What to Do If You Test Positive for GBS
So you tested positive for GBS? Learn all about Group B Strep treatment, plus learn about home remedies that can help your body fight off the bacteria.
When you’re in the home stretch, an unexpected diagnosis can throw you for a loop. But since 1 in 4 healthy women are colonized with Group B Strep, a GBS diagnosis is a very real possibility for many pregnant women. So what happens if you test positive? Read on to learn all about Group B Strep treatment to increase your chances of having the natural birth you desire.
I Tested Positive for GBS. Now What?
Most providers in the United States treat Group B Strep in one of two different ways.
Preventive Group B Strep treatment
This conventional form of treatment is the most common the U.S., where health officials say the risks of GBS outweigh the risks of antibiotics. This form of Group B Strep treatment often includes automatic IV antibiotics, like Penicillin and Ampicillin, during labor if mama tests positive for GBS. According to the CDC, the antibiotics work best when administered for at least four hours before delivery.
These medications are usually safe for both mom and baby, but up to 4 percent of women may experience a mild reaction like a rash. In rare cases (approximately 1 in 10,000) antibiotic use can cause diarrhea, abdominal pain, nausea/vomiting, fever, or more severe allergic reactions like anaphylaxis.
Though the chances are much slimmer, research shows antibiotic use doesn’t guarantee baby won’t get GBS or an infection from it:
- When antibiotics are administered during delivery, baby has a 1 in 4,000 chance of developing an infection from GBS.
- Without antibiotics, baby has a 1 in 200 chance of developing an infection from GBS.
The risk-based approach to Group B Strep treatment
Even if you test positive for GBS at your 35-37 week prenatal appointment, research shows this can change.
Between 17 and 25 percent of women who have a positive swab at 35-37 weeks of gestation will be GBS negative at delivery.
Because of this, Group B Strep treatment with antibiotics is not necessarily the norm around the world. In the UK, for example, health authorities say that if all women are screened for Group B Strep, this automatically increases antibiotic use during labor, which has its own set of risks, including infection and antibiotic resistance. (source)
In the U.S, some providers will allow this wait-and-see approach. Instead of giving antibiotics to every GBS positive case, the doctor will assess mom’s risk factors, including:
- Clear signs of infection during labor, like fever of 100.4 or higher
- Pre-term labor (before 37 weeks)
- Ruptured amniotic sac (water breaking) 18 hours or more before delivery
- Having a previous baby who developed early-onset GBS disease
If mama shows no signs of infection, baby will be closely monitored for 12 hours after delivery for signs of infection.
Note: Exact protocol for your Group B Strep treatment will depend on the policies of the birthing place, so it’s important to discuss your options before labor begins.
How to Treat Group B Strep Without Antibiotics
If you test positive for GBS, the following strategies promote healthy vaginal flora, which may lower your chances of having GBS at delivery and passing it on to baby. No matter which method of Group B Strep treatment you and your healthcare provider decide on, these home remedies are worth a try with your doctor’s approval.
This midwife found that L. Rhamnosus is particularly effective in combating GBS.
That’s why we created a groundbreaking prenatal probiotic with L. Rhamnosus and as 11 other strains clinically shown to help restore healthy vaginal flora: The Mama Natural Prenatal Probiotic
Prenatal Probiotic by Mama Natural
You can also:
- Up your daily intake of fermented foods like homemade sauerkraut, pickles, Kefir, and yogurt
- Or, target GBS locally by using a probiotic capsule as a suppository before bed.
Bacteria comes and goes, so you should continue to take probiotics until you go into labor. Even better, continue taking probiotic supplements while breastfeeding to further transfer good flora to baby. (source)
Chlorhexidine wash (Hibiclens)
In the medical world, the jury is out when it comes to the effectiveness of using chlorhexidine to cleanse the vagina before and during birth. It’s a standard medical practice in some parts of Europe, and there is some evidence that it does reduce the rate of infection from GBS and other medical conditions. Still, some practitioners are wary of this technique, because it only temporarily cleanses the vagina and rectum.
For maximum effectiveness:
- Mix 2 Tbsp. Hibiclens (4% chlorhexidine solutions) with 20 oz. sterile water in a periwash bottle
- Slowly instill the solution into the vagina with very gentle pressure (this can be self-administered or assisted by your spouse or midwife)
- Wash the exterior of the rectum separately
- Repeat every 4 hours through labor
Garlic is thought to have antimicrobial properties, and one small study suggests garlic was able to kill Group B Strep bacteria within 3 hours. More research needs to be done, but it seems like a promising alternative.
