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Ida Nikoline Mandic¹, Victoria Elizabeth de Knegt², Hristo Stanchev¹

¹Børne- og Ungeafdeling, Københavns Universitetshospital - Slagelse Sygehus.

Ugeskrift for Laeger

|July 2, 2024

Summary

Risk-based screening and antibiotics reduced early-onset Group B Streptococcus (GBS) disease in neonates but not late-onset disease. Antibiotic stewardship and a future GBS vaccine may further reduce infant GBS disease and antibiotic exposure.

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Area of Science:

Neonatal infectious diseases
Bacterial pathogenesis
Public health interventions

Background:

Group B Streptococcus (GBS) causes neonatal disease in early-onset (EOD) and late-onset (LOD) forms.
Intrapartum screening and antibiotic administration are standard prevention strategies.
Current diagnostic methods cannot exclude GBS disease at symptom onset.

Purpose of the Study:

To evaluate the impact of risk-based intrapartum screening and antibiotic use on EOD and LOD incidence in Denmark.
To assess the extent of antibiotic exposure in neonates and identify potential reductions.
To explore future strategies for GBS disease prevention, including vaccination.

Main Methods:

Review of data on GBS disease incidence in Denmark.

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Analysis of trends in EOD and LOD following implementation of screening protocols.

Assessment of antibiotic usage patterns in neonates with suspected GBS disease.

Main Results:

Risk-based intrapartum screening and antibiotics significantly reduced EOD incidence.
No significant reduction in LOD incidence was observed.
A substantial proportion of uninfected infants received antibiotics, with wide variations in practice.
Antibiotic stewardship strategies show potential for reducing unnecessary antibiotic exposure.

Conclusions:

Intrapartum GBS screening effectively reduces EOD but not LOD.
Strategies for antibiotic stewardship are crucial to minimize unnecessary antibiotic use in neonates.
A GBS vaccine for pregnant women represents a promising future approach to decrease GBS disease burden and antibiotic exposure.