Materiały źródłowe

• #1

  https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/group-b-streptococcus-(gbs)

  Group B Streptococcus (GBS) is a leading cause of neonatal and infant sepsis and meningitis globally. GBS was estimated to have caused 319,000 cases of neonatal disease annually (2015), resulting in 90000 deaths and at least 57,000 stillbirths. The highest burden is in Africa, where 54% of estimated invasive GBS cases, and 65% of all fetal/infant deaths occur. […] An average of 18% (with regional variation) of pregnant women carry GBS worldwide. Administration of intrapartum antibiotic prophylaxis (IAP) to pregnant women with GBS colonization can substantially reduce the incidence of early-onset GBS disease, but IAP does not prevent late-onset GBS disease, which in most cases are transmitted postnatally. […] The development of Group B Streptococcus (GBS) vaccines for maternal immunization has been identified by the Product Development for Vaccines Advisory Committee (PDVAC) as a priority, because of the major public health burden posed by GBS in LMIC.

• #2 Group B Strep Surveillance and Trends | Group B Strep | CDC

  https://www.cdc.gov/group-b-strep/php/surveillance/index.html

  CDC conducts active surveillance for invasive group B Streptococcus (group B strep, GBS) disease. […] GBS bacteria remain a leading cause of meningitis and bloodstream infections in newborns younger than 3 months old. […] CDC conducts active surveillance for invasive GBS disease through Active Bacterial Core surveillance (ABCs). ABCs is part of CDC’s Emerging Infections Program. […] Approximately 28,010 cases of invasive GBS disease occur annually in the United States in all age groups. […] GBS bacteria remain a leading cause of meningitis and bloodstream infections in newborns younger than 3 months old. […] As use of intrapartum prophylaxis increased, GBS disease declined by 80% in babies younger than one week old.

• #3 Group B Strep Surveillance and Trends | Group B Strep | CDC

  https://www.cdc.gov/group-b-strep/php/surveillance/index.html

  CDC conducts active surveillance for invasive group B Streptococcus (group B strep, GBS) disease. […] GBS bacteria remain a leading cause of meningitis and bloodstream infections in newborns younger than 3 months old. […] CDC conducts active surveillance for invasive GBS disease through Active Bacterial Core surveillance (ABCs). ABCs is part of CDC’s Emerging Infections Program. […] Approximately 28,010 cases of invasive GBS disease occur annually in the United States in all age groups. […] GBS bacteria remain a leading cause of meningitis and bloodstream infections in newborns younger than 3 months old. […] As use of intrapartum prophylaxis increased, GBS disease declined by 80% in babies younger than one week old.

• #4

  https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/group-b-streptococcus-(gbs)

  Group B Streptococcus (GBS) is a leading cause of neonatal and infant sepsis and meningitis globally. GBS was estimated to have caused 319,000 cases of neonatal disease annually (2015), resulting in 90000 deaths and at least 57,000 stillbirths. The highest burden is in Africa, where 54% of estimated invasive GBS cases, and 65% of all fetal/infant deaths occur. […] An average of 18% (with regional variation) of pregnant women carry GBS worldwide. Administration of intrapartum antibiotic prophylaxis (IAP) to pregnant women with GBS colonization can substantially reduce the incidence of early-onset GBS disease, but IAP does not prevent late-onset GBS disease, which in most cases are transmitted postnatally. […] The development of Group B Streptococcus (GBS) vaccines for maternal immunization has been identified by the Product Development for Vaccines Advisory Committee (PDVAC) as a priority, because of the major public health burden posed by GBS in LMIC.

• #5 Group B streptococcal infection – Wikipedia

  https://en.wikipedia.org/wiki/Group_B_streptococcal_infection

  Estimates of the incidence of GBS-EOD per 1,000 births differ among countries, Japan 0.09, Panama 0.58, Hong Kong 0.76, and 2.35 in the Dominican Republic. Overall, rates are highest in Africa and lowest in Asia. The estimate of the global incidence of GBS LOD is 0.26 cases per 1,000 live births. […] It has been appraised that GBS infections cause at least 409.000 maternal/fetal/infant cases and 147.000 stillbirths and infant deaths worldwide annually.

• #6 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Colonization and infection in neonates largely correlate with maternal colonization at the time of delivery. Vertical transmission from colonized mothers to their neonates occurs in approximately 41% to 72% of cases (mean, approximately 50%). However, about 1% to 12% of colonized infants (mean, 5%) are born to non-colonized mothers. Furthermore, heavy maternal colonization in the genital tract (greater than 10 colony-forming units per milliliter) greatly increases the rate of vertical transmission and the rate of heavily colonized infants. Heavily colonized infants are then more likely to have either early- or late-onset GBS disease. […] Before the widespread use of intrapartum prophylactic antibiotics, reported attack rates of early-onset neonatal GBS infections ranged from 1.8 to 4.0 per 1000 live births. Early-onset disease (onset within the first 6 days of life) accounted for approximately 80% of cases or about 7600 cases annually. Following the 2002 guidelines for universal screening of pregnant women at 35 to 37 weeks gestation and administration of prophylactic antibiotics to colonized women, the incidence of early-onset disease has decreased to approximately 0.25 cases per 1000 live births, a finding representing a decline of nearly 85% from 1990.

• #7 Group B Streptococcus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–group-b-streptococcus/id/418093

  Maternal colonization is a major risk factor for EO-GBS disease in infants. In order to estimate the true burden of GBS disease, it is useful to determine the maternal colonization rate by region along with the prevalence of serotypes. The overall prevalence of maternal GBS colonization worldwide is 15%. Estimated prevalence rates in developed countries is 18.4%, however, prevalence rates from countries in Western Africa seem to be lower (14%), and the lowest colonization rates are seen in Southern Asia and Eastern Asia (13 and 11%, respectively). The overall prevalence of colonizing serotype III is 25%, but lower prevalence of serotype III is seen in South Eastern Asia and South Asia. […] Intrapartum antibiotics (IAP) can prevent EO-GBS disease, and in a number of resource-rich countries, EO-GBS disease is significantly less common following the introduction of IAP strategies. These strategies include both universal and risk-based screening of pregnant women. In the USA, women between 36 and 38 weeks of pregnancy are screened for GBS and if GBS is identified they are offered high-dose intravenous benzylpenicillin in labor, alongside at-risk women whose GBS status is unknown. This strategy is thought to result in reduced incidence of GBS disease.

• #8 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation. […] Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. In the absence of intrapartum antibiotic prophylaxis, 12% of those newborns will develop GBS EOD. […] Indications for intrapartum antibiotic prophylaxis are listed in Table 1. […] All women whose vaginalrectal culture at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis, unless a prelabor cesarean birth is performed in the setting of intact membranes. […] Women with reported or known GBS colonization status in a previous pregnancy and who present in labor at 37 0/7 weeks of gestation or more with unknown culture status in the current pregnancy also should be considered candidates to receive antibiotic prophylaxis intrapartum.

• #9 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Colonization and infection in neonates largely correlate with maternal colonization at the time of delivery. Vertical transmission from colonized mothers to their neonates occurs in approximately 41% to 72% of cases (mean, approximately 50%). However, about 1% to 12% of colonized infants (mean, 5%) are born to non-colonized mothers. Furthermore, heavy maternal colonization in the genital tract (greater than 10 colony-forming units per milliliter) greatly increases the rate of vertical transmission and the rate of heavily colonized infants. Heavily colonized infants are then more likely to have either early- or late-onset GBS disease. […] Before the widespread use of intrapartum prophylactic antibiotics, reported attack rates of early-onset neonatal GBS infections ranged from 1.8 to 4.0 per 1000 live births. Early-onset disease (onset within the first 6 days of life) accounted for approximately 80% of cases or about 7600 cases annually. Following the 2002 guidelines for universal screening of pregnant women at 35 to 37 weeks gestation and administration of prophylactic antibiotics to colonized women, the incidence of early-onset disease has decreased to approximately 0.25 cases per 1000 live births, a finding representing a decline of nearly 85% from 1990.

• #10 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  However, the incidence of late-onset disease (onset from 7 through 89 days of life) was not changed through maternal intrapartum antibiotic prophylaxis, remaining at approximately 0.27 per 1000 live births. Late, late-onset GBS disease occurs in infants older than 3 months of age and accounts for 7% to 13% of childhood GBS infections. Affected infants typically were born before 34 weeks gestation or have an underlying immunodeficiency or concomitant infection with human immunodeficiency virus (HIV). In the past 2 decades, 2-fold to 4-fold increases in the incidence of GBS disease have occurred in nonpregnant adults, mostly those who have underlying medical conditions or are 65 years of age or older. Residents of nursing homes have a markedly higher incidence of invasive group B streptococcal disease than community residents.

• #11 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Colonization and infection in neonates largely correlate with maternal colonization at the time of delivery. Vertical transmission from colonized mothers to their neonates occurs in approximately 41% to 72% of cases (mean, approximately 50%). However, about 1% to 12% of colonized infants (mean, 5%) are born to non-colonized mothers. Furthermore, heavy maternal colonization in the genital tract (greater than 10 colony-forming units per milliliter) greatly increases the rate of vertical transmission and the rate of heavily colonized infants. Heavily colonized infants are then more likely to have either early- or late-onset GBS disease. […] Before the widespread use of intrapartum prophylactic antibiotics, reported attack rates of early-onset neonatal GBS infections ranged from 1.8 to 4.0 per 1000 live births. Early-onset disease (onset within the first 6 days of life) accounted for approximately 80% of cases or about 7600 cases annually. Following the 2002 guidelines for universal screening of pregnant women at 35 to 37 weeks gestation and administration of prophylactic antibiotics to colonized women, the incidence of early-onset disease has decreased to approximately 0.25 cases per 1000 live births, a finding representing a decline of nearly 85% from 1990.

• #12 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  However, the incidence of late-onset disease (onset from 7 through 89 days of life) was not changed through maternal intrapartum antibiotic prophylaxis, remaining at approximately 0.27 per 1000 live births. Late, late-onset GBS disease occurs in infants older than 3 months of age and accounts for 7% to 13% of childhood GBS infections. Affected infants typically were born before 34 weeks gestation or have an underlying immunodeficiency or concomitant infection with human immunodeficiency virus (HIV). In the past 2 decades, 2-fold to 4-fold increases in the incidence of GBS disease have occurred in nonpregnant adults, mostly those who have underlying medical conditions or are 65 years of age or older. Residents of nursing homes have a markedly higher incidence of invasive group B streptococcal disease than community residents.

• #13 Factors in group B streptococcus late-onset disease | IDR

  https://www.dovepress.com/understanding-factors-in-group-b-streptococcus-late-onset-disease-peer-reviewed-fulltext-article-IDR

  The LOGBS rates among infants have stabilized in the USA (mean 0.31/1000 live births) and are now higher than those of EOGBS. Therefore, investigation of RFs associated with LOGBS is important because in some high income countries LOGBS is now the most common presentation of neonatal GBS disease. […] Hospital clusters of invasive GBS infections were investigated in a recent systematic review; crowding, inadequate disinfection of equipment and surfaces, unsatisfactory practices for prevention of infection, or a high patient-to-nurse ratio were implicated in the occurrence of LOGBS clusters. […] Data from the surveillance network in France show a sustained increase in the incidence of LOGBS, with an overall 65% higher incidence over the past 20 years, along with an increase in prevalence of the hypervirulent CC17 GBS clone and its MDR sub-lineage in LOGBS.

• #14 Epidemiology of Neonatal Group B Streptococcal Disease in the U.S., 2006–2015logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na48331/2019/01/16/epidemiology-neonatal-group-b-streptococcal-disease-us

  Late-onset group B streptococcal disease has outpaced early-onset disease. […] Neonatal group B streptococcal disease (GBS) is a major cause of infant morbidity and mortality. […] To better define the epidemiology of EOD and LOD, investigators have analyzed 9 years of data (2006–2015) from the multistate Active Bacterial Core surveillance program, which captures approximately 10% of U.S. born infants and in 2015 included 439,000 live births. […] Incidence of EOD decreased from 0.37 to 0.23 per 1000 live births during the study period; the declines were significant in both term and preterm infants. […] Incidence of LOD remained stable during the study period and was highest in preterm infants (rate ratio, 6.4 times) and in black infants (RR, 2.9 times). […] In the era of universal screening and prophylaxis for GBS, late-onset disease is now more common than early-onset disease, and this study highlights the remarkable success of the current recommendations for intrapartum prophylaxis.

