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Updated: Aug 16, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Neonatal invasive disease caused by Streptococcus agalactiae in Europe: the DEVANI multi-center study
Florens Lohrmann1,2, Markus Hufnagel1, Mirjam Kunze3
1Department of Pediatrics and Adolescent Medicine, University Medical Center, Medical Faculty, University of Freiburg, Freiburg, Germany.
Insights
Group B Streptococcus (GBS) causes serious infant infections. Maternal immunization is the most promising strategy to prevent GBS early- and late-onset disease in newborns.
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.
Purpose:
Group B streptococcus (GBS) remains a leading cause of invasive disease, mainly sepsis and meningitis, in infants < 3 months of age and of mortality among neonates. This study, a major component of the European DEVANI project (Design of a Vaccine Against Neonatal Infections) describes clinical and important microbiological characteristics of neonatal GBS diseases. It quantifies the rate of antenatal screening and intrapartum antibiotic prophylaxis among cases and identifies risk factors associated with an adverse outcome.
Methods:
Clinical and microbiological data from 153 invasive neonatal cases (82 early-onset [EOD], 71 late-onset disease [LOD] cases) were collected in eight European countries from mid-2008 to end-2010.
Results:
Respiratory distress was the most frequent clinical sign at onset of EOD, while meningitis is found in > 30% of LOD. The study revealed that 59% of mothers of EOD cases had not received antenatal screening, whilst GBS was detected in 48.5% of screened cases. Meningitis was associated with an adverse outcome in LOD cases, while prematurity and the presence of cardiocirculatory symptoms were associated with an adverse outcome in EOD cases. Capsular-polysaccharide type III was the most frequent in both EOD and LOD cases with regional differences in the clonal complex distribution.
Conclusions:
Standardizing recommendations related to neonatal GBS disease and increasing compliance might improve clinical care and the prevention of GBS EOD. But even full adherence to antenatal screening would miss a relevant number of EOD cases, thus, the most promising prophylactic approach against GBS EOD and LOD would be a vaccine for maternal immunization.
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