Current knowledge and future perspectives on management and prevention of group B streptococcus in neonates and young infants

Group B Streptococcus (GBS) remains a leading cause of neonatal sepsis and meningitis in the UK, with an incidence of around 0.9 per 1000 live births. Early-onset disease usually results from vertical transmission during delivery, while late-onset disease is also acquired through postnatal exposures. GBS disease presents as sepsis, meningitis or pneumonia and leads to death in 6% of affected infants and long-term neurodevelopmental impairment in up to a third of survivors. The current UK prevention strategy of risk-based intra-partum antibiotic prophylaxis has several limitations, including lack of impact on disease burden in infants without associated risk factors and on late-onset disease. Ongoing studies of universal antenatal GBS screening and GBS maternal immunisations, along with a new British Paediatric Surveillance Unit surveillance study to provide updated epidemiological data will help to guide policy and practice.