Group B Streptococcus (GBS) in Newborns: A Nursing Overview
Definition
Group B Streptococcus (GBS) is a type of bacteria commonly found in the gastrointestinal and genital tracts of adults. While often harmless in adults, GBS can cause serious infections in newborns, including sepsis, pneumonia, and meningitis. It is one of the leading causes of neonatal morbidity and mortality.
Transmission
GBS can be transmitted from mother to infant during childbirth, especially if the mother is colonized with GBS in the genital or rectal area. To reduce the risk of transmission, pregnant women are usually screened for GBS colonization between 35-37 weeks gestation.
Early-Onset vs. Late-Onset GBS Disease
• Early-Onset GBS Disease: Occurs within the first 24-48 hours to 7 days after birth, usually due to transmission during delivery. Symptoms include respiratory distress, lethargy, poor feeding, and temperature instability.
• Late-Onset GBS Disease: Occurs after the first week of life, often up to three months. Symptoms can include fever, irritability, and feeding difficulties. Late-onset GBS may lead to conditions like meningitis.
Prevention Strategies
1. Maternal Screening and Antibiotics:
• Screening for GBS at 35-37 weeks of pregnancy.
• If the mother is GBS-positive, intravenous antibiotics (usually penicillin) are administered during labor to reduce the risk of transmission to the newborn.
2. Monitoring in the Newborn:
• Newborns of GBS-positive mothers are monitored closely after birth for signs of infection.
• Observation typically includes regular assessment of vital signs, feeding tolerance, and any signs of respiratory or neurological distress.
Nursing Care and Interventions
1. Initial Assessment:
• Upon birth, assess the newborn for respiratory distress, temperature instability, and feeding difficulties.
• Notify the healthcare provider of any signs of GBS infection for prompt intervention.
2. Supportive Care:
• If the newborn develops GBS symptoms, supportive care may include oxygen therapy, IV fluids, and nutritional support.
• Administer antibiotics as prescribed, typically IV antibiotics like ampicillin and gentamicin.
3. Parent Education:
• Educate parents on recognizing signs of infection in newborns, such as fever, irritability, poor feeding, and lethargy.
• Inform them about the importance of completing the full course of treatment if antibiotics are started.
Long-Term Follow-Up
Some infants who recover from GBS infection may require follow-up care, particularly if the infection involved the central nervous system, as complications like hearing loss or developmental delays may occur.
Conclusion
Nursing care for GBS involves prevention, early detection, and prompt treatment to reduce risks to the newborn. Nurses play a key role in educating parents, administering care, and closely monitoring infants for signs of infection.
Citation
Smith, J., & Roberts, K. (2021). Group B Streptococcus in Newborns: A Nursing Guide for Early Detection and Management. Journal of Perinatal and Neonatal Nursing, 35(2), 120-126.