Snapshot A 26-year-old, G2P1, female at 37 weeks gestation was admitted in active labor at 6-cm dilation. Spontaneous rupture of membranes occured prior to admission. Past obstetric history reveals a prior uncomplicated vaginal delivery with one living child. On physical exam, the patient's vital signs are normal and the fetal heart rate tracing is reactive. Her prenatal records reveal a positive vaginal culture for group B streptococci (GBS) at 35 weeks gestation. Intrapartum penicillin G was administered. Introduction Clinical definition gram-positive coccus that frequently colonizes the genital tract of females upper respiratory tract of infants Epidemiology incidence asymptomatic cervical colonization occurs in up to 30% of women 50% of infants become colonized Associated conditions neonatal sepsis in infants of colonized mothers Prognosis intrapartum prophylaxis has reduced the incidence of neonatal sepsis mortality rates are higher in preterm infants neonates with meningitis Presentation Symptoms can have an asymptomatic bacteriuria dysuria increased urinary frequency urinary urgency Studies Labs vaginal and rectal culture at 35-37 weeks gestation except in women with GBS bacteriuria while currently pregnant women with who previously gave birth to their newborn with invasive GBS disease Differential Differential diagnosis of asymptomatic bacteruria Escherichia coli is the most frequently isolated organism Treatment Medical intrapartum intravenous penicillin G indication for a pregnant woman colonized with GBS at 35-37 weeks prior birth of an infant with GBS disease GBS bacteriuria in current pregnancy unknown status of antepartum culture alternative treatments intravenous clindamycin or erythromycin in patients with a penicillin-allergy Complications Complications infants of colonized women are at increased risk of GBS sepsis incidence only 1-2% of neonates develop actual disease treatment intravenous penicillin G indications when GBS is identified as the sole organism