A faster laboratory test to detect potentially deadly maternal infections of Group B strep (GBS) has been successful at identifying GBS colonization in six and a half hours, according to the results of a new study from The University of Texas Health Science Center at Houston (UTHealth). The standard test takes 48 hours.
GBS’ Devastating Fetal Effects
Since women that experience GBS typically have no symptoms, all pregnant women usually are tested for GBS at approximately 35 – 37 weeks of gestation. The new test could be especially helpful for the 13% of women who experience preterm labor before they are screened for GBS. It is crucial to treat GBS because if a woman gives birth while infected with GBS, it can be passed to the baby, which can cause serious conditions such as brain damage, cerebral palsy, meningitis, sepsis (blood infection), pneumonia, hearing loss, blindness and even death. When women are positive for GBS, antibiotics are administered at the time of delivery to kill the bacteria.
According to the Centers for Disease Control (CDC), GBS is the most common cause of sepsis and meningitis, and a frequent cause of pneumonia in newborns. The CDC estimates the bacterium, which is passed through the birth canal, is carried by 25 to 30 percent of women at any one time. Many women do not know they are carriers of GBS. In 2001, 1,700 babies less than 1 week old contracted GBS.
New GBS Test Can Treat Maternal Infection and Reduce Antibiotic-Resistant Blood Infections in Children
“This new test could change the management of patients who present to labor and delivery with threatened preterm labor and aren’t expected to deliver right away,” said Jonathan Faro, M.D., Ph.D., assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at The University of Texas Medical School at Houston, part of UTHealth. “It would likely gain use in this patient population, which is a small number, but still very significant clinically. We could target this population and this would help cut down on overuse of resources and minimize our contribution to the increased level of bacterial resistance.”
“Typically, if a patient comes into the emergency room in labor and you don’t know if she carries GBS, you have to treat her with antibiotics,” Faro said. “Everyone is concerned that the overuse of antibiotics is leading to greater resistance to them. Some have expressed concern that by giving penicillin to everyone, we are increasing the number of babies who are getting sick from E. coli sepsis.”
Since a large number of women in preterm labor are treated with antibiotics before the results of the GBS test are known, many mothers and infants are unnecessarily exposed to antibiotics. There has been an increase in blood infection among newborns, which is likely due to bacteria made drug-resistant by antibiotic overuse. Evidence exists that increased use of antibiotics frequently leads to increasing bacterial resistance. When a woman is given antibiotics during labor to treat GBS, the antibiotics cross the placenta and enter the amniotic fluid. While the antibiotics may have the desired effect of killing the GBS bacteria, some GBS bacteria can survive and become difficult (if not impossible) to kill with traditional antibiotics. Similarly, other bacteria, such as E. coli that may be present in the mother or infant, can become resistant to antibiotic treatment. These bacteria may not have presented a large risk of infection to the newborn until they were exposed to antibiotics and made into “superbugs.”
Penicillin can create other unwanted side effects in infants, which include seizures, watery or bloody diarrhea, fever, chills, flu symptoms, bruising easily, unusual weakness, reduced urination, and severe skin rash.
New Test Treats Maternal Infection that May Have Been Missed
The new test, developed by NanoLogix, can also detect antibiotic sensitivities for women who are allergic to penicillin, saving the additional 42 hours the standard test for antibiotic sensitivity takes, Faro said.
In the study, 356 patients at 35 – 37 weeks of gestation at UT Physicians clinics were tested for GBS using two standard tests and the new test, which provided a high level of validity, according to the study results.
Faro is studying an even faster version of the test with the hope it could detect GBS in as little as 30 minutes. This could be beneficial for the 15 percent of pregnant women who arrive for full-term delivery and have not been screened. Right now, physicians must determine whether to give these women intravenous antibiotics automatically or use risk factors, which have been shown to be only half as effective as laboratory tests, to assess whether the patient has the bacteria.
Indeed, for physicians who rely on risk factors in order to determine if a woman has GBS, the new, fast test may mean that instead of assessing risk factors and potentially not treating a woman with GBS, the new test will be given and all women who have GBS will be treated. The new test shows promise in diagnosing more women with GBS, thereby preventing potentially devastating newborn complications. The drug also looks promising for prevention of drug-resistant blood infections in newborns.
GBS, Maternal Infection, and Medical Negligence
Since GBS can have devastating and deadly complications, it is essential that the physicians follow guidelines and standards of care for treatment and prevention of GBS. It is negligence when a mother and baby are not properly tested for GBS, and when standards for treating the condition are not followed. If this negligence leads to injury of the mother or baby, it is medical malpractice.
Reiter and Walsh ABC Law Centers have been helping families with birth injuries for many years. Call our highly skilled attorneys for a free case review. 888-419-2229.