For maximum effectiveness, try:
- Garlic paste: Mix 1 glove chopped and 1 teaspoon honey. Swallow this without chewing it. Repeat several times a day, preferably with a meal.
- Eat garlic: Chop fresh garlic and add to salad, dressing, vegetables, and almost any savory dish.
- Garlic elixir: Add ½ Cup Honey, ¼ Cup apple cider vinegar, and ½ bulb garlic to a blender. Blend until liquefied. Take ½ tsp. up to twice each day.
- Garlic suppository: Peel a garlic clove and insert it into the vagina. Sleep with it in overnight, before removing. Rotate with probiotics. (Don’t forget to get your doctor’s approval first.)
Herbs such as Echinacea may boost the immune system, and a healthy immune system naturally wards off colonized bacteria. Since mama’s antibodies are passed to baby through colostrum and breast milk, a strong immune system in mama means a stronger immune system in baby. You can also try elderberry syrup, which works the same way.
For maximum effectiveness, try taking a 1/2 tsp. of Echinacea tincture two times each day for no more than 6 weeks.
A root used for centuries in Chinese medicine, Astragalus is an adaptogen, meaning it helps protect the body from physical, mental, and emotional stresses. There haven’t been any studies on the effectiveness of Astragalus in the treatment or prevention of GBS, but it has long been used to fight bacteria and viruses, as well as support the immune system.
For maximum effectiveness, take a 1/2 tsp. of Astragalus tincture two times each day.
Studies suggest vitamin C supplementation after 14th weeks can strengthen the amniotic sac and help prevent the membrane from rupturing prematurely. This is important with a GBS diagnosis, since baby is more at risk of contracting GBS after the water breaks.
Use a natural, food-based source of vitamin C, like camu camu powder. Just one teaspoon of this camu camu powder contains over 600 mg of vitamin C, over 1,000 percent of the RDA of this vitamin.
Studies suggest GBS can penetrate the placenta’s collagen-rich membrane. When ingested, collagen can help protect joints, improve gut health, and improve liver function. Though scientific data is lacking, it makes sense that collagen may also help strengthen the amniotic sac.
To get more collagen, try:
- Collagen peptides: Collagen peptides cost less than collagen supplements and are easy to add to any recipe. Try Vital Proteins collagen.
- Collagen-rich recipes: Check out this post for my favorite collagen-rich recipes, including smoothies, waffles, and tea.
According to a number of studies, giving birth in water reduced the risk of baby contracting GBS from low-risk moms.
“The literature provides a single case of early onset newborn Group B Strep (GBS) among 4,432 waterbirths, suggesting that low-risk women who give birth in water may have a far lower rate of newborn GBS than women who have a dry birth. ” — source
Diet & nutrition
As always, a rich and nutritiously dense diet helps support overall wellness, particularly before and during pregnancy. A few tips include:
- Lower your sugar intake. This should include lowering your white flour intake, too. These are pro-inflammatory foods that feed bad bacteria populations.
- Eat a balanced diet. Make sure to get enough protein, fruits and vegetables, complex carbs, and enough healthy fat, especially omega-3 fatty acids.
- Incorporate cultured foods that support healthy gut and vaginal health, such as yogurt, sauerkraut, kefir, kombucha, etc.
- Drink plenty of water: A pregnant women should aim for at least 10 cups of water each day. Dehydration can lead to complications, including preterm labor.
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What Is GBS Anway?
Now that we’ve covered a few ways to manage GBS, let’s rewind and talk about what GBS is and how you can prevent it in future pregnancies. GBS — officially called Group B Streptococcus — refers to a type of bacteria that commonly live in people’s digestive systems, urinary tracts, and reproductive tracts. This type of bacteria is very common, can come and go, and many people don’t even realize they have it. GBS can, however, cause urinary tract infections.
Even if you don’t have any symptoms of GBS, it can be passed from mama to baby during birth.
Note: Group B is not the same type of bacteria that causes strep throat. Group A Streptococcus is responsible for causing strep throat, scarlet fever, impetigo, and cellulitis.
How Do You Get GBS?
About 25% of women have GBS at any given time, but it’s important to know that you didn’t do anything to contract GBS. The exact method of how GBS spreads isn’t known, but the Centers for Disease Control and Prevention (CDC) maintain that GBS is not spread through contaminated food or water or through contaminated objects. (source)
Can You Prevent GBS?
Just because you tested positive for GBS during one pregnancy doesn’t mean you’ll necessarily test positive during subsequent pregnancies. The best way to help reduce your risk of developing GBS — both now and in future pregnancies — is to focus on gut health and supporting healthy vaginal flora.
