Current and future strategies for prevention of neonatal early-onset group B streptococcus disease

Abstract

Group B streptococci (GBS) have been recognized as a leading cause of serious early-onset neonatal sepsis for 30 years. Introduction of intrapartum antibiotic prophylaxis (IAP) has led to a decrease in neonatal early-onset GBS (EOGBS) disease and in early neonatal sepsis-related mortality in many countries. At present decisions concerning the administration of IAP are usually based on either the presence of risk factors at the time of labor, or on screening of women at 35-37 weeks gestation. A new generation of rapid test for GBS suitable for point of care use offer the prospect of accurately detecting GBS during labor, which might improve targeting of IAP. Looking further ahead, active immunization of women before or during pregnancy may become the mainstay of prevention of neonatal EOGBS disease. In this article the role of GBS as a neonatal pathogen, and current and possible future strategies for prevention of neonatal EOGBS disease, are reviewed.