What is GBS?

Group B Streptococcus

GBS stands for Group B Streptococcus

This is a bacterium. Many people carry this GBS bacterium, along with many other types of bacteria, in their gut. As long as the bacterium stays in the gut, it can do no harm. But when the GBS bacterium finds a way to enter the body, it causes a life-threatening infectious disease. When a pregnant woman carries the GBS bacterium, the GBS bacterium can infect the baby before, during or after the delivery. This sometimes leads to the death of the baby during birth, premature birth, or pneumonia, blood poisoning or meningitis in the baby after birth. Fortunately, by acting timely, this can usually be effectively prevented with antibiotics, but to do so, it is important to know whether someone is a carrier.

What are the symptoms of GBS?

In adults, the symptoms of GBS usually show itself as a bladder infection. In pregnant women, there are a number of signs that may indicate a GBS infection. For example, before birth:

If a mother who is a carrier of Group B Streptococcus is not given medication, there is a risk that the infection will be passed on to the baby. Directly after the birth, the following may show in the baby:

A number of these symptoms persist after birth, along with additional symptoms. These GBS symptoms usually occur in the first few days or first weeks until approximately 12 weeks after the birth:

Rapid breathing and grunting when breathing
Pale and grey colour
A fever, or conversely, a low body temperature
Weakness and drowsiness
Recurring apnoea
Poor feeding
Irritation and overstretching

How does GBS develop in your body?

In adults, the GBS bacterium is usually found as a harmless resident of the gut. From there, the GBS bacterium can cause a bladder infection. The bacterium may also be present in the vagina without causing any symptoms. However, during pregnancy and childbirth, the presence of the GBS bacterium can be dangerous for the (unborn) baby. In the Netherlands, 1 in 5 pregnant women is (unaware that she is) a carrier of the bacterium.
How the GBS bacterium spreads is not (yet) known. It is not clear why some people carry the GBS bacterium (and will remain a carrier), whilst others do not.

Unfortunately, we cannot answer the question how GBS develops in your body.

Transmitting the infection to the baby

Research shows that there are three critical moments a baby may be infected by the GBS bacterium:

1

In the womb, as soon as the waters break, the bacterium can infect the amniotic fluid and thus reach the unborn child. Infection can also occur when the waters have not yet broken.

2

In the vagina, the baby can be infected by the bacterium during the second stage of labour if the bacterium is present in the vagina of the mother.

3

Infection can also occur after birth through physical contact with someone who is carrying the GBS bacterium. This usually happens in the first few days or weeks after the birth.

Can GBS be cured?

Your body can get rid of the bacterium, but it can also be infected again. GBS bacteria are common bacteria found in the large intestine. A course of antibiotics to completely eliminate the bacteria usually doesn’t help or is only temporarily effective. There is a good chance the bacterium will return later. Once it has been established that you are, or have been, infected with GBS, you are considered part of a high-risk group and preventive measures will need to be taken in the event of a subsequent pregnancy.

Prevention of Group B Streptococcus in babies

Unfortunately, it is not always possible to prevent the GBS illness in your baby. A risk factor is identified before birth in half of the children who become ill shortly after birth. In that case, antibiotics can be administered in the mother’s vein during labour. This reduces the likelihood of the child becoming ill. For the best result, the mother should be given antibiotics for at least 4 hours before giving birth. Children born to mothers who were given these antibiotics during labour are not protected against GBS disease in the months following birth.

If a baby looks ill, the paediatrician will treat it via a drip after birth. Even if the baby does not look ill, if there are risk factors, the paediatrician will recommend keeping a close eye on him or her in the hospital. If there are multiple risk factors, the paediatrician will recommend treating the baby with antibiotics.

Having the right information is important to help you get through this difficult time, so that you can stand by the choices you’ve made in hindsight.

Marja Estourgie

The history of GBS

Before 1970, GBS was only known as a pathogen in livestock. The infection primarily caused udder infections in cows, causing them to give less milk. In this period, the infectious disease also received its official name: Streptococcus agalactiae. Coccus means a round bacterium, strepto means the bacteria are formed in a twisted chain, and a-galactiae means ‘without milk’. Furthermore, the GBS bacterium frequently causes infections in tilapia (a type of fish) and sometimes also in other animal species.

To this day, it is unknown how the bacterium was able to reach humans around 1970. It may be due to changes in the bacterium’s characteristics, or perhaps to changes in humans. We just don’t know. There are rare cases where a human has infected an animal and vice versa. However, the GBS bacteria that make babies ill are different from GBS bacteria found in animals. Unfortunately, there are still many questions surrounding the bacterium to which we do not have an answer. Luckily, we know how to deal with it once the bacterium is identified – and that is very important.

Research on GBS

A number of studies are currently underway that contribute to the prevention of Group B Streptococcus. As there are still many questions left unanswered about this disease, it is important further research is carried out. We, as Foundation OGBS, consider research into the bacterium to be very important and are therefore keen to support initiatives that accelerate this research.

Research is important not only in the Netherlands, but also in developing countries, where not everyone has access to the right medication and preventive measures.

GBS Options Card

Were you identified as a carrier of the GBS bacterium during your pregnancy?

If so, it is important to thoroughly research your options during birth. In collaboration with NVOG (Dutch Society for Obstetrics and Gynaecology), we created the GBS options card to help you make your choice. The options card provides further information on the pros and cons of taking antibiotics during labour to prevent GBS infection.

Want to know more about GBS?

We can imagine you have more questions about Group B Streptococcus, particularly from the perspective of parents who have been through the same experience. We’d love to get in touch with you.

WHAT IS GBS?