Dealing With a GBS Diagnosis
A Group B Strep diagnosis can feel like the end of your natural birth plan, but it doesn’t have to be. Try the above home remedies to balance your vaginal flora, but remember some things are out of your control. Many healthy mamas get a Group B Strep diagnosis. Work with your healthcare provider to find a Group B Strep treatment plan that best complements your natural birth plan. Your health and that of your baby’s is what’s most important.
Group B Strep Prevention and Your Options for GBS+ Birth
These days, the most common request on a birth plan, whether VBAC parent or not, is to avoid interventions. Particularly for parents who want the full benefits of a natural birth, Group B Strep prevention can be a concern.
During pregnancy, providers will typically test a birthing person for something called Group B Strep (GBS). This test has become a little controversial in the birth world because a positive GBS test involves treatment during labor.
In this article, we want to talk about what GBS is, and how to prevent Group B Strep in pregnancy.
Originally published October 10, 2018, this article was updated and republished on January 18, 2021.
What is Group B Strep?
Group B Streptococcus is a type of infection that lives in the intestines and can travel down into the vagina or rectal area. Approximately 25% (AMA, 2017) of healthy pregnant people are carriers during their pregnancy.
Some people hear Group B Strep and think strep throat. Although they both have the word strep, Group B Strep and strep throat are two different types of infections.
Have you ever heard people say that their provider would rather them not labor at home and wants them to go into their birthing location right away after their water breaks? Even if labor hasn’t started. This is especially common for GBS positive mothers.
Providers are concerned about this because, when the bag of waters ruptures, there is a chance that the GBS infection will travel up to the fetus.
Streptococcus B Symptoms
One of the hardest things for people is it’s nearly impossible to know if you have GBS or not without testing. Although, some people are more at risk to have GBS than others.
If you are younger than 20 years old, use tampons, have multiple sex partners, or have recently had sex, it is possible to have slightly higher odds of having GBS.
People are usually tested during their 36th week of pregnancy. This is done via swab to the vagina or rectum. If you test positive, it has become standard practice to receive IV antibiotics during labor to avoid passing the infection to your baby.
The biggest concern with Group B Strep prevention and treatment is the effect of GBS infection on the newborn baby. A newborn can get GBS during labor, which is called a vertical transmission (early infection) of GBS.
When the birthing person’s water breaks and the bacteria travels up to the unborn baby, the baby can swallow the infected fluid. According to ACOG, 50% of people who are colonized with GBS will transfer the infection to their baby.
1-2% of people who don’t treat with antibiotics will have a newborn develop GBS. Babies who have early infection of GBS will typically show signs a few hours, or up to 2 weeks after birth.
Symptoms of Early Onset GBS in a newborn
- Breathing problems: Breathing fast or making grunting sounds could be signs of pneumonia.
- Fussy or sleepy: Although it is common for babies to be fussy, a baby that is over-the-top fussy and or the opposite, very sleepy, can indicate a problem. These may be signs that a newborn is going into sepsis.
- Decrease in blood pressure: If the newborn’s blood pressure is low, it could be a sign of early transmission of GBS.
There is also a way that the baby can get GBS that is not transferred from the birthing person. These symptoms would not typically show up until a month later. Symptoms of late infection of GBS could be the following:
- Breathing problems: As stated above, if you feel like your baby is not breathing well or grunting for air, contact your provider.
- Fever: If your baby has a fever higher than 100.4, it is always recommended to call their provider.
- Pain: If it seems that your baby has pain in moving their body, or lack of movement, this could be a symptom of infection.
- Unexplained redness: GBS could cause unexplained redness on a newborn’s face or other parts of their body.
If you are noticing any of these symptoms, and are worried your baby may have GBS, never hesitate to call your provider.
What Causes Strep B?
It is possible that you are what is called a strep carrier. This means you can have GBS in your body all the time or it can come and go.
The crazy thing about GBS is other than the transfer to newborns, it is unknown how anyone else gets it. That’s what makes Group B Strep prevention difficult. It is believed that it is not transferred through food and water.
Group B Streptococcus Prevention
Some people may question why they are testing positive for GBS when they are healthy overall, eat well, and exercise. As mentioned above, approximately 25% of ALL birthing people will test positive for GBS, even those who are very healthy.
It is possible to test positive for GBS and become negative and vice versa. Many people try their best at Group B Strep prevention during pregnancy, and despite their efforts, still test positive.
Can you get rid of group B Strep?
As we stated above, it is possible to test positive for Group B Strep and then test negative. It can come and go from our bodies.
If you have tested positive for Group B Strep, it is not a bad option to try some of the natural Group B Strep prevention tips listed below, and ask to be re-tested as it gets closer to your due date.
