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Prevalence of early-onset Group B Strep infection

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    Information on recent research on the prevalence of Group B Strep infection, and highlighting the importance of prevention or early treatment of the infection in newborn babies during this GBS Awareness Month 2014.

    By Kerstin Kubiak

I read with interest recently a Northern Irish review paper which was published in May 2014 in the British Journal of Obstetrics and Gynaecology, reviewing whether adherence to Step B guidelines helped to prevent Group B Strep (GBS) infection in newborn babies.

The review paper:

The Northern Irish paper reviewed the management of women with 1 or more risk factors for GBS Infection or those who delivered babies with confirmed GBS infection, or those who had suffered a stillbirth due to GBS. It found that, of the 574 women with risk factors for GBS, only 42% had prophylactic antibiotics (IAP) during labour.  Improved administration of antibiotics was noted with increased risk factors, although “at best, guideline adherence was 50-70%.”

It further noted that: “43 neonates had proven early-onset Group B Streptococcal disease; 55.8% had maternal risk factors. Of the total identified cases, 25.5% received IAP. The mortality rate was 11.46%. The incidence of [Early Onset Group B Streptococcus] disease in NI was 0.57/1000 live births.”

These results do appear to support the campaign of the charity Group B Strep Support that early testing would allow for early diagnosis of what can be a life threatening condition for the newborn. It is disappointing to note that at best the adherence to guidelines in respect of antibiotics was 50-70%, when full compliance would greatly alleviate the risk to the newborn. The review paper did note that antibiotics will not prevent all cases of GBS however.

BPSU: Surveillance of Rare Childhood Diseases:

Further research is required to truly endorse the need for NHS funded GBS tests in pregnancy. A new study is now aiming to assess the incidence of Group B streptococcal disease in infants less than 90 days of age in the UK and Ireland. This is managed by the British Paediatric Surveillance Unit (BPSU) and Public Health England (PHE).

A Health Protection report noted that: “The study will provide valuable data on the current burden of GBS disease (incidence, mortality, and short-term complication rate), current maternal risk factors, serotype distribution and antimicrobial susceptibility of isolates. The study begins on 1 April 2014 and will run for a period of 13 months.”

GBS is the most common cause of sepsis and infectious death during the neonatal period and the most common cause of meningitis within the first three months of life. Approximately 10% of babies with GBS disease will die and neuro-disability occurs in up to 50% of survivors of GBS”.

It is fantastic that further research is being done in an effort to enable detailed review of the effects of GBS and hopefully endorse the need for availability of testing to all women.

GBS Awareness Month 2014

The charity Group Step B Support are promoting GBS awareness month in July 2014. See @GBSSupport on Twitter and #GBSaware. It is vital that women are aware of this infection and have availability of testing, which at the very least informs medics and allows mothers to make informed decisions on the management of their labour and care of their newborn.

The Clinical Negligence Team fully supports this campaign. I act for several children who have suffered serious brain injuries as a result of a negligent failure to diagnose Group B Strep infection which has caused them to suffer from meningitis just after their birth.  These children have lifelong care needs as a result, some never being able to lead the independent life most of us take for granted, all of which could have been avoided had testing and treatment been undertaken when they were born.

[1] BJOG May 23. Doi: 10.1111/1471-0528.12841 Prevention of early-onset Group B Streptococcal disease – the Northern Ireland experience.  Eastwood K et al.

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