{
 "topic": "Group B Streptococcal Infection",
 "slug": "group-b-streptococcal-infection",
 "category_id": 15118,
 "passage_count": 14,
 "source_chars": 12565,
 "enough_material": true,
 "references": [
  {
   "title": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition",
   "author": "Hay, William W., Levin, Myron J., Deterding, Robin R., Abzug, Mark J.",
   "pages": [
    1283
   ]
  },
  {
   "title": "Red Book 2018",
   "author": "Kimberlin, David W.; Long, Sarah S.; Brady, Michael T.",
   "pages": [
    813,
    814,
    819
   ]
  },
  {
   "title": "Cover",
   "author": "Vitalsource Download",
   "pages": [
    4102,
    4103,
    4105
   ]
  },
  {
   "title": "Red_Book_2021_2024_Report_of_the_Comm_z_library_sk,_1lib_sk,",
   "author": null,
   "pages": [
    762
   ]
  },
  {
   "title": "Red Book Atlas of Pediatric Infectious Diseases",
   "author": "American Academy of Pediatrics (AAP);Tan, Tina Q.;",
   "pages": [
    594,
    660,
    665
   ]
  },
  {
   "title": "Red Book Atlas 4th Ed.indb",
   "author": "American Academy of Pediatrics;Carol J. Baker, MD, FAAP;",
   "pages": [
    672
   ]
  },
  {
   "title": "MedStudy Pediatrics Core 11th Edition 2024-2025",
   "author": null,
   "pages": [
    744
   ]
  }
 ],
 "passages": [
  {
   "source": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition, p. 1283",
   "text": "Shulman ST et al: Clinical practice guideline for the diagnosis and ~~management of group A streptococcal pharyngitis: 2012 update~~ by the Infectious Diseases Society of America. Clin Infect Dis 2012;55(10):1279\u20131282. http://cid.oxfordjournals.org/content/ early/2012/09/06/cid.cis629.full. [PMID: 22965026] ## **GROUP B STREPTOCOCCAL INFECTIONS** ## ESSENTIALS OF DIAGNOSIS & TYPICAL FEATURES - \u00bb Early-onset disease: - [Newborn younger than age 7 days, with rapidly ] progressing overwhelming sepsis, with or without meningitis. - [Pneumonia with respiratory failure is frequent; chest ] radiograph resembles that seen in hyaline membrane disease. - [Blood or cerebrospinal fluid (CSF) cultures growing ] group B streptococci (GBS). - \u00bb Late-onset disease: - [Meningitis, sepsis, or other focal infection in a child ] aged 7\u201389 days with blood or CSF cultures growing GBS. ## \u00bb **Prevention**"
  },
  {
   "source": "Red Book 2018, p. 819",
   "text": "**CLINICAL MANIFESTATIONS:** Streptococci other than Lancefield groups A or B can be associated with invasive disease in infants, children, adolescents, and adults. The principal clinical syndromes of groups C and G streptococci (most belong to the _Streptococcus dysgalactiae_ group) are bacteremia, septicemia, upper and lower respiratory tract infections (eg, pharyngitis, sinusitis, and pneumonia), skin and soft tissue infections, septic arthritis, osteomyelitis, meningitis with a parameningeal focus, brain abscess, toxic shock syndrome, pericarditis, and endocarditis with various clinical manifestations. Viridans streptococci are the most common cause of bacterial endocarditis in children, especially children with congenital or valvular heart disease, and these organisms are a common cause of bacteremia in neutropenic patients with cancer in the first 2 weeks after hematopoietic stem cell transplantation and as a cause of central line-associated bacteremia. Among the viridans streptococci, group F"
  },
  {
   "source": "Cover, p. 4103",
   "text": "## **PATHOGENESIS AND EPIDEMIOLOGY** Group B streptococci are gram-positive cocci that grow readily as white to graywhite colony-forming units with a narrow zone of \u03b2-hemolysis when inoculated on blood agar. Group B streptococci have been classified, based on capsular polysaccharide antigens, into 10 types. Contemporary data indicate that types Ia, III, and V predominate in early-onset disease, accounting for more than threefourths of isolates from infants with invasive infection. Together with types Ib and II, these 5 types account for approximately 98% of isolates from infant invasive early-onset disease. Among late-onset cases of group B streptococcal infection, type III strains predominate, accounting for more than one-half of infections. Serotype IV, formerly uncommon, appears to be emerging as a cause of invasive disease in neonates."