Keep in mind, even with these efforts, it is possible that you will still test positive.
Home Birth and GBS positive?
If you are planning on a home birth or an HBAC, and you test positive for Group B Strep, it is a good idea to discuss the plan when labor begins with your provider.
They may be able to treat with probiotics if that is desired. There is also a cleanse called Hibiclens that may be suggested to treat GBS. Providers may suggest this be used every 2-4 hours with a peri bottle over the toilet to assure it reaches inside the vagina.
Group B Strep Natural Treatment and Prevention
If you are interested in learning more on preventing Group B Strep, we are going to give you some of the known natural treatments and ways to try and prevent your chances of having GBS.
Below are 7 things you can do to try and prevent GBS.
1. Probiotics for Group B Strep
Probiotics have many health benefits. They may impact our mental state, help boost our immune system, and boost the health of our gut flora.
Regardless of Group B Strep prevention, probiotics can help your overall health. Probiotics can also help lower your chances of being GBS positive.
If for any reason, in addition to GBS, you are put on antibiotics during pregnancy, labor, or your postpartum journey, probiotics will ensure you are starting with stronger gut flora.
Check with your provider for recommended dosage and any brands of probiotics they suggest.
Yes, I know this may sound super strange, but garlic is known as a natural antibiotic. Inserting a clove of garlic vaginally for one night, typically the night or two before being tested, and drinking minced raw garlic in the morning can help get rid of any infection.
Some are worried about the garlic getting lost so they tie it to a string like a tampon.
3. Vitamin C
Taking up to 2,000 mg of vitamin C per day helps boost the immune system. Boosting your immune system can help your body potentially fight any type of infection.
Taking vitamin C during pregnancy has also shown to decrease the chances of pregnant people being hospitalized. A study showed “42.2% women in the vitamin C group and 27.9% in the control group were not hospitalized during pregnancy; this difference was found statistically significant.”
4. Grapefruit Seed Extract
Taken orally, grapefruit seed extract has a lot of great antimicrobial properties and may reduce the chances of infection and prevent group B strep.
Lactobacilli are the most abundant vaginal bacteria. Lactobacilli prevents infection. Just like many things in our bodies emotional stress can diminish the Lactobacilli in the body, possibly enhancing chances of infection. Lactobacilli comes in capsules and it is important to follow the dose suggested on the bottle or by your provider.
6. Apple Cider Vinegar Rinse
Rinsing vaginally with apple cider vinegar will help you absorb good nutrients and has been known to help kill bad bacteria. You can also take a shallow bath filled with water and some apple cider vinegar.
7. Eating a Healthy Diet
Our bodies need a healthy diet to perform well. When we are pregnant, a healthy diet is extra important. Dialing in and focussing on your nutrition during pregnancy will make sure that you get enough protein, fats, and carbohydrates. Try and eliminate processed sugars as well.
Antibiotics for GBS
Group B Strep prevention in newborns is most often accomplished by administering IV antibiotics during labor.
Just like most things in life, there are pros and cons to both accepting antibiotics, and not accepting antibiotics. We want to help make it easier for you to know both the benefits and risks of taking antibiotics for GBS.
If you haven’t heard us talk about the acronym B.R.A.I.N. before, check out our blog about using your B.R.A.I.N with Interventions or listen to The VBAC Link Podcast.
When someone tests positive for Group B Strep, they will likely be suggested IV antibiotics when labor begins. These are given every 4 hours until your sweet little one is born. However, it has been shown that exposure to antibiotics within 2 hours has still been shown to prevent Group B Strep transferring to the newborn.
One of the biggest questions is, should I get antibiotics or not? Like every other intervention, there are risks and benefits. Results could vary from week to week and a “rapid test” is possible during labor.
So let’s break it down here a little:
Benefits of antibiotics for GBS
In 1993-1994, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics recommended screening all pregnant women for GBS and treating GBS-positive women with intravenous (IV) antibiotics during labor. Since that time, we have seen a remarkable drop in early GBS infection rates in the U.S.—from 1.7 cases per 1,000 births in the early 1990’s, to 0.25 cases per 1,000 births today.
Using antibiotics, you could avoid early or late GBS infection in the newborn. In a study done by NCBI, 2012, they reviewed 143,384 newborns. 94 of the newborns tested positive for GBS.
93 of those 94 developed early GBS Sepsis within the first hour of life.
Not treating Group B Strep with antibiotics could potentially raise the baby’s risk of being colonized with GBS by approximately 50%. The risk of having a serious life-threatening complication is approximately 1-2%.
If a person decides to receive antibiotics during labor, the risks go down by approximately 80%, bringing down the total risk of serious complications to 0.2-1%.
