1. Streptococcus Agalactiae
Kristen Glasspoole
Streptococcus Agalactiae

2. Objectives After the presentation, the audience should:
Identify who is at risk for contracting Streptococcus agalactiae.
Recognize the route of transmission of Streptococcus agalactiae.
Define how the symptoms of Streptococcus agalactiae are diagnosed.
Predict the prognosis of a person that has contacted Streptococcus agalactiae
Be aware of what treatment options are available to patients with Streptococcus agalactiae.
Evaluate ways in which to be proactive in preventing the disease.

3. Facts Emerged as pathogen in 1970, as sepsis in infants.
25% of women carry Group B Strep.
Neonatal sepsis occurs per 1000 live births.
Before prevention – 20,000 cases annually
Cost 300 million dollars

4. Morphology
Aerobic gram positive Cocci, gray-white with narrow zone of beta hemolysis, encapsulated.
Virulence is do to polysaccharide toxin it produces.

5. Gram Stain

6. Etiologic agents/ Causes
Streptococcus agalactiae
Mostly seen as normal vaginal flora of women
Causes problem during pregnancy
Adults – sepsis and soft tissue infections

7. Who is at Risk
Infants born to mothers with Streptococcus agalactiae colonization.
Prolonged rupture of the membrane
Preterm birth
Elderly people
African Americans
Adults with chronic illnesses
Diabetes, heart disease, malignancy, cirrhosis, AIDS, steroids

8. Adults with Streptococcus agalactiae
Increase chance of Group B strep with age.
Bloodstream infections, pneumonia, skin and soft tissue infections, bone and joint infections.
Blood or spinal fluid sampled.
Treat with penicillin .
Can be fatal.

9. Risk Factors
Colonization of Streptococcus agalactiae during third trimester of pregnancy.
Positive Group B Strep screening culture
Delivery at less than 37 weeks of gestation
Rupture of the amniotic membrane for more than 18 hours
Intrapartum Fever of > F
Previous Infant with Streptococcus agalactiae infection.

10. Transmission Pregnant women Adults
Asymptomatic – carried in genital tract and gastrointestinal tract
Transmission to baby occurs vertically in utero or through the genital tract during delivery.
Adults
Transmission is unknown
Possibility of endogenous isolates gaining access to sterile sites.

11. Symptoms in Neonates Meningitis, sepsis, pneumonia
Early on set (<7 days old)
Late on set (7-90 days old)
Fever, difficulty breathing, difficulty feeding, bluish color of skin, lethargic, irregular heart rate

12. Neonates with Streptococcus agalactiae

13. Neonate with Streptococcus agalactiae
Tests:
Complete blood count, blood gases, prothrombin time (PT), partial thromboplastin time (PTT), blood culture, CSF culture, urine culture, X-ray.
Treatment:
Antibiotics, fluids through a vein, breathing help, medication for shock

14. Collection Streptococcus agalactiae maybe seen in the urine
Only a concern if woman is of child bearing age (15-45)
Specimens are cultured at weeks of pregnancy.
A swab is collected from lower vagina and rectum.

15. Diagnosis Found in the blood, CSF, and urine. Test include:
Latex agglutination
CAMP Test
Group B Strep Broth
PCR

16. Detection–Latex agglutination

17. Detection – CAMP Test

18. Group B Strep Broth Positive Negative

19. Streptococcus agalactiae
Non-hemolytic
Hemolytic

20. PCR *

21. Prognosis For women who are pregnant the prognosis is good.
Neonates have a better prognosis than in previous years but the mortality rate is still significant.
For adults (elderly) the prognosis is a high mortality rate.

22. Neonates with Streptococcus agalactiae

23. Neonates with Streptococcus agalactiae

24. Neonates with Streptococcus agalactiae

25. Treatment Penicillin or Ampicillin is the drug of choice Anaphylaxis
Testing aminoglycosides
Anaphylaxis
Clindamycin, Erythromycin
Antibiotic are only given DURING labor.
Bacteria grows back very quickly

26. Drug Resistance

27. Prevention Working on a vaccine Problem with shifting serotypes
Women not comfortable with vaccination during pregnancy

28. Prevention

29. References
(2010, November 18). Group b strep (gbs). Retrieved from Center for Disease Control and Prevention website:
(2011, November 14). Group b streptococcal septicemia of the newborn. Retrieved from Medline Plus website:
(2011, September 13). Streptococcus group b infections clinical presentation. Retrieved from medscape website:
(2009, ). Group b streptococcal disease causes. Retrieved from Thridage.com website:
(2011, ). Streptococcus agalactiae. Retrieved from Microbiology in Pictures website:
(2010, November 19). Early-onset group b streptococcal disease prevention: for clinicians. Retrieved from Centers for Disease Control and Prevention website:

30. References
(2010, November 19). Early-onset group b streptococcal disease prevention: procedures for laboratories. Retrieved from Centers for Disease Control and Prevention website:
Verani, J. R., McGee, L., & Schrag, S. J. (2010, November 19). Prevention of prenatal group b streptococcal disease. Retrieved from Morbidity and mortality weekly report website:
Mahon, C. R., Lehman, D. C., & Manuselis, G. (2011). Diagnostic microbiology fourth edition. Missouri: Saunders Elsevier.
Forbes, B. A., Sahm, D. F., & Weissfeld, A. S. (2007). Diagnostic microbiology 12th edition. Bailey And Scott's.
Brooke, S., Whitworth, J., & Calabretta, N. (2009, January). How best to manage the patient in term labor whose group b strep status is unknown? website: *
(2011, ). What is group b strep. Retrieved from Group B Strep International website: