SHS Chan, KM Wan, WH Lee

Abstract

Group B streptococcal (GBS) infections cause significant morbidity and mortality in the newborn population of the western countries. Since 1990, the focus of group B streptococcus (GBS) disease research has shifted to prevention. Intrapartum chemoprophylaxis is well proven to be cost-effective in the prevention of early onset GBS infection. In 1996, a consensus guideline on the "Prevention of Perinatal Group B Streptococcal Disease" was published in 1996, by the collaboration of the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP).1 In recent 10 years, there are enormous ongoing studies leading to new insight in epidemiology, bacteriology, treatment and different preventive strategies of GBS infection. Vaccine development has yielded encouraging result on phase I human trial, demonstrating high immunogenicity and good tolerance when monovalent vaccine was given to women of reproductive age. Development of multivalent conjugated vaccine efficacious against major serotypes causing clinical disease, will be the next goal of effective prevention that may decrease use of antibiotic prophylaxis and to offer protection to a larger population including pregnant mothers and their babies, and also to the high risk elderly. Active research comparing the "universal cultures-based" vs "risksbased" screening strategies for intrapartum chemoprophylaxis is actively ongoing. These enormous upcoming data will lead to further refinement of current consensus guidelines.