Risks of antibiotics for GBS
There are people who choose not to treat GBS because they would like to avoid the extra interventions. Although treating GBS with antibiotics has been shown to lower the chances of newborns getting infected, it may be hard on the newborn’s health and affect gut flora.
Choosing to get antibiotics could potentially damage both you and your baby’s gut flora. Studies are vague, but they do show that antibiotics can affect a newborn’s microbiome at least temporarily, and may impact the gut flora later in life.
Alternatives to antibiotics
According to (CDC, 2018), because GBS can grow back so quickly, doctors may not give antibiotics before labor begins. They consider antibiotics to be safe and explain that only 1 in 10 birthing parents will have a mild side effect.
Oral antibiotics and vaginal washes are not believed to be effective for preventing GBS. On the other hand, research shows that giving IV antibiotics during labor could lower the newborn’s chance of GBS by 83%.
It is possible for GBS to show up at one gestational week and then be gone another. To be sure, you can ask your provider for a “rapid test” the day you’re in labor to confirm that you are still GBS positive before starting antibiotics.
Some women have chosen to do Chlorhexidine (aka Hibiclens) which is a vaginal suppository that kills bacteria on contact. It typically lasts for 3-6 hours. However, studies are not conclusive on the true effect of using Hibiclens during labor to reduce GBS infection rates.
Trusting your intuition
We say it a lot, and let us be honest, you probably will continue to hear us talk about INTUITION. It’s so very important to listen to your intuition while making choices about Group B Strep prevention and everything else in the birth setting.
There are such a variety of options on GBS and following your own intuition, like Jenn in this podcast episode, will lead you down the best path for you and your baby.
For a lot of parents, the risk of GBS is enough that antibiotics is the best alternative for them. It leaves them feeling more confident that their baby will be protected. Others may see the risks being so low, that they would rather avoid antibiotics that can risk their baby’s future health and gut flora.
The same set of data and facts is there for everyone. Everyone is entitled to make a decision based on their specific circumstances and what risks they prefer to accept.
Should you do nothing?
You could do nothing and take the universal approach.
Although not approved by the CDC, a “risk-based approach” is when you hold off on accepting antibiotics unless other factors and symptoms are present. For example, if your bag of waters has been broken for 18 hours or more or your temperature starts to rise, you may decide to accept antibiotics.
We encourage you to continue your research and check out our good friend Rebecca Dekker at Evidence Based Birth as she dives into GBS and a lot of really great studies, and following your gut won’t lead you astray.
If you would like to hear a personal story on GBS, take a listen to episode 24 on our podcast for a story about Jenni who had a VBAC with GBS.
Want to learn everything there is to know about VBAC before your big day? Sign up today for our Ultimate VBAC Prep Course for Parents!
Streptococcal infection: Causes of streptococcal infection, Symptoms, Treatment of diseases caused by streptococcal infection
Streptococcal infection is a group of infectious diseases caused by different types of streptococcal flora. The infection affects the upper skin, mainly the skin of the face, hands, neck, as well as the respiratory organs. Streptococcal infection causes diseases such as streptoderma, pneumonia, glomerulonephritis, vasculitis, tonsillitis, rheumatism, erysipelas, scarlet fever, etc.
Here you can choose a doctor who treats Streptococcal infection If you are not sure about the diagnosis, make an appointment with a general practitioner or general practitioner to clarify the diagnosis.
Causes of streptococcal infection
Treatment of diseases caused by streptococcal infection
Streptococcus is a genus of bacterial organisms that is present in the human body. There are more than 15 subtypes of bacteria, but the most common are: alpha, beta and gamma. With an acceptable value of alpha and gamma, streptococci are part of the normal microflora of the gastrointestinal tract, oral cavity, larynx and respiratory system of a person, they do not carry harm to the body. Beta streptococci are dangerous to human health, and they cause a wide range of human diseases.
Hemolytic streptococcus (group A) is a common bacterium found in the body. The predominant number of infections develops precisely due to group A streptococcus. In this regard, a person has a high susceptibility to streptococcus and, accordingly, under favorable conditions for the bacterium, it actively multiplies in the human body. Group A bacteria most often cause:
- scarlet fever;
Group B streptococcus mainly affects the genitourinary system, because this type of bacteria is found in the urethra in men and in the vagina in women.
Causes of streptococcal infection
A pathogenic bacterium is transmitted in three ways:
- airborne — the spread of infection with saliva and mucus when sneezing, crying, coughing;
- household contact — direct contact with the carrier of the infection, even if he does not show symptoms of diseases, contact with household items in the house and public places;
- sexual — through unprotected intercourse.
The fastest way to spread streptococcus is by airborne droplets, so children who are in a large group (school, kindergarten, various classes) very often succumb to infection.
Streptococcal infection in children develops most often in the cold season (late autumn, winter). Due to the fact that children do not always observe hand hygiene, they can become infected in almost any environmental condition.
Often streptococcal infection occurs in newborns, this is due to the ability of streptococcus to penetrate into tissues and organs. At the time of childbirth, infection can occur through the amniotic fluid. The infection develops in the first few hours of life and leads to pneumonia, sepsis, and meningitis. The mortality rate with this development of infection is more than 50%.
In children aged 2 to 8 years, streptococcus often causes pneumonia as a complication of a previous infection: whooping cough, influenza, measles, chicken pox. Immunocompromised children who have suffered severe hypothermia are also susceptible to this disease.
In medical practice, in diseases, streptococcal infection is manifested by a variety of symptoms. It depends on the specific disease that this type of pathogenic bacterium caused.
For the group of diseases of the respiratory tract, these are:
- sore throat;
- temperature increase;
- plaque formation with pus on tonsils;
- swollen lymph nodes.
Streptococcal skin infection is usually accompanied by: inflammatory processes on the skin;
- the appearance of vesicles, plaques on the skin;
Diseases of the genitourinary system caused by hemolytic streptococcus are most often asymptomatic. However, there may also be symptoms similar to those of diseases in this area:
- soreness in the organs of the genitourinary system.
To identify bacteria of the genus Streptococcus, a series of tests are carried out that allow you to determine the specific causative agent of the infection, its type and sensitivity to medicines. Traditionally, doctors (whose specialty depends on the affected area or organ) conduct a comprehensive diagnosis:
- bacteriological examination (inoculation of biological material) — a swab from the tonsils, foci on the skin, sputum examination on the lungs;
- general analysis of urine, blood;
- microbiological examination for the level of sensitivity to antibiotics;
- examination of the affected organs by a narrow specialist.
Treatment of diseases caused by streptococcal infection
Treatment of streptococcal infection requires an initial correct diagnosis of the underlying disease, its differentiation from similar diseases.
When diagnosing the pathogenic bacterium streptococcus, treatment should be carried out by a narrow specialist depending on the affected organ: pulmonologist, dermatologist, gynecologist, urologist, etc.
Streptococcus on the skin is treated mainly at home under medical supervision. In mild forms of the disease, such as impetigo (bubble-purulent rash), external treatment is used: antibacterial and disinfectant ointments. In a severe course of the disease, the doctor prescribes antibiotics, multivitamins, immunostimulants to the patient, in addition, lotions of disinfectants are applied to the wounds.
Airway infections require treatment for specific diseases caused by the bacterium. A strep throat infection most often leads to tonsillitis and pharyngitis, which are treated with antibiotics. The patient should take plenty of fluids (about 3 liters) to remove toxins from the body. The patient should follow a light diet rich in vitamins.
On our website you can find reference information on medicines (instructions, analogues), as well as book medicines, which will save you a lot of time.
Current data on streptococcal co-infection in pig production
Current data on streptococcal co-infection in pig production
Streptococcus suis causes meningitis, arthritis, polyserositis, endocarditis, otitis, bronchopneumonia, which ultimately lead to significant economic losses in pig production. The bacterium adapts quite well to the defense mechanisms of the host’s immune system, colonizes many types/types of mucous membranes, and is also a permanent inhabitant of the upper respiratory tract and tonsils.
S. suis is genetically and phenotypically a heterogeneous bacterial species. Strains belonging to different capsular serotypes or even to the same serotype are genetically different from each other (Blume et al., 2009; Gottschalk et al., 2013). This key aspect determines the constant presence of streptococcus both in the body of individual animals and in general in the herds of farms with different epizootic conditions, which causes their stationary trouble.
Piglets first encounter this pathogen in utero and during childbirth, when passing through the birth canal of the sow, as well as in the postnatal period, consuming milk and colostrum, through the umbilical cord, when chipping fangs, docking tails, castration and other veterinary manipulations. About 98% of piglets become infected with streptococcus during the rearing period. The maximum spread and manifestation of streptococcal infection is observed in the periods after weaning, rearrangement, decrease in maternal immunity at the age of 35–60 days, and also during fattening. In addition, streptococcal infection can manifest itself at any age and in any technological group of piglets and sows, in any organ and tissue of the animal.
S. suis infection also occurs in other animals such as cattle, sheep, goats, wild boars, horses, cats, dogs, and birds.
The contagiousness index of S. suis is 0.4, that is, the average number of cases is 40% of the number of individuals who in one way or another came into contact with sick and infected animals. The severity of the disease depends on the virulence of the bacterium, that is, on the ability of the infectious agent to become infected.