• #15 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  In this population-based study of 21250 patients with invasive group B Streptococcus detected by the Active Bacterial Core surveillance network from 2008 through 2016, invasive group B Streptococcus incidence among nonpregnant adults increased significantly from 8.1 cases per 100000 population in 2008 to 10.9 in 2016; incidence was highest among those with male sex, age 65 years or older, and black race. […] The incidence of invasive group B Streptococcus continues to rise among nonpregnant adults; chronic diseases, such as obesity and diabetes, may contribute. […] Using population-based surveillance data, this case study reports epidemiology trends in invasive group B Streptococcus disease among US nonpregnant adults according to demographic characteristics, underlying clinical conditions, and isolate characteristics.

• #16 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  In this population-based study of 21250 patients with invasive group B Streptococcus detected by the Active Bacterial Core surveillance network from 2008 through 2016, invasive group B Streptococcus incidence among nonpregnant adults increased significantly from 8.1 cases per 100000 population in 2008 to 10.9 in 2016; incidence was highest among those with male sex, age 65 years or older, and black race. […] The incidence of invasive group B Streptococcus continues to rise among nonpregnant adults; chronic diseases, such as obesity and diabetes, may contribute. […] Using population-based surveillance data, this case study reports epidemiology trends in invasive group B Streptococcus disease among US nonpregnant adults according to demographic characteristics, underlying clinical conditions, and isolate characteristics.

• #17 Group B streptococcus: Beyond pregnancy and neonatal infections | Medical Laboratory Observer

  https://www.mlo-online.com/disease/infectious-disease/article/53061966/group-b-streptococcus-beyond-pregnancy-and-neonatal-infections

  Since the ABCs began tracking GBS in 1997, the overall rate of GBS has increased 42% from 6.2 per 100,000 to 8.8 per 100,000 in 2021, the last year of data currently available. […] The ABCs surveillance network also performs additional characterization of GBS isolates from selected surveillance areas using whole genome sequencing. Performing whole genome sequencing allows epidemiologists to determine capsular serotypes, multi-locus sequence typing, and phylogenetic clustering to identify transmission events. […] Infections due to GBS in nonpregnant persons is high. In the United States, the incidence among all persons was estimated to be 11 cases per 100,000 persons in 2016. […] Several NAAT test manufacturers are approved for testing following a broth enrichment step and do not require culture confirmation of negative results.

• #18 Group B Strep (GBS) Infection | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/invasive-and-respiratory-diseases-and-conditions/streptococcal-strep-diseases/group-b-strep-gbs-infection

  GBS is no longer a reportable condition in Texas. […] The number of invasive GBS cases reported in Texas has increased 457.8% over the past fifteen years, increasing from 464 (1.5 cases per 100,000 population) in 2005 to 2,124 (7.3 cases per 100,000 population) in 2019. […] Among the cases in 2019, 68.3% of the GBS cases in Texas occurred in adults aged 50 years or more. […] The highest age-specific incidence rates of invasive GBS in Texas are seen in children less than one year of age (52.6 cases per 100,000 population) followed by adults aged 60 years or more (19.5 cases per 100,000 population).

• #19

  https://link.springer.com/article/10.1007/s15010-024-02210-3

  Group B streptococcus (GBS) colonizes the gastrointestinal and vaginal mucosa in healthy adults, but has also become an increasing cause of invasive infection. The aims of this study were to describe the incidence and factors associated with the occurrence of invasive GBS disease in adults in Norway. […] A total of 3710 GBS episodes were identified. The age-standardized incidence rate increased steadily from 1.10 (95% CI 0.801.50) in 1996 to 6.70 (95% CI 5.907.50) per 100,000 person-years in 2019. The incidence rate had an average annual increase of 6.44% (95% CI 5.127.78). […] The incidence of invasive GBS disease in adults increased significantly from 1996 to 2019. The increasing age of the population with accompanying underlying comorbid conditions might contribute to the increasing burden of invasive GBS disease.

• #20 Group B streptococcal infection – Wikipedia

  https://en.wikipedia.org/wiki/Group_B_streptococcal_infection

  Another study on the epidemiology of invasive GBS infections in England and Wales reported a rise in the incidence of GBS-EOD between 2000 and 2010 from 0.28 to 0.41 per 1,000 live births. Rates of GBS-LOD also increased between 1991 and 2010 from 0.11 to 0.29 per 1,000 live births in England and Wales. […] In the past, the incidence of GBS-EOD ranged from 0.7 to 3.7 per thousand live births in the US, and from 0.2 to 3.25 per thousand in Europe. […] In 2008, after widespread use of antenatal screening and intrapartum antibiotic prophylaxis, the Centers for Disease Control and Prevention in the United States reported an incidence of 0.28 cases of GBS-EOD per thousand live births in the US. From 2006 to 2015 the incidence of GBS EOD decreased from 0.37 to 0.23 per thousand live births in the US.

