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Streptococcus
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==== Group B ==== ''[[Streptococcus agalactiae|S. agalactiae]]'', or group B ''streptococcus'', '''GBS''', causes pneumonia and meningitis in [[Infant|newborns]] and the [[elderly]], with occasional systemic [[bacteremia]]. Importantly, ''Streptococcus agalactiae'' is the most common cause of meningitis in [[infant]]s from one month to three months old. They can also colonize the intestines and the female reproductive tract, increasing the risk for premature [[rupture of membranes]] during pregnancy, and [[vertically transmitted infection|transmission]] of the organism to the infant. The [[American College of Obstetricians and Gynecologists]], [[American Academy of Pediatrics]], and the [[Centers for Disease Control]] recommend all pregnant women between 35 and 37 weeks gestation to be tested for GBS. Women who test positive should be given prophylactic antibiotics during labor, which will usually prevent transmission to the infant.<ref name=Schrag_2002>{{cite journal | vauthors = Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A | title = Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC | journal = MMWR. Recommendations and Reports | volume = 51 | issue = RR-11 | pages = 1β22 | date = August 2002 | pmid = 12211284 }}</ref> Group III polysaccharide vaccines have been proven effective in preventing the passing of GBS from mother to infant.<ref>{{Cite journal |last1=Noya |first1=Francisco J. D. |last2=Baker |first2=Carol J. |date=1992-03-01 |title=PREVENTION OF GROUP B STREPTOCOCCAL INFECTION |url=https://www.sciencedirect.com/science/article/pii/S0891552020304244 |journal=Infectious Disease Clinics of North America |volume=6 |issue=1 |pages=41β55 |doi=10.1016/S0891-5520(20)30424-4 |pmid=1578122 |issn=0891-5520}}</ref> The United Kingdom has chosen to adopt a risk factor-based protocol, rather than the culture-based protocol followed in the US.<ref>{{cite journal | vauthors = | title = Prevention of Early-onset Neonatal Group B Streptococcal Disease: Green-top Guideline No. 36 | journal = BJOG | volume = 124 | issue = 12 | pages = e280βe305 | date = November 2017 | pmid = 28901693 | doi = 10.1111/1471-0528.14821 | doi-access = free }}</ref> Current guidelines state that if one or more of the following risk factors is present, then the woman should be treated with ''intrapartum'' antibiotics: * GBS [[bacteriuria]] during this pregnancy * History of GBS disease in a previous infant * Intrapartum fever (β₯38 Β°C) * Preterm labour (<37 weeks) * Prolonged rupture of membranes (>18 hours) This protocol results in the administration of intrapartum antibiotics to 15β20% of pregnant women and the prevention of 65β70% of cases of early onset GBS sepsis.<ref>{{cite book | vauthors = Norwitz ER, Schorge JO |title=Obstetrics and Gynecology at a Glance |date=2013 |publisher=John Wiley & Sons, Ltd. |location=Chichester |isbn=978-1118341735 |edition=4th}}</ref>
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