Group B streptococcal colonization in 160 mother-baby pairs: a prospective cohort study

J Pediatr. 2013 Oct;163(4):1099-104.e1. doi: 10.1016/j.jpeds.2013.05.064. Epub 2013 Jul 15.


Objectives: To identify the source of postnatal colonization with group B Streptococcus (GBS) and to evaluate the impact of intrapartum antibiotic prophylaxis (IAP) administration in newborn infant transmission.

Study design: A prospective, longitudinal study evaluated GBS colonization in 160 mother-baby pairs. Specimens were collected from the time of delivery to 8 weeks post-partum, from rectum, vagina, and milk of mothers, and from throat and rectum of neonates. Women were grouped according to their GBS status at discharge from the hospital: culture-positive carriers (n = 83), culture-negative carriers (n = 26), and noncarriers (n = 51). Newborns were considered colonized if GBS was yielded from at least 1 site.

Results: A total of 35 (21.9%) neonates were colonized; 30 were born to culture-positive carriers, 2 to culture-negative carriers, and 3 to noncarriers. Infants of culture-positive carriers exposed to IAP were less likely to be colonized (15/57 vs 15/26, P = .01), or heavily colonized, (7/57 vs 9/26, P = .04). Of all newborns, those exposed to IAP and discharged GBS-free from hospital, often became colonized subsequently (12/57 vs 1/26, P = .09). Molecular typing analysis (available for 30 of 32 carrier mothers and their infants) confirmed an identical strain of GBS in all mother-baby pairs. Six of 83 culture-positive carrier mothers had a positive milk culture. Their respective neonates all were heavily colonized.

Conclusions: Newborns exposed to IAP and GBS-free at hospital discharge subsequently acquire GBS from their mothers. Culture-positive milk is associated with heavy neonatal colonization.

Keywords: EOD; Early-onset disease; GBS; Group B Streptococcus; IAP; Intrapartum antibiotic prophylaxis; LOD; Late-onset disease; PFGE; Pulsed field gel electrophoresis; THB; Todd-Hewitt broth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Longitudinal Studies
  • Male
  • Milk, Human / microbiology
  • Mothers
  • Prospective Studies
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / prevention & control
  • Streptococcal Infections / transmission*
  • Streptococcus agalactiae*
  • Time Factors
  • Young Adult