National case definition: Group B streptococcal disease of the newborn

Date of last revision: May 2008

National notification

Only confirmed cases of disease should be notified.

Type of surveillance

Routine case-by-case notification to the federal level.

Case classification

Confirmed case

Clinical illness in an infant less than 1 month of age with laboratory confirmation of infection:

• isolation of group B Streptococcus (Streptococcus agalactiae) from a normally sterile site (such as blood or cerebrospinal fluid)
  or
• demonstration of group B Streptococcus DNA in a normally sterile site

Probable case

Clinical illness in an infant less than 1 month of age with laboratory confirmation of infection:

• detection of group B Streptococcus antigen in a normally sterile site

Laboratory comments

Isolates should be forwarded to the National Microbiology Laboratory reference centre for further characterization.

Clinical evidence

There are two forms of clinical illness: early onset disease (1-7 days), characterized by sepsis, respiratory distress, apnea, shock, pneumonia and meningitis; and late onset disease (7 days to 1 month), characterized by bacteremia, meningitis and other focal infections.

ICD code(s)

• ICD-10 code(s)
  • A 40.1; B 95.1
• ICD-9 code(s)
  • 041.02

Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

References

Case definitions for diseases under national surveillance. CCDR 2000;26(S3):55.

• Lachenauer CS, Wessels MR. Group B Streptococcus. In: Behrman RE, Kliegman RM,  Jenson HB (eds.). Nelson Textbook of Paediatrics. 17th ed. Philadelphia: W.B. Saunders, 2004;879-83.
• Zangwill KM, Schuchat A, Wenger JD. Group B Streptococcal disease in the United States, 1990: report from a multistate active surveillance system. In: CDC Surveillance Summaries (November 20). MMWR 1992;41(No. SS-6):25-32.
• Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease. MMWR 2002;51(No. RR-11):1-18.
• Money DM, Boucher M, Crane J et al. SOGC Clinical Practice Guidelines. The prevention of early onset neonatal Group B streptococcal disease. J Obstet Gynecol Can 2004;26(9):826-32.
• Schrag SJ, Zywicki S, Farley MM et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000;342:15-20.