From the Guidelines
Group B Streptococcus (GBS) urinary tract infection (UTI) is a significant risk factor for early-onset GBS disease in newborns.
Implications of GBS UTI
- GBS bacteriuria in pregnant women is a marker for heavy genital tract colonization, and maternal GBS bacteriuria has been associated with an increased risk for early-onset disease in the newborn 1.
- Women with GBS urinary tract infections during pregnancy should receive appropriate treatment at the time of diagnosis as well as intrapartum GBS prophylaxis 1.
- The presence of GBS bacteriuria in any concentration in a pregnant woman is a marker for heavy genital tract colonization, and therefore, women with any quantity of GBS bacteriuria during pregnancy should receive intrapartum chemoprophylaxis 1.
- GBS can cause both symptomatic and asymptomatic urinary tract infections, which should be diagnosed and treated according to current standards of care for urinary tract infections in pregnancy 1.
- Laboratory personnel should report any presence of GBS bacteriuria in specimens obtained from pregnant women, and labels on urine specimens from prenatal patients should clearly state the patient's pregnancy status to assist laboratory processing and reporting of results 1.
Intrapartum Chemoprophylaxis
- Intrapartum chemoprophylaxis should be given to all pregnant women identified as GBS carriers, including those with GBS bacteriuria 1.
- The recommended regimen for women without penicillin allergy is penicillin G, 5 million units intravenously initial dose, then 2.5 million units intravenously every 4 hours until delivery 1.
- For women with penicillin allergy, alternative regimens such as cefazolin, clindamycin, or erythromycin may be used, depending on the severity of the allergy and the susceptibility of the GBS isolate 1.
From the Research
Implications of Group B Streptococcus Urinary Tract Infections
The implications of a Group B Streptococcus (GBS) urinary tract infection (UTI) can be severe, particularly in pregnant women and newborns. Some key points to consider include:
- GBS UTIs can lead to serious infections in neonates and pregnant women, including chorioamnionitis, endometritis, and pyelonephritis 2, 3.
- The risk of progression to pyelonephritis is lower with GBS UTIs compared to Escherichia coli UTIs, although obstetric outcomes are similar 4.
- GBS UTIs can also occur in nonpregnant adults, particularly those with underlying conditions such as urinary tract abnormalities or chronic renal failure 5.
- The presence of the fungus Candida albicans can promote GBS colonization in the bladder, increasing the risk of UTI 6.
Antibiotic Resistance and Treatment
GBS UTIs can exhibit antibiotic resistance, making treatment challenging. Key points to consider include:
- GBS isolates can be resistant to penicillin, ampicillin, clindamycin, and vancomycin, highlighting the need for alternative treatment options 2.
- All GBS isolates in one study were sensitive to all antibiotics tested except gentamicin, emphasizing the importance of antibiotic susceptibility testing 5.
Risk Factors and Prevention
Certain risk factors can increase the likelihood of developing a GBS UTI. These include:
- Pregnancy, particularly in women with a history of urinary tract infections or other underlying conditions 2, 4.
- Underlying conditions such as urinary tract abnormalities or chronic renal failure in nonpregnant adults 5.
- The presence of Candida albicans in the urogenital tract, which can promote GBS colonization 6.