• #21 Group B streptococcal infection – Wikipedia

  https://en.wikipedia.org/wiki/Group_B_streptococcal_infection

  In 2021, in the United States the CDC reported an incidence of 0.21 per 1,000 live births of GBS-EOD and of 0.23 per thousand live births of GBS-LOD. In 2021 had been estimated a total of 1970 deaths ((0.59/100,000 population) in the US caused by GBS neonatal infections. […] In Spain, the incidence of GBS vertical sepsis declined by 73.6%, from 1.25/1,000 live births in 1996 to 0.33/1,000 in 2008. […] In France since 2001, a rapid decrease in the incidence of the neonatal GBS infections has also been reported after widespread use of IAP, from 0.7 to 0.2 per 1,000 births between 1997 and 2006. The incidence of GBS-EOD infections has been reported to be 0.2 per 1000 live births in 2011. […] Since 2012 the incidence of neonatal GBS infection has been estimated as 0.53 per 1,000 births in the European region, 0.67 in America, and 0.15 in Australasia. Countries reporting no use of IAP had a 2.2-fold higher incidence of GBS-EOD compared with those reporting any use of IAP.

• #22 Factors in group B streptococcus late-onset disease | IDR

  https://www.dovepress.com/understanding-factors-in-group-b-streptococcus-late-onset-disease-peer-reviewed-fulltext-article-IDR

  The LOGBS rates among infants have stabilized in the USA (mean 0.31/1000 live births) and are now higher than those of EOGBS. Therefore, investigation of RFs associated with LOGBS is important because in some high income countries LOGBS is now the most common presentation of neonatal GBS disease. […] Hospital clusters of invasive GBS infections were investigated in a recent systematic review; crowding, inadequate disinfection of equipment and surfaces, unsatisfactory practices for prevention of infection, or a high patient-to-nurse ratio were implicated in the occurrence of LOGBS clusters. […] Data from the surveillance network in France show a sustained increase in the incidence of LOGBS, with an overall 65% higher incidence over the past 20 years, along with an increase in prevalence of the hypervirulent CC17 GBS clone and its MDR sub-lineage in LOGBS.

• #23 Group B streptococcal infection – Wikipedia

  https://en.wikipedia.org/wiki/Group_B_streptococcal_infection

  In 2021, in the United States the CDC reported an incidence of 0.21 per 1,000 live births of GBS-EOD and of 0.23 per thousand live births of GBS-LOD. In 2021 had been estimated a total of 1970 deaths ((0.59/100,000 population) in the US caused by GBS neonatal infections. […] In Spain, the incidence of GBS vertical sepsis declined by 73.6%, from 1.25/1,000 live births in 1996 to 0.33/1,000 in 2008. […] In France since 2001, a rapid decrease in the incidence of the neonatal GBS infections has also been reported after widespread use of IAP, from 0.7 to 0.2 per 1,000 births between 1997 and 2006. The incidence of GBS-EOD infections has been reported to be 0.2 per 1000 live births in 2011. […] Since 2012 the incidence of neonatal GBS infection has been estimated as 0.53 per 1,000 births in the European region, 0.67 in America, and 0.15 in Australasia. Countries reporting no use of IAP had a 2.2-fold higher incidence of GBS-EOD compared with those reporting any use of IAP.

• #24 Group B Streptococcus neonatal infections, the ongoing history | Enfermedades Infecciosas y Microbiología Clínica

  https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-group-b-streptococcus-neonatal-infections-S0213005X2200012X

  The follow-up of these recommendations brought an important change in the clinical practice in Spain, and a significant reduction (more than 85%) in the rate of GBS EOD. The incidence of EOD in Spain dropped from 1.23 per 1000 live births in 1996 to 0.32 in 2002 and to 0.17 in 2018. […] Despite the success of measures recommended in guidelines in preventing EOD, IAP is not effective in preventing LOD, and also GBS cause stillbirths and preterm births.

