In maternal health, knowledge is power – and when it comes to Group B Streptococcus (GBS), that knowledge can be a game-changer. The presence of GBS in expectant mothers is a significant concern in perinatal care. As healthcare providers, it's crucial to be well-versed in the implications, management, and testing protocols for GBS to safeguard maternal and neonatal health.

This blog post will serve as a refresher for swabbing for GBS and what tools are best for the job. 

What is Group B Strep?

GBS, or Streptococcus agalactiae, is a type of naturally-occurring bacteria found in the digestive tract of adults. GBS can pose a significant risk to newborns, pregnant women, the elderly and individuals with weakened immune systems. For the purposes of this blog post, we’ll be focusing on pregnant women and newborns. 

GBS is primarily transmitted from mother to baby during childbirth, making it essential for pregnant women to be screened for GBS around the 35th to 37th week of pregnancy – in fact, one in four pregnant women are shown to have the bacteria. For context, in newborns, GBS infection can lead to serious health issues such as pneumonia, sepsis, and meningitis. 

If identified, preventive measures such as administering antibiotics during labor can significantly reduce the risk of transmission to the infant. Timely diagnosis and management are crucial in preventing GBS-related complications, underscoring the importance of prenatal care and awareness about this bacterium in healthcare settings. 

Group B Strep – What to Watch Out For

GBS infections typically don't exhibit noticeable symptoms in healthy adults who carry the bacteria. However, when GBS causes infection, especially in the vulnerable populations we covered above, it can lead to a range of symptoms: 

• Newborns: GBS infection may manifest as fever, difficulty feeding, irritability and potentially life-threatening issues like pneumonia or sepsis. 
• Pregnant women: GBS infections might present symptoms like urinary tract infections (UTIs), high fever, chills and abdominal pain. 

It's crucial to seek prompt medical attention if you or your baby display any concerning symptoms, particularly during pregnancy or shortly after childbirth. Early diagnosis and treatment are key to managing GBS infections effectively.

Types of Group B Strep

There are three types of group B strep disease:

• Prenatal-onset GBS disease: before birth
• Early-onset GBS disease: birth through the first week of life
• Late-onset GBS disease: over one week of age through several months of age

Women who are screened and test positive for prenatal-onset GBS can receive IV antibiotics during labor and delivery to help prevent early-onset GBS disease. Timing is crucial because GBS bacteria act incredibly quickly and can cause a healthy-seeming baby to fall critically ill.

Unfortunately, late-onset GBS disease can not be prevented, so it's best to test early. Group B Strep International advises that women have their first culture taken for GBS and other bacteria at least eight weeks after their last missed period. 

Refresher: How to Collect a Group B Strep Swab

The American College of Obstetricians and Gynecologists recommends GBS screening between 36 and 37 weeks of gestation. Adequate training in the collection process is essential; the swab must be correctly inserted to obtain a representative sample. Strict adherence to aseptic techniques will minimize the risk of contamination. 

It’s also vital to ensure that the culture is transported and processed under conditions that preserve bacterial viability. Providers should maintain open communication with their laboratory services to confirm timely and accurate assay interpretation. By rigorously following these procedures, healthcare providers can significantly reduce the risk of GBS transmission and its subsequent complications in newborns.

Proper Swabbing Technique [Infographic]

We've provided a step-by-step infographic for proper swabbing technique – while this was initially developed for STI swabbing, the technique can also be applied for GBS testing. 

Can Women Self-Swab for Group B Strep?

It’s not recommended.

While self-swabbing has become increasingly popular for its convenience and non-invasiveness, particularly in the context of sexually transmitted infection (STI) screening, it is not the recommended approach for GBS screening in pregnant women. The accuracy of GBS screening is paramount, as false negatives can lead to severe, life-threatening infections in newborns. Self-swabbing introduces a higher risk of improper sample collection and potential contamination, which can affect the sensitivity and specificity of the test. 

Unlike STI screening, where self-swabbing may be comparably effective to clinician-collected samples, the complexities of GBS colonization and the critical need for precise diagnosis to inform the administration of intrapartum antibiotics demand a professionally executed procedure. It is essential that GBS cultures are collected by trained medical personnel to ensure the validity of the results and the safety of both mother and child.

If you need to undergo GBS screening, please see a trusted healthcare professional.

Which Swabs to Use to Collect a Strep B Sample

Puritan's HydraFlock® flocked swabs are perfect for such an important task. The patented flocked technology turns each strand of fiber into a velvet-like brush that creates hundreds of thousand contact points for superior collection and release of specimen samples. The increased number of target cells (compared to non-flocked swabs) help to improve the sensitivity of diagnostic tests. And our Lim Broth enrichment medium, which we created for use in the qualitative procedures for the isolation of GBS from clinical specimens, can help sustain the viability of the sample in settings where immediate laboratory processing is not possible.

Have more questions about taking swab samples for group B strep, or about any of Puritan’s disposable medical products? Contact us to speak with one of our sales representatives.