The prevention of neonatal group B streptococcal disease: a report by a working group of the Medical Screening Society

Abstract

Streptococcus agalactiae, or Lancefield group B streptococcus (GBS), is the most frequent cause of serious bacterial sepsis, including neonatal meningitis, in UK neonates. Early-onset neonatal GBS infection, but not late-onset, can be prevented by screening to identify high-risk pregnancies and administering penicillin during delivery. A vaccine has been developed as an alternative means of prevention but it is awaiting a randomized trial before being available for general use. In this review we examine the published literature to assess the morbidity and mortality attributable to neonatal GBS infection, quantify the screening performance of the two alternative modes of screening (microbiological and risk factor based), review the evidence on the efficacy of the vaccine, and estimate the numbers of deaths and cases of serious disability that each strategy in turn might prevent in the UK, in order to assess the most effective means of prevention for the UK.

A unique serine-rich repeat protein (Srr-2) and novel surface antigen (ε) associated with a virulent lineage of serotype III Streptococcus agalactiae

“…Although a long-sought goal and the focus of promising research (Law et al, 2005;Lindahl et al, 2005;Maione et al, 2005), a GBS vaccine is not yet available. A reduction in the incidence of early-onset neonatal GBS infections has been achieved by intrapartum treatment of colonized women with high-dose intravenous antibiotics (Schrag et al, 2000;Puopolo et al, 2005), but this approach currently does not take into consideration potential differences in relative risk associated with different lineages of GBS.…”

The changing spectrum of neonatal infectious disease

“…Today, the majority of EOS, approaching 90%, will present within the first 24 h of life. 13 The route of transmission or type of exposure can influence the timing of presentation. The earliest in utero exposure can come as a result of a maternal subclinical infection at any time during the pregnancy.…”

Antimicrobial resistance in colonizing group B Streptococci before the implementation of a Swedish intrapartum antibiotic prophylaxis program

“…In an attempt to prevent GBS infection in neonates, most western countries have introduced programs for intrapartum antibiotic prophylaxis (IAP) (1,2). The use of IAP has drastically reduced neonatal invasive GBS infections during the first week of life (1,3). However, the increased use of antibiotics to women in labor has raised concerns about development of antibiotic resistance.…”