Group B streptococcal infection laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Laboratory Findings
Infants with Signs of Sepsis
Any newborn with signs of sepsis should receive a full diagnostic evaluation and receive antibiotic therapy pending the results of the evaluation, regardless of maternal colonization status. The evaluation should include a blood culture; a CBC including white blood cell differential and platelet count; a chest radiograph if any abnormal respiratory signs are present; and a lumbar puncture if the newborn is stable enough to tolerate the procedure and sepsis is suspected. Therapy for the infant should include antimicrobial agents active against GBS (including intravenous ampicillin) as well as other organisms that might cause neonatal sepsis, such as E. coli (AII).
Among infants with signs of early-onset disease, the detection of GBS can be increased by performing culture of both blood and cerebrospinal fluid (CSF). Blood cultures can be sterile in as many as 15%--33% of newborns with meningitis, and the clinical management of an infant with abnormal CSF findings differs from that of an infant with normal CSF.
Infants Born to Women with Chorioamnionitis
Well-appearing newborns whose mothers had suspected chorioamnionitis should undergo a limited evaluation and receive antibiotic therapy pending culture results (AII). The evaluation should include a blood culture and a CBC including white blood cell differential and platelet count; no chest radiograph or lumbar puncture is needed. Consultation with obstetric providers to assess whether chorioamnionitis was suspected is important to determine neonatal management (CIII).