• #25 Epidemiology and bacterial characteristics of invasive group B streptococcus disease: a population-based study in Japan in 2010–2020 | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-and-bacterial-characteristics-of-invasive-group-b-streptococcus-disease-a-populationbased-study-in-japan-in-20102020/01C1F0A0BBED05C2F5382788EDDC992B

  This is the first report on a population-based prospective study of invasive group B streptococcus (GBS) disease among children aged 15 years conducted over a period of 11 years in Japan. This study investigated the incidence and clinical manifestations of invasive GBS disease in children in Chiba Prefecture, Japan, and analysed the serotypes and drug susceptibility of GBS strains isolated during the study period. Overall, 127 episodes of invasive GBS disease were reported in 123 patients. Of these, 124 were observed in 120 patients aged 1 year, and the remaining three episodes were reported in a 9-year-old child and two 14-year-old children with underlying disease. For patients aged 1 year, the incidence rate per 1000 live births was 0.24 (0.150.36). The incidences of early-onset disease and late-onset disease were 0.04 (0.00.09) and 0.17 (0.080.25), respectively. The rate of meningitis was 45.2%, and the incidence of GBS meningitis was higher than that of other invasive diseases among children in Japan. This study showed that the incidence of invasive GBS disease among Japanese children was constant during the study period. Because of the high incidence of meningitis and disease burden, new preventive strategies, such as GBS vaccine, are essential.

• #26

  https://link.springer.com/article/10.1007/s10096-021-04396-y

  We aimed to define the burden and clinical features of invasive group B streptococcus (GBS) disease in infants younger than 1 year in Japan, to explore transmission route of late-onset disease (LOD), and to identify risk factors associated with recurrent GBS disease. […] We conducted a retrospective, questionnaire-based nationwide surveillance study between 2016 and 2020. […] A total of 875 GBS cases were identified, including 186 early-onset disease, 628 LOD, and 61 ultra-late-onset disease. […] Annual incidence in infants younger than 1 year and in LOD significantly increased from 0.28 to 0.45/1000 livebirths (p=0.021) and from 0.19 to 0.29/1000 livebirths (p=0.046), respectively. […] Maternal colonization status at the LOD diagnosis was available for 148 mothers, of whom 21/58 (36.2%) had positive rectovaginal swabs and 42/117 (36.2%) had GBS in breastmilk culture.

• #27 Epidemiology of invasive group B streptococcal disease in infants from urban area of South China, 2011–2014 | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2811-0

  Group B Streptococcus (GBS) is a leading cause of morbidity and mortality in infants in both developed and developing countries. To our knowledge, only a few studies have been reported the clinical features, treatment and outcomes of the GBS disease in China. The severity of neonatal GBS disease in China remains unclear. Population-based surveillance in China is therefore required. […] The overall incidence of invasive GBS infection was 0.55 per 1000 live births (95% CI 0.440.69) during 20112014. The disease incidences increased significantly from 0.29 per 1000 live births (95% CI 0.140.59) in 2011 to 0.69 per 1000 live births (95% CI 0.481.01) in 2014 (P0.05). Incidences for EOD and LOD were 0.39 per 1000 live births (95% CI 0.290.51) and 0.17 per 1000 live births (95% CI 0.110.25), respectively.

• #28 Epidemiology of group B streptococcus in Korean pregnant women | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-group-b-streptococcus-in-korean-pregnant-women/E5547D828E603C61A2D8CA766A534967

  GBS colonization is reportedly low in Asia, and especially Korea (0359%). Therefore, even though the incidence of neonatal sepsis in Korea is much higher than in other countries there are no guidelines for GBS prevention. Using media selective for GBS, we found a colonization rate of 8% (46105% depending on the hospital), predominance of the more virulent serotypes (serotypes III and V), and very high levels of antimicrobial resistance (540% for clindamycin, 256% for erythromycin, 37% for cefazolin). […] The higher prevalence of colonization observed in our study compared to previous reports probably reflects the large sample size (2624 pregnant women in four hospitals), use of selective media, and inclusion of urine samples with vaginal and anorectal swabs for GBS culture. […] The frequency of maternal GBS colonization and the incidence of early-onset GBS infection in newborns varies by country, influencing the choice of GBS prevention strategy. In Korea, no guidelines exist for GBS prevention and no data for the risk of GBS colonization; given the high rates of sepsis, and increasing GBS colonization, it is time for Korea to implement a screening-based strategy to prevent GBS neonatal infections.

