Group B Strep

Overview

Group B strep (also called GBS) is a common bacteria that many people carry in their gut, bladder, or vagina. It usually causes no harm, but it can lead to serious infection in newborns, older adults, and people with certain health conditions.

Yes. GBS is very common. Up to one in three adults carry it at some point, often without knowing.

GBS chiefly affects newborn babies, adults over 65, and people with weakened immune systems. In pregnancy, it matters because it can be passed to a baby during birth.

Symptoms

Common symptoms

• Fever and chills
• Pain or burning when passing urine
• Needing to urinate more often than usual
• Lower belly pain or discomfort
• Unusual discharge from the vagina
• A general feeling of being unwell

Symptoms in children

• Poor feeding or not waking for feeds
• High-pitched crying or irritability
• Pale, blotchy, or blue-looking skin
• Breathing fast, grunting, or pauses in breathing
• Fever or a low body temperature
• Floppiness or a weak cry

Symptoms in older adults

• Symptoms of a bladder or kidney infection, such as pain when urinating or cloudy urine
• Shortness of breath or a new cough
• Confusion or feeling very drowsy
• Stiff, painful, or swollen joints
• A high temperature and shaking chills

Causes

Main causes

• GBS is caused by the group B Streptococcus bacterium.
• The bacteria live naturally in the bowel or lower genital tract of some people.
• It is not usually harmful while it stays in these places, but if it causes an infection in the bloodstream, urine, lungs, or tissues, serious illness can develop.

Risk factors

• Being pregnant, especially if GBS is found in your urine during pregnancy.
• Going into labor before 37 weeks of pregnancy.
• Having a previous baby who had GBS disease.
• Being over 65 years old.
• Having a weakened immune system from conditions like diabetes, kidney disease, liver disease, cancer, or immunosuppressive medicines.

When to see a doctor

See a doctor urgently if:

• If your newborn is under 3 months old and has any warning signs like fever, poor feeding, fast breathing, or unusual sleepiness, seek medical help the same day.
• If you are pregnant and you think labour has started and you know you carry GBS, go to the maternity unit immediately.
• If an adult develops sudden confusion, fast breathing, a racing heart, or severe fever, attend your nearest emergency department or call your local emergency number.

Book a routine appointment if:

• If you are pregnant and have questions about GBS testing, bring them up at your next antenatal appointment.
• If you keep getting urine infections and your doctor has not checked for GBS, ask about a urine test.

Diagnosis

Doctors diagnose GBS by taking a swab from the lower vagina and rectum in pregnant women, or by testing a sample of urine, blood, or other fluid if an infection is suspected.

Tests that may be done

• A vaginal/rectal swab at 35–37 weeks of pregnancy
• A urine test (to find GBS in the bladder or kidney)
• A blood test (if a bloodstream infection is suspected)
• A lumbar puncture (spinal fluid test) in a newborn with serious symptoms, to check for meningitis

What to expect at your appointment

Swab tests are quick and painless — they feel a little like a cotton bud being brushed against the skin. Results usually take a few days. If you are GBS-positive in pregnancy, your healthcare team will write this on your birth plan so that antibiotics can be given in labour when needed.

Treatment

Most people who carry GBS do not need any treatment. If you are pregnant and test positive for GBS, you will be offered antibiotics through a drip during labour to lower the chance of passing GBS to your baby. If you develop a GBS infection, your doctor will usually prescribe antibiotics and may ask you to go to hospital for close monitoring and support.

Self-care at home

• Get plenty of rest and drink extra fluids if you have an infection.
• Wash your hands often, and keep any cuts or sores clean and covered.
• If you are recovering from an infection, finish all the medicine your doctor prescribed, even if you start to feel better.
• Follow the advice from your maternity team about monitoring for labour or signs of preterm labour.

Medical treatments

Treatment is with antibiotics. In pregnancy, intravenous (IV) antibiotics are given from the start of labour and repeated every few hours until the baby is born. This is not the same as taking antibiotics by mouth weeks earlier. For an established GBS infection, antibiotics and fluids may be given in the hospital. If a newborn develops GBS infection, they will be cared for in a neonatal unit with intravenous antibiotics and careful observation.

When is surgery considered?

Surgery is not a treatment for GBS. It may be needed only for rare complications, such as an abscess or joint infection, when infected fluid needs to be drained. If this is necessary, your surgeon will explain the procedure fully.

Living with this condition

For most people, carrying GBS does not affect everyday life. If you have had a GBS infection, take time to recover and go to any follow-up appointments. If you are pregnant and GBS-positive, it helps to tell your maternity team so they can prepare the right care for you during birth.

Lifestyle tips

• Keep your hands and any wounds clean.
• Attend your antenatal appointments and discuss GBS testing with your midwife.
• Look after any chronic conditions, such as diabetes, with regular check-ups.
• If you have symptoms of a urine infection, don't wait — ask your doctor for a test.

Diet and exercise

A balanced diet rich in fruit, vegetables, wholegrains, and protein helps your immune system. In pregnancy, continue normal physical activity unless your doctor says otherwise. After an infection, build up exercise gradually and stay hydrated.

Mental health and emotional wellbeing

Learning you carry GBS can be worrying, especially during pregnancy. It is important to remember that routine prenatal care and safeguards are usually effective. If you are still feeling anxious, talk to your midwife or doctor, and know that most babies remain well when the care pathway is followed.

Prevention

For babies, the most effective prevention is identifying GBS-carrying mothers and giving them IV antibiotics during labour. Good hygiene, such as washing hands after using the toilet and cleaning all wounds, also reduces the chance of GBS causing infection.

Vaccines

There is currently no licensed vaccine against Group B Strep, although research is ongoing. Antibiotics remain the mainstay of prevention and treatment.

Screening programmes

In the UK, universal screening for GBS in pregnancy is not currently part of routine national care, but testing can be arranged if you have a higher risk or are concerned. Ask your midwife about local options, especially if you have had a previous baby affected by GBS.

Complications

If left untreated

• In newborns, untreated GBS can cause pneumonia, sepsis (a life-threatening blood infection), or meningitis.
• In adults, untreated GBS can lead to urinary tract infection, bloodstream infection, joint infections, or infection of the heart lining.
• In rare cases, severe GBS infection can be fatal, which is why prompt screening and treatment are important.

Long-term outlook

With current care, the outlook for GBS is very good. Most babies of GBS-carrying mothers are born completely healthy, and even babies who develop GBS infection respond well when treated quickly. Early detection and antibiotics in labour have dramatically reduced the number of newborn infections. For adults with milder infections, full recovery is common. Carriers themselves have no illness and need no treatment.

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