Streptococcus has a fairly large number of virulence factors. In the cell wall of streptococcus, there are M-, T-, and R-proteins. M-protein is one of the main virulence factors. Streptococci are capable of producing toxins: erythrogenic toxin (rash toxin), which has a cytotoxic, erythrogenic, sympathetic, allergic effect; exo and endotoxins: streptolysin S, which has an immunosuppressive effect; streptolysin O, which has cardiotropism; enterotoxin that causes diarrhea. Streptococci also produce the enzymes hyaluronidase, streptokinase, amylase, lipoproteinase and others that contribute to the spread of infection in the body.
Recent studies by Chuzeville et al. (2017) found that strains of streptococcus serotypes 2 and 9 express genes encoding multimodal adhesin proteins known as antigen I/II (Ag I/II). In the presence of salivary glycoproteins in the oral cavity, these adhesins lead to S. suis aggregation, adhesion, and colonization of the upper respiratory tract of pigs. In the aggregated state, they are protected from the effects of low gastric pH, which leads to their further colonization of the intestine (Chuzeville et al., 2017). S. suis also has adhesin, which is abundantly synthesized by bacteria found in blood plasma, and is responsible for protecting the bacteria from the host’s immune responses, in particular complement (reviewed by De Cordoba and de Jorge, 2008). The most significant antigenic structure of S. suis, like that of most streptococci, is the polysaccharide capsule, which determines such a wide variety of serogroups and serotypes of streptococcus. The capsule covers the entire surface of the bacterial cell, partially preventing its adhesion to host epithelial cells. Studies have shown that the absence (or suppression of synthesis) of the capsule increases the interaction of adhesins and allows subsequent bacterial attachment (Salasia et al., 1995; Lalonde et al., 2000; Benga et al., 2004; Esgleas et al., 2005). The thickness of the capsule depends on the conditions surrounding the bacterium, as well as the habitat of the bacterium in the tissues of susceptible animals.
The capsule has been shown to be thinner when colonized and invaded in respiratory epithelial cells (Gottschalk and Segura, 2000). The capsule was found to interfere with adhesins and hydrophobic components of the S. suis cell wall, which are responsible for biofilm formation (Tanabe et al. , 2010). In the bloodstream, the capsule is thicker, allowing S. suis to avoid phagocytosis. The bacterial capsule is also an effective means of resisting antibiotics to bacteria (Smith et al., 1999a,b; Gottschalk and Segura, 2000; Segura et al., 2004; Roy et al., 2016). S. suis is able to form biofilms that unite bacteria into the so-called biochemical information quorum. This is a signaling network regulated by the luxS gene (coding for the enzyme S-ribosylhomocysteinase) that has been found in virulent strains of S. suis. In addition, mucin produced by goblet cells in the epithelium can enhance the formation of biofilms and promote the survival of bacteria even when there is a lack of nutrients (Mothey et al., 2014). Bacterial biofilms effectively protect bacteria from antimicrobials (Olson et al., 2002; Grenier et al., 2009). There are reports that virulent strains of S. suis have a higher ability to produce biofilms than avirulent strains (Wang et al., 2011a).
Within five years, bacteriological diagnostics was carried out with the identification of pure cultures of streptococcus; it was subjected to PCR detection based on the determination of the genome responsible for the formation of capsular features, and serological monitoring was also carried out. The results of the research formed the basis for the creation of a vaccine against porcine streptococcosis StreptoVac-C.
It is known that the natural reservoir of streptococcus are pigs and wild boars. However, do not forget about the carriage of bacteria among people. The subclinical course of infection is a key factor in the establishment and spread of streptococcus among susceptible animals. This plays an important role in both epizootology and epidemiology. As a facultative pathogenic bacterium, S. suis causes diseases of varying severity and degree of clinical manifestation, depending on various factors, the main of which is the environment: overcrowding of animals, frequent rearrangements, inadequate microclimate parameters, poor sanitary and hygienic conditions, high viral and bacterial load, increased concentration of harmful gases (CO2, Nh4), etc. The presence of circulating virus in the herd can be safely attributed to stress factors. s that cause severe immunosuppression / depression (PRRS, CSF, PCV2, PCV3, type A influenza and others). The most susceptible to streptococcus are weaned piglets and gilts. The reason for this is primarily the destruction and complete loss of protective maternal antibodies by the age of 35–40 days, while the adaptive immune response has not yet had time to form. The situation is further complicated by the fact that after weaning, the respiratory tract of piglets begins to be intensively colonized by pathogenic microflora and other types of bacteria, such as Haemophilus parasuis, M. hyopneumoniae, Actinobacillus pleuropneumoniae, Actinobacillus suis, P. multocida, Bordetella bronchiseptica.