• #29 Group B Streptococcus Carriage in Pregnancy: Burden of Early-onset Neonatal Disease and Estimation of the Cost of Universal Antenatal Screening in a Hospital of the Eastern Region of Saudi Arabia – Mediterranean Journal of Infection Microbes and Antimicro

  https://mjima.org/articles/group-b-streptococcus-carriage-in-pregnancy-burden-of-early-onset-neonatal-disease-and-estimation-of-the-cost-of-universal-antenatal-screening-in-a-hospital-of-the-eastern-region-of-saudi-arabia/doi/mjima.galenos.2023.2023.31

  Group B streptococcus (GBS) is recognized as a significant cause of neonatal infections worldwide. The study investigated the burden of early-onset neonatal disease and assessed the cost of routine GBS screening in a hospital of the eastern region of Saudi Arabia. […] The annual incidence of early-onset disease increased from a baseline level of 0.5 in 2012 to 3.9 per 1,000 births in 2018. […] A large geographical variation exists in the rates of asymptomatic rectovaginal colonization with GBS, occurring in approximately 10-30% of pregnant women in different regions globally. […] In Saudi Arabia, pregnant women are not routinely screened for rectovaginal GBS colonization. […] The colonization rate of 23% obtained in this study is within the range reported previously both from developed and developing countries and is consistent with findings in countries such Palestine (21%) and subregions of Africa such as North Africa (22.9%).

• #30 Microbiological and clinical characteristics of invasive Group B Streptococcal blood stream infections in children and adults from Qatar | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07801-9

  Group B Streptococci (GBS) colonize almost one third of human gastrointestinal and genitourinary tracts, particularly in females. The aim of this study is to evaluate the epidemiology, microbiological characteristics, and clinical outcomes of invasive GBS disease in Qatar from all age groups. […] During the four years period, the incidence steadily rose from 1.48 to 2.09 cases per 100.000 population. […] There is a rising trend of Group B Streptococcal blood stream infections in Qatar with significantly high clindamycin and erythromycin resistance rates. Universal susceptibility rates were demonstrated for penicillin, ceftriaxone, and vancomycin. […] The global epidemiology of GBS disease is variable since the average estimate of maternal colonization is about 20% with regional variations ranging between 11% (lower estimates) and 35% (higher estimates), with lower prevalence in Southern and Eastern Asia at 11% and 12.5% respectively.

• #31 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Implementation of national guidelines for intrapartum antibiotic prophylaxis has resulted in a reduction in the incidence of GBS EOD of more than 80%, from 1.8 newborns per 1,000 live births in the 1990s to 0.23 newborns per 1,000 live births in 2015. […] The primary risk factor for neonatal GBS EOD is maternal vaginalrectal colonization with GBS during the intrapartum period. Other risk factors include gestational age less than 37 weeks, very low birth weight, prolonged rupture of membranes, intraamniotic infection, young maternal age, and maternal black race. […] Vaginalrectal colonization with GBS at the time of labor onset is the most important risk factor for neonatal GBS EOD, and a universal culture-based screening strategy for identifying candidates for GBS intrapartum antibiotic prophylaxis was demonstrated to be superior to risk-based screening protocols for the prevention of GBS EOD.

• #32 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Implementation of national guidelines for intrapartum antibiotic prophylaxis has resulted in a reduction in the incidence of GBS EOD of more than 80%, from 1.8 newborns per 1,000 live births in the 1990s to 0.23 newborns per 1,000 live births in 2015. […] The primary risk factor for neonatal GBS EOD is maternal vaginalrectal colonization with GBS during the intrapartum period. Other risk factors include gestational age less than 37 weeks, very low birth weight, prolonged rupture of membranes, intraamniotic infection, young maternal age, and maternal black race. […] Vaginalrectal colonization with GBS at the time of labor onset is the most important risk factor for neonatal GBS EOD, and a universal culture-based screening strategy for identifying candidates for GBS intrapartum antibiotic prophylaxis was demonstrated to be superior to risk-based screening protocols for the prevention of GBS EOD.

