Neonatal invasive disease caused by Streptococcus agalactiae in Europe: the DEVANI multi-center study

Area of Science:

• Neonatal infectious diseases
• Microbiology
• Vaccinology

Background:

• Group B Streptococcus (GBS) is a primary cause of neonatal sepsis and meningitis.
• Neonatal GBS infections lead to significant mortality in infants under three months.
• The European DEVANI project focuses on developing a vaccine against neonatal infections.

Purpose of the Study:

• To describe clinical and microbiological features of neonatal GBS diseases.
• To quantify antenatal screening and intrapartum antibiotic prophylaxis rates.
• To identify risk factors for adverse outcomes in neonatal GBS cases.

Main Methods:

• Collected clinical and microbiological data from 153 invasive neonatal GBS cases (82 early-onset, 71 late-onset).
• Data gathered across eight European countries between mid-2008 and end-2010.
• Analyzed screening rates, prophylaxis, clinical signs, and outcomes.

Main Results:

• Respiratory distress was common in early-onset disease (EOD); meningitis in over 30% of late-onset disease (LOD).
• 59% of EOD mothers lacked antenatal screening; GBS detected in 48.5% of screened mothers.
• Meningitis (LOD), prematurity, and cardiocirculatory symptoms (EOD) correlated with adverse outcomes. Type III GBS was most frequent.

Conclusions:

• Standardizing GBS guidelines and improving compliance can enhance neonatal care.
• Antenatal screening alone is insufficient to prevent all EOD cases.
• Maternal immunization represents the most effective prophylactic approach for GBS EOD and LOD.