Not Just an Intrapartum Problem: Late-Onset Group B Streptococcus Disease

Area of Science:

• Neonatal Medicine
• Infectious Diseases
• Bacteriology

Background:

• Group B streptococcal (GBS) infection is a major global cause of newborn illness and death.
• Current prevention strategies are effective for early-onset GBS but not late-onset GBS, which has rising incidence.
• Preterm infants face the highest risk of late-onset GBS infection and mortality.

Purpose of the Study:

• To review the pathogenesis, risk factors, clinical signs, diagnostics, and treatment of neonatal late-onset GBS infection.
• To highlight the implications for clinical practice regarding neonatal GBS.
• To emphasize the need for broader risk assessment beyond birth-related factors.

Main Methods:

• Literature review on Group B streptococcal infections in neonates.
• Analysis of risk factors, including horizontal transmission post-birth.
• Discussion of clinical manifestations, diagnostic approaches, and therapeutic interventions.

Main Results:

• Late-onset GBS disease continues to pose a significant threat, with meningitis as a common severe complication (30% of cases).
• Horizontal transmission from mothers, caregivers, and community sources contributes to infection risk.
• Risk assessment should extend beyond maternal screening and intrapartum prophylaxis.

Conclusions:

• Late-onset GBS disease and its complications remain a critical concern for neonates.
• Clinicians must be vigilant in recognizing GBS signs and symptoms for prompt treatment.
• Further strategies are needed to mitigate the burden of late-onset GBS disease.