Should infection with group B streptococcus (GBS) be considered a sexually transmitted disease (STD) the way methicillin-resistant Staphylococcus aureus (MRSA) is? What treatment do you recommend? What educational information should be given to patients?—ERIKA SHEA, APN-C, Oaklyn, N.J.
One study did show a higher incidence of MRSA in geographical areas of San Francisco with a higher percentage of male same-sex couples (Ann Intern Med. 2008;148:249-257). But MRSA can be spread by any close personal contact and is not primarily considered an STD as conventionally defined.
GBS frequently colonizes the genital and GI tracts of adults and the upper respiratory tract of infants. The organisms can cause serious infection in neonates and pregnant women. In adults who are not pregnant, GBS is increasingly recognized as a cause of skin and soft-tissue infections, bacteremia, UTIs, pneumonia, and other infections. These infections are more common in patients older than age 65 years and patients with underlying chronic illnesses. A study of 462 college students living in a dormitory did show colonization rates to be twice as high in sexually experienced students, suggesting that GBS may be transmitted by sexual contact (Clin Infect Dis. 2004;39:380-388), but transmission modes may vary by colonization site. More prospective studies are needed to better understand the transmission of GBS. —JoAnn Deasy, PA-C, MPH (133-13)