• Completing full course of antibiotics when prescribed

GBS differs from classic STIs like chlamydia and gonorrhea in that it can be part of normal flora, but sexual transmission is well-documented. Testing and treating both partners simultaneously is the most effective approach to managing GBS infections and preventing reinfection cycles.