  },
  {
   "source": "Red_Book_2021_2024_Report_of_the_Comm_z_library_sk,_1lib_sk,, p. 762",
   "text": "## Non-Group A or B Streptococcal and Enterococcal Infections **CLINICAL MANIFESTATIONS:** Streptococci other than Lancefield groups A or B can be associated with invasive disease in infants, children, adolescents, and adults. The principal clinical syndromes of groups C and G streptococci (most belong to the _Streptococcus dysgalactiae_ group) are bacteremia, septicemia, upper and lower respiratory tract infections (eg, pharyngitis, sinusitis, and pneumonia), skin and soft tissue infections, septic arthritis, 714 NON-GROUP A OR B STREPTOCOCCAL AND ENTEROCOCCAL INFECTIONS"
  },
  {
   "source": "Red Book Atlas of Pediatric Infectious Diseases, p. 665",
   "text": "Streptococci other than lancefield groups A or B can be associated with invasive disease in infants, children, adolescents, and adults. the principal clinical syndromes of groups c and g streptococci (most belong to the _Streptococcus dysgalactiae_ group) are bacteremia, septicemia, upper and lower respiratory tract infections (eg, pharyngitis, sinusitis, and pneumonia), skin and soft tissue infections, septic arthritis, osteomyelitis, meningitis with a parameningeal focus, brain abscess, toxic shock syndrome, pericarditis, and endocarditis with various clinical manifestations. Viridans streptococci are the most common cause of bacterial endocarditis in children, especially children with congenital or valvular heart disease. Viridans streptococci are a common cause of bacteremia in neutropenic patients with cancer, especially following intensive induction chemotherapy for acute myeloid leukemia, after hematopoietic stem cell transplant, and as a cause of central catheter\u2013 associated bacteremia. Among the"
  },
  {
   "source": "Red Book 2018, p. 813",
   "text": "**CLINICAL MANIFESTATIONS:** Group B streptococci are a major cause of perinatal infections, including bacteremia, endometritis, intra-amniotic infection (formerly called chorioamnionitis), and urinary tract infections in women during pregnancy and immediately postpartum, and of systemic and focal infections in neonates and young infants. Invasive disease in infants is categorized on the basis of chronologic age at onset. Early-onset disease usually occurs within the first 24 hours of life (range, 0 through 6 days) and is characterized by signs of systemic infection, respiratory distress, apnea, shock, pneumonia, and less often, meningitis (5%\u201310% of cases). Late-onset disease, which typically occurs at 3 to 4 weeks of age (range, 7 through 89 days), commonly manifests as occult bacteremia or meningitis (approximately 30% of cases); other focal infections, such as osteomyelitis, septic arthritis, necrotizing fasciitis, pneumonia, adenitis, and cellulitis, occur less commonly. Nearly 50% of survivors of"
  },
  {
   "source": "Red Book Atlas 4th Ed.indb, p. 672",
   "text": "B can be associated with invasive disease in infants, children, adolescents, and adults. The principal clinical syndromes of groups C and G streptococci (most belong to the _Streptococcus dysgalactiae_ group) are bacteremia, septicemia, upper and lower respiratory tract infections (eg, pharyngitis, sinusitis, and pneumonia), skin and soft tissue infections, septic arthritis, osteomyelitis, meningitis with a parameningeal focus, brain abscess, toxic shock syndrome, pericarditis, and endocarditis with various clinical manifestations. Viridans streptococci are the most common cause of bacterial endocarditis in children, especially children with congenital or valvular heart disease, and these organisms are a common cause of bacteremia in neutropenic patients with cancer in the first 2 weeks after hematopoietic stem cell transplantation and as a cause of central lineassociated bacteremia. Among the viridans streptococci, group F streptococci (most belong to the _Streptococcus anginosus_ group) are implicated in"
  },
  {
   "source": "Cover, p. 4102",
   "text": "## **281 Group B** _**Streptococcus**_ ## Morven S. Edwards ## **INTRODUCTION** Group B _Streptococcus_ has been a common cause of invasive infection in neonates and young infants for several decades. Group B _Streptococcus_ also is an important cause of maternal obstetrical morbidity and fetal loss. The incidence of early-onset group B streptococcal neonatal infections has declined 85% in the United States in association with universal culture-based screening of pregnant women and administration of intrapartum antibiotic prophylaxis to women colonized with group B _Streptococcus_ . ## **PATHOGENESIS AND EPIDEMIOLOGY**"
  },
  {
   "source": "Cover, p. 4105",
   "text": "## **DIAGNOSIS** Isolation of group B streptococci from a normally sterile body site such as the blood or cerebrospinal fluid or from the site of focal infection such as bone, joint, or abscess fluid is diagnostic. Abnormalities of the white blood cell count, such as neutropenia or elevation of the ratio of immature to total neutrophils, can be found in association with group B streptococcal infection, as well as in neonatal sepsis caused by other bacterial pathogens. ## **TREATMENT**"
  },
  {
   "source": "Red Book Atlas 4th Ed.indb, p. 672",
