In about 20% of pregnant women, serogroup B streptococci are found in the genital or anal area.
Normally, these bacteria are harmless. They are also found on the skin and in the lower gastrointestinal and genitourinary tracts (gastrointestinal tract as well as urinary tract and sex organs).
Serogroup B streptococci can be detected in the following diseases:
- Wound infections
- Sepsis (blood poisoning)
- Neonatal sepsis
- Cystitis (bladder infection) and pyelonephritis (kidney pelvic inflammation).
The diagnosis of streptococcus serogroup B can be determined by vaginal swab (vaginal swab) including anal swab.
Special features during pregnancy
During birth, streptococci can be transmitted to the child.
This can cause severe infection of the child either immediately after birth (early onset) or during the next one to six weeks (late onset). The former occurs primarily in premature infants. The late onset infection can also be caused by caregivers; the early form is always caused by the mother.About one in 3,000 newborns becomes infected with B streptococcus at birth, of whom 3.2 percent die as a result. The lethality (mortality related to the total number of people infected with the disease) is dominated mainly by meningitis (meningitis).
Symptoms and complaints of the newborn after early infection:
- Sepsis
- Pneumonia (pneumonia)
- Meningitis
- Neurological damage
In late infection, there is a high risk of mortality (mortality rate), especially for premature infants.
Mortality in mature newborns is 2-3% and up to 30% in infants with gestation shorter than 24 weeks.
Laboratory Diagnostics
Every pregnant woman should be screened for B streptococcus between the 35th and 36th week (B streptococcus screening; B streptococcus test for pregnant women).
The current guideline of the German Society of Gynecology and Obstetrics also recommends the B-streptococcus test towards the end of pregnancy.
The examination is carried out by means of a vaginal swab (vaginal smear) including anal swab (pathogen and resistance determination).Note! By possibly omitting the anal smear, approx. 30% of positive findings are missed.
Independent of the above-mentioned examination for B-streptococci, pregnant women are offered infection screening for vaginal asymptomatic infections with bacteria and mycosis pathogens between the 16th and the completed 24th week of pregnancy as a health insurance benefit. A study demonstrated that this infection screening can reduce preterm birth rates by up to 43%.
Therapy
If B streptococci are detected, the risk of infection to the child can be minimized by targeted administration of antibiotics at birth.Antibiotic therapy is required for:
- Premature births before the completed 37th week.
- Duration between rupture of the membranes and delivery of more than 12 hours.
- Fever of the pregnant woman during childbirth above 38 °C.
- Streptococcal infection during previous births.
- Urinary tract infection due to B streptococcus in pregnancy.
- Signs of infection in the mother and / or child
Benefit
By means of a simple vaginal swab, infection with B streptococci can be detected and the risk of infection of the child can be effectively minimized.
By testing pregnant women for B streptococci in the vagina and rectum and preventively administering antibiotics at birth to mothers who test positive, the incidence (frequency of new cases) of B streptococcal infection in the child can be reduced to <1 case per 1,000 live births.
