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Epidemiology of group B streptococci: one year's experience in an obstetric and special care baby unit
Insights
Group B Streptococcus (GBS) epidemiology shows maternal transmission is common in newborns. Strict infection control can minimize nosocomial GBS transmission in hospitals.
Area of Science:
- Neonatal infections
- Microbiology
- Epidemiology
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal infections.
- Understanding GBS transmission dynamics in healthcare settings is crucial for prevention.
Purpose of the Study:
- To investigate the epidemiology of GBS acquisition in an obstetric and special care baby unit (SCBU).
- To identify sources of GBS transmission and assess the role of nosocomial spread.
Main Methods:
- Prospective study over one year in an obstetric unit and SCBU.
- Collection of rectal and umbilical swabs from neonates.
- Phage-typing and serotyping to trace GBS strains.
Main Results:
- Maternal GBS acquisition led to higher early colonization rates (77%) compared to non-maternal sources (35%).
- Mother-baby pairs were the primary source of hospital-acquired GBS, not staff.
- Non-maternal GBS sources were more prevalent in the obstetric unit (36%) than in the SCBU (9%).
- Rectal and umbilical swabs yielded the highest GBS isolation rates.
Conclusions:
- Maternal-infant transmission is a key route for GBS acquisition in newborns.
- Nosocomial transmission of GBS occurs but can be reduced through diligent infection control.
- Hospital-acquired GBS colonization in this cohort did not lead to long-term carriage post-discharge.
Abstract:
The epidemiology of group B streptococci (GBS) was studied in an obstetric unit and the related special care baby unit (SCBU). In 1 year 53 (77%) of 69 babies who acquired GBS from their mothers were colonized within 24 h of birth, compared with only 9 (35%) of 38 who acquired GBS from non-maternal sources. While 38 (36%) of 107 GBS colonized babies in the obstetric unit derived the organism from a non-maternal source, the value for the SCBU was only 2 (9%) of 23. In babies rectal and umbilical swabs gave the highest GBS isolation rates. Phage-typing and serotyping suggested that colonized mother baby pairs, rather than staff, were the primary source of hospital acquired GBS. This mode of GBS acquisition did not result in long-term carriage once babies had left hospital. Nosocomial transmission can play an important part in GBS epidemiology, but can be minimized by attention to infection control procedures.