Group B Streptococci: Declining Incidence in Infants in Germany

Area of Science:

• Neonatal infections
• Maternal-fetal medicine
• Infectious disease epidemiology

Background:

• Group B Streptococcus (GBS) is a major cause of newborn illness and death globally.
• German guidelines evolved from risk-based intrapartum antibiotic prophylaxis to universal GBS screening for pregnant women.

Purpose of the Study:

• To evaluate the incidence of invasive GBS infections in German infants (0-90 days) between 2009-2010.
• To compare GBS incidence rates before and after the 2008 guideline change to universal screening.

Main Methods:

• Prospective active surveillance study utilizing capture-recapture analysis of pediatric and laboratory reporting systems.
• Comparison with a prior study (2001-2003) using an equivalent methodology.

Main Results:

• A 32% reduction in GBS incidence was observed, decreasing from 0.47 to 0.34 per 1000 live births.
• The decline was mainly attributed to a decrease in early-onset GBS disease (infants < 7 days old).
• The ratio of early-onset to late-onset GBS cases shifted from 1.52 in 2001-2003 to 0.75 in 2009-2010.

Conclusions:

• The implementation of universal, culture-based GBS screening in Germany has significantly reduced invasive GBS infections in newborns.
• The updated guidelines effectively lowered the burden of early-onset GBS disease, demonstrating a successful public health intervention.