Streptococcus agalactiae

One-Sentence Definition

Streptococcus agalactiae (group B Streptococcus, GBS) is a Gram-positive coccus that colonizes the genital/GI tract and is the classic cause of early- and late-onset neonatal sepsis and meningitis, also causing disease in adults with comorbidity.

Taxonomy & Morphology

  • Gram-positive cocci in chains; Lancefield group B
  • β-hemolytic (usually); CAMP-test positive historically
  • Capsular serotypes Ia, Ib, II–IX — vaccine development targets

Virulence Highlights

  • Polysaccharide Capsule — antiphagocytic
  • β-hemolysin/cytolysin; pili for adhesion
  • Sialylated capsule mimics host glycans

Clinical Syndromes

  • Early-onset neonatal disease (≤7 days): pneumonia/sepsis from peripartum transmission
  • Late-onset (7–89 days): bacteremia/meningitis
  • Adults: bacteremia, soft-tissue infection, UTI, endocarditis (diabetes, elderly)

Diagnosis

  • Maternal rectovaginal screening culture / NAAT (prevention programs)
  • Blood/CSF culture in neonates; MALDI for ID
  • Serotyping / WGS in surveillance

Treatment Notes (conceptual)

  • Intrapartum antibiotic prophylaxis (IAP) when indicated — usually penicillin/ampicillin
  • Invasive disease: penicillin G (± aminoglycoside early for synergy in severe cases — protocol-dependent)
  • Clindamycin only if susceptibility confirmed (inducible MLS resistance)

AMR

  • Penicillin generally reliable; rising macrolide/clindamycin resistance matters for IAP alternatives
  • Monitor via AST when using non-β-lactam prophylaxis

Genomics & Computational Notes

Active Recall

  1. Early-onset vs late-onset GBS — transmission difference?
  2. Why confirm clindamycin susceptibility before using it for IAP?
  3. What is the purpose of late-pregnancy GBS screening?