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group strongbstrong streptococcus (gbs), is the gram positive diplococcus.doc

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group strongbstrong streptococcus (gbs), is the gram positive diplococcus

Introduction Group B streptococcus (GBS), is the gram positive aerobic diplococcus Streptococcus agalactiae, and is found in pairs or in chains. The bacterium is encapsulated in a polysaccharide coating. The Lancefield classification system distinguishes different streptococci by the specific carbohydrate antigen; GBS has Lancefield group B antigen. There are nine serotypes of GBS; in the United States, serotype Ia, Ib, II, III, and V account for approximately 95% of all cases. Serotype III is most prevalent in early-onset meningitis and late-onset disease in neonates. Early onset disease is defined by infection at 7 days of life, and late-onset disease from 7 days to 3 months. Approximately 80% of early–onset is due to vertical transmission from mother to infant during labor, and usually presents as sepsis and pneumonia within the first 24 hours, with 5 – 10% of cases presenting as meningitis. Approximately 10 – 30% of pregnant women are colonized with GBS. Risk factors for colonization during pregnancy include diabetes, age 20 years, less than four pregnancies, African-American or Hispanic ethnicity, and low maternal serum antibody specific to GBS serotype. Obstetric risk factors include intrapartum fever, prolonged rupture of membranes, GBS bacteriuria, previous infant affected by GBS disease, and delivery 37 weeks gestation. In GBS culture positive women, the mean rate of transmission risk is 50%, with a range of 29% to 85%. Of those infants who become colonized, 1-4 Background In the 1970s, GBS was identified as the leading cause of neonatal sepsis, with approximately 7500 cases per year prior to recommended prevention protocols.5 Neonatal mortality rates were reported as high as 50%, with annual cost approaching $300 million. Morbidity from this disease included blindness, hearing loss, mental retardation, and cerebral palsy. 3,6 With studies in the late 1970s and 1980s demonstrating the effectiveness of intrapartum antibiotic regimens in decreasing neonata