Group B Streptococcus
Description Diagnostic criteria General and supportive measures Medicine treatment Referral DESCRIPTION Group B streptococcus is an encapsulated Gram-positive coccus that colonises the gastrointestinal and genitourinary tracts. Infection in the first 6 days of life is referred to as early-onset disease (EOD). Late-onset disease (LOD) refers to infection from day 7–89 of life. DIAGNOSTIC CRITERIA
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
DESCRIPTION
Group B streptococcus is an encapsulated Gram-positive coccus that colonises the gastrointestinal and genitourinary tracts.
Infection in the first 6 days of life is referred to as early-onset disease (EOD). Late-onset disease (LOD) refers to infection from day 7–89 of life.
DIAGNOSTIC CRITERIA
- Infants may present in respiratory distress or with signs of septicaemia.
- Complications include meningitis, cellulitis, osteomyelitis or septic arthritis.
- A blood culture should be performed before initiation of antibiotics in infants that are at risk of sepsis, namely, maternal fever, prolonged rupture of membranes or prematurity due to an unknown cause.
- Meningitis should be excluded in all patients that have a positive blood culture for group B streptococcus.
GENERAL AND SUPPORTIVE MEASURES
See: Septicaemia of the Newborn
MEDICINE TREATMENT
- Ampicillin, IV, 50 mg/kg/dose for 10 days.
| Gestational Age | Postnatal Age | Dose |
| ≤ 34 weeks | ≤ 7 days | 50 mg/kg/dose every 12 hours |
| 8 to 28 days | 75 mg/kg/dose every 12 hours | |
| >34 weeks | ≤ 28 days | 50mg/kg/dose every 8 hours |
Uncomplicated meningitis: 14 days of ampicillin plus:
- Gentamicin, IV, for 5 days for synergy.
- If < 32 weeks gestation: 5 mg/kg/36 hours in the first week of life.
- If ≥ 32 weeks gestation: 5 mg/kg/24 hours in the first week of life.
- Monitor blood levels.
REFERRAL
- For surgical complications such as hydrocephalus, septic arthritis, osteomyelitis.
- Septicaemia not responding to treatment.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 19: Prematurity And Neonatal Conditions, 19.5 Infections, 19.5.3 Group B Streptococcus