Prevention of group B streptococcal neonatal disease revisited. The DEVANI European project

Abstract

The purpose of this paper was to present the current knowledge on the prevention of group B streptococcus (GBS) neonatal infections and the status of prevention policies in European countries and to present the DEVANI pan-European program, launched in 2008. The aim of this program was to assess the GBS neonatal infection burden in Europe, to design a new vaccine to immunize neonates against GBS infections, to improve the laboratory performance for the diagnosis of GBS colonization and infection, and to improve the methods for the typing of GBS strains. The current guidelines for GBS prevention in different countries were ascertained and a picture of the burden before and after the instauration of prevention policies has been drawn. After the issue of the Centers for Disease Control and Prevention (CDC) guidelines, many European countries have adopted universal screening for the GBS colonization of pregnant women and intrapartum prophylaxis to colonized mothers. Nevertheless, some European countries continue advocating the risk factor approach to GBS prevention. Most European countries have implemented policies to prevent GBS neonatal infections and the burden of the disease has decreased during the last several years. Nevertheless, further steps are necessary in order to develop new strategies of prevention, to improve microbiological techniques to detect GBS colonization and infection, and to coordinate the prevention policies in the EU.

Epidemiological surveillance of colonising group B Streptococcus epidemiology in the Lisbon and Tagus Valley regions, Portugal (2005 to 2012): emergence of a new epidemic type IV/clonal complex 17 clone

“…Due to its low prevalence in European countries and in the US, serotype IV was not selected for the development of capsular polysaccharide-based vaccines [4,5]. This situation has changed in the last decade, when some countries, including the US, saw the emergence of serotype IV among colonising and invasive GBS isolates [15,16].…”

“…Thus, the continuous monitoring of circulating GBS isolates is important in assessing changes in GBS serotype distribution, which is essential for the development of polysaccharide-based vaccines suitable for different geographical areas [4,5]. Serotypes Ia, II, III and V have been the most frequently described in European countries such as the Czech Republic, France, Germany, Greece, Ireland, Italy, the Netherlands, Portugal, Sweden, and the United Kingdom [6], as well as in the United States (US) [7], whereas serotypes VI and VIII, to date scarcely found in these countries, could frequently be identified in Japan [8].…”

Xpert GBS Assay for Rapid Detection of Group B Streptococcus in Gastric Fluid Samples from Newborns

“…Two strategies have significantly reduced the rate of early neonatal GBS colonization and infection (4): (i) late antenatal GBS screening of pregnant women and (ii) intrapartum chemoprophylaxis for colonized women to reduce vertical transmission of GBS. Despite international guidelines, the worldwide incidence rate of GBS neonatal diseases is still 0.23 to 1.22‰ of births (5,6).…”

Capsular Gene Typing of Streptococcus agalactiae Compared to Serotyping by Latex Agglutination

“…as an important human pathogen in the 1960s and has become the leading cause of neonatal invasive infections (1)(2)(3). More recently, S. agalactiae has also been recognized as a common cause of infections in immunocompromised patients and in the elderly (4).…”