   "text": "B can be associated with invasive disease in infants, children, adolescents, and adults. The principal clinical syndromes of groups C and G streptococci (most belong to the _Streptococcus dysgalactiae_ group) are bacteremia, septicemia, upper and lower respiratory tract infections (eg, pharyngitis, sinusitis, and pneumonia), skin and soft tissue infections, septic arthritis, osteomyelitis, meningitis with a parameningeal focus, brain abscess, toxic shock syndrome, pericarditis, and endocarditis with various clinical manifestations. Viridans streptococci are the most common cause of bacterial endocarditis in children, especially children with congenital or valvular heart disease, and these organisms are a common cause of bacteremia in neutropenic patients with cancer in the first 2 weeks after hematopoietic stem cell transplantation and as a cause of central lineassociated bacteremia. Among the viridans streptococci, group F streptococci (most belong to the _Streptococcus anginosus_ group) are implicated in"
  },
  {
   "source": "MedStudy Pediatrics Core 11th Edition 2024-2025, p. 744",
   "text": "(Group B Streptococcus [GBS]) GBS is a common cause of infection in the newborn and young infant. It is a major cause of newborn sepsis, pneu- monia, bacteremia, and meningitis. (This is one of the reasons why ampicillin is included in the empiric treat- ment for neonatal meningitis; it also covers Listeria and enterococci in this age group.) S. agalactiae can cause UTIs in pregnant people, and it is also a cause of post- partum endometritis and bacteremia. Asymptomatic colonization of the vagina or anorectum of pregnant people serves as the source for most infections in infants. There are 10 GBS types, based on their capsular polysac- charide composition. There are early- and late-onset group B streptococcal infections in the newborn/early infancy period. Maternal GBS screening and treatment have significantly reduced only the early-onset GBS infections. Things to know about early-onset GBS disease: * Onset occurs within 7 days of birth (most within 1 hour after delivery)."
  },
  {
   "source": "Red Book Atlas of Pediatric Infectious Diseases, p. 594",
   "text": "Streptococci other than Lancefield groups A or B can be associated with invasive disease in infants, children, adolescents, and adults. The principal clinical syndromes of groups C and G streptococci are septicemia, upper and lower respiratory tract infections, skin and soft tissue infections, septic arthritis, meningitis with a parameningeal focus, brain abscess, and endocarditis with various clinical manifestations. Group F streptococcus is an infrequent cause of invasive infection. Viridans streptococci are the most common cause of bacterial endocarditis in children, especially children with congenital or valvular heart disease, and these organisms have become a common cause of bacteremia in neutropenic patients with cancer and in the first 2 weeks after bone marrow transplantation. Among the viridans streptococci, organisms from the _Streptococcus angi\u00ad nosus_ group often cause localized infections, such as brain or dental abscesses or abscesses in other sites, including lymph nodes, liver, and lung."
  },
  {
   "source": "Red Book Atlas of Pediatric Infectious Diseases, p. 660",
   "text": "Group B streptococci are a major cause of perinatal infections, including bacteremia, intra-amniotic infection (formerly called _chorioamnionitis_ ), and endometritis in pregnant and postpartum women, as well as systemic and focal infections in neonates and young infants (figure 136.1). In newborns, early-onset disease (eoD) usually occurs within the first 24 hours after birth (range, 0\u20136 days), manifesting with respiratory distress, apnea, shock, pneumonia, and, less often, meningitis (5%\u201310% of cases). late-onset disease (loD), which typically occurs at 3 to 4 weeks of age (range, 7\u201389 days), commonly manifests as bacteremia or meningitis (approximately 30% of cases); other focal infections, such as osteomyelitis, septic arthritis, necrotizing fasciitis, pneumonia, adenitis, and cellulitis, occur less commonly. approximately 20% of survivors of neonatal group B streptococcal (GBS) meningitis have moderate to severe neurodevelopmental impairment. cases in infants older than 90 days are reported rarely,"
  },
  {
   "source": "Red Book 2018, p. 814",
   "text": "**ETIOLOGY:** Group B streptococci _(Streptococcus agalactiae)_ are gram-positive, aerobic diplococci that typically produce a narrow zone of beta hemolysis on 5% sheep blood agar. These organisms are divided into 10 types on the basis of capsular polysaccharides (Ia, Ib, and II through IX). Types Ia, Ib, II, III, and V account for approximately 95% of cases in infants in the United States, with type IV emerging as an important cause of invasive infections in adults. Type III is the predominant cause of early- and late-onset meningitis and the majority of late-onset infections in infants. Capsular polysaccharides and piluslike structures are important virulence factors and are potential vaccine candidates. **EPIDEMIOLOGY:** Group B streptococci are common inhabitants of the human gastrointestinal and genitourinary tracts. Less commonly, they colonize the pharynx. The colonization rate in pregnant women ranges from 15% to 35%. Colonization during pregnancy can be constant or intermittent. Before"
  }
 ]
}