In sum, all these factors cause a complex of broncho-pulmonary diseases in piglets, which are quite difficult to treat. The most difficult to deal with viral-bacterial co-infections, such as PRRS, CSF, PCV2, PCV3 and S. suis, and at later stages of fattening also Actinobacillus pleuropneumoniae, Actinobacillus suis .
For several years, in the conditions of the economy, observation and collection of data on the reasons for the unproductive disposal of piglets was carried out. The photographs show pathoanatomical changes in the internal organs of animals (lungs, heart, brain), a pronounced chronic inflammatory process, characterized by croupous and fibrinous-catarrhal pneumonia, pleurisy and pericarditis, and hemorrhages in the membrane of the brain are also noted (Fig. 1–5). It should be noted that pathoanatomical changes depend primarily on the stage and duration of the infectious process.
During bacteriological and virological examination of pathological material from piglets (lungs, heart, brain), microflora was isolated: S. suis, Streptococcus spp., Staphylococcus spp., Enterococcus spp., single E. coli.
The PCR study revealed the S. suis genome (serotypes: 2, 3, 7, 12, 16, 18, 24, 29, 30, 31). The genome of the porcine reproductive and respiratory syndrome virus was detected in pieces of organs (spleen) and blood serum of gilts at the age of 40 days.
Our studies have shown that exposure to immunosuppressive viruses significantly suppresses the phagocytic activity of dendritic cells and macrophages, as well as inhibition of the antigen-presenting function of plasma cells, Ti B-lymphocytes, which leads to the subsequent clinical manifestation of streptococcal infection caused by S. suis. It has been established that exposure to the PRRSV virus from the 40th to the 80th day of life in piglets results in a significant inhibition of the synthesis of GM-CSF, IFN-γ, IL-1, IL-6, IL-18. When an infection occurs and immunity is weakened, the level of IL-8 increases sharply (+1319%) and cachexin (TNF-α), as well as a decrease in the amount of IL-10 (–51%). A high content of cachexin in the blood causes inflammation, which subsequently leads to the depletion of the animal.
We also conducted a study of the level of immunoglobulins (IgG) against the PRRS virus, as well as S. suis, before and after vaccination of piglets with the StreptoVaK-C vaccine, as well as against PPCC. It has been established that against the background of the use of these drugs, a gradual stabilization of the serological profile in relation to PRRS occurs, and in relation to S. suis, under the pressure of vaccination, the pathogen is forced out of the herd, which is confirmed by a subsequent study by the microbiological method, as well as by PCR, since this etiological agent was arrested.
Our work has shown that long-term use of both feed and injectable antibiotics in the treatment regimens does not allow to adequately rid the swine population of the circulation of S. suis. Streptococci are by far the most common pathogens of bacterial etiology in pig production, causing arthritis, meningitis, pleurisy, pneumonia, and pericarditis in both young and adult livestock.
In the farm where the studies were carried out, stationary trouble was observed for S. suis serotypes 2, 3, 7, 12, 16, 18, 24, 29, 30, 31. Such diversity, as well as significant antigenic differences in streptococci, create difficulties in developing strategies for preventing and curbing the spread of the disease. Evolutionarily, the bacterium S. suis has developed resistance to the effects of the immune system and resistance to antibiotics. The use of an intensive vaccination scheme for breeding stock and piglets with the StreptoVac-C vaccine made it possible to stop the spread and negative impact of S. suis up to the complete absence of its subsequent circulation in the farm.
The results of the study of cellular immunity (cytokine profile) of piglets indicate a significant dominance of inflammatory processes in the bronchopulmonary tissue, heart, leading to exhaustion and cachexia caused by associative co-infections of predominantly viral-bacterial etiology (PRRSV and S. suis). Unfortunately, there are no registered vaccines on the market of the CIS countries, which include attenuated PRRSV type 1 subtypes 2, 3. The PRRSV virus identified and genotyped by us, circulating in the analyzed farm, is closest to strains SU1-Bel, Lena type 1 subtype 3. The degree of homology is 94.76%. The implementation of the vaccination program using the PPCC vaccine made it possible to stop the acute phase of the clinical manifestation of PRRS, reducing the circulation of a highly pathogenic field virus in the farm. Of course, its circulation is not completely stopped, and without the implementation of a minimum of mandatory measures aimed at controlling the spread of field PRRSV, there is always a risk of re-spread of the disease.