Understanding Factors in Group B Streptococcus Late-Onset Disease

Area of Science:

• Neonatal infections
• Pediatric infectious diseases
• Microbiology

Background:

• Group B Streptococcus (GBS) causes significant infant morbidity and mortality.
• Intrapartum antibiotic prophylaxis reduced early-onset GBS disease, increasing the relative proportion of late-onset GBS (LOGBS).
• Understanding LOGBS pathogenesis, transmission, and risk factors is crucial for prevention.

Purpose of the Study:

• To review current and previous studies on late-onset GBS infections in neonates.
• To identify and discuss known and potential risk factors for LOGBS.
• To highlight knowledge gaps hindering effective prevention strategies.

Main Methods:

• This study is a narrative review of existing literature.
• It synthesizes findings from current and previous research on LOGBS.
• It discusses identified risk factors and limitations in current knowledge.

Main Results:

• Maternal GBS colonization, prematurity, young maternal age, HIV exposure, and Black ethnicity are identified risk factors for LOGBS.
• Transmission routes include delivery, postpartum via breast milk, and nosocomial or community acquisition.
• Reliable assessment of maternal GBS colonization, breastfeeding, and twin delivery as risk factors is limited due to few well-designed studies.

Conclusions:

• Late-onset GBS disease is a significant concern in neonates, with transmission occurring intrapartum and postpartum.
• Several maternal and infant factors are associated with increased LOGBS risk, but further research is required.
• More robust studies are needed to confirm risk factors and develop effective prevention strategies for LOGBS.