• #33 Late-onset group B streptococcal disease is a rare but devastating disease | HKMJ

  https://www.hkmj.org/abstracts/v27n3/229.htm

  Group B streptococcus (GBS) or Streptococcus agalactiae is an organism colonising the maternal gastrointestinal and genital tracts which may lead to significant morbidities and mortalities in infants. Universal screening of pregnant mothers for GBS carriage has been implemented in Hong Kong since 2012 but we continue to encounter late-onset GBS disease. This commentary reviews the epidemiology, risk factors, mortality, and morbidity of late-onset GBS especially pertinent to Hong Kong. A 2017 global study revealed some 21.7 million pregnant women carry GBS and infections cause 150 000 preventable stillbirths and infant mortality annually. The worldwide incidence of late-onset GBS disease is 0.26 per 1000 live births, while the incidence in Hong Kong was 0.38 per 1000 live births despite intrapartum antibiotics. Maternal risk factors for early-onset GBS disease include vaginal GBS colonisation, GBS bacteriuria, intrapartum maternal fever, and chorioamnionitis. Overall 18% of women worldwide and 21.8% of Hong Kong mothers are colonised. The risk of neonatal GBS septicaemia for infants born to women diagnosed with vaginal GBS colonisation can be as high as 25 times compared with women who are not colonised. For late-onset GBS disease, in contrast to early-onset GBS disease, vaginal GBS colonisation is not a crucial factor. Reported risk factors include prematurity, exposures to colonised family members and medical equipment. The use of maternal intrapartum chemoprophylaxis has been shown to be ineffective in the prevention of late-onset GBS disease. The mortality rate of invasive GBS diseases ranges from 5% to 37%. Late-onset GBS disease is associated with higher morbidity and significant neurodevelopmental impairments. As late-onset GBS disease is not a notifiable disease in Hong Kong it is difficult to comment on the local prevalence. The widespread use of intrapartum antibiotics has effectively reduced the rate of early-onset GBS disease, but not the rate of late-onset GBS disease. Although it is uncommon in Hong Kong, late-onset GBS disease is a serious condition with significant consequences, including stillbirths, and high infant mortality and morbidity. At present, effective ways to reduce late-onset infection are limited, but with the development of a safe and effective maternal vaccination, it is potentially a preventable infection.

• #34 Late-onset group B streptococcal disease is a rare but devastating disease | HKMJ

  https://www.hkmj.org/abstracts/v27n3/229.htm

  Group B streptococcus (GBS) or Streptococcus agalactiae is an organism colonising the maternal gastrointestinal and genital tracts which may lead to significant morbidities and mortalities in infants. Universal screening of pregnant mothers for GBS carriage has been implemented in Hong Kong since 2012 but we continue to encounter late-onset GBS disease. This commentary reviews the epidemiology, risk factors, mortality, and morbidity of late-onset GBS especially pertinent to Hong Kong. A 2017 global study revealed some 21.7 million pregnant women carry GBS and infections cause 150 000 preventable stillbirths and infant mortality annually. The worldwide incidence of late-onset GBS disease is 0.26 per 1000 live births, while the incidence in Hong Kong was 0.38 per 1000 live births despite intrapartum antibiotics. Maternal risk factors for early-onset GBS disease include vaginal GBS colonisation, GBS bacteriuria, intrapartum maternal fever, and chorioamnionitis. Overall 18% of women worldwide and 21.8% of Hong Kong mothers are colonised. The risk of neonatal GBS septicaemia for infants born to women diagnosed with vaginal GBS colonisation can be as high as 25 times compared with women who are not colonised. For late-onset GBS disease, in contrast to early-onset GBS disease, vaginal GBS colonisation is not a crucial factor. Reported risk factors include prematurity, exposures to colonised family members and medical equipment. The use of maternal intrapartum chemoprophylaxis has been shown to be ineffective in the prevention of late-onset GBS disease. The mortality rate of invasive GBS diseases ranges from 5% to 37%. Late-onset GBS disease is associated with higher morbidity and significant neurodevelopmental impairments. As late-onset GBS disease is not a notifiable disease in Hong Kong it is difficult to comment on the local prevalence. The widespread use of intrapartum antibiotics has effectively reduced the rate of early-onset GBS disease, but not the rate of late-onset GBS disease. Although it is uncommon in Hong Kong, late-onset GBS disease is a serious condition with significant consequences, including stillbirths, and high infant mortality and morbidity. At present, effective ways to reduce late-onset infection are limited, but with the development of a safe and effective maternal vaccination, it is potentially a preventable infection.

• #35 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  The public health burden of invasive GBS disease among nonpregnant adults is substantial and continues to increase. Chronic diseases, such as obesity and diabetes, may contribute. […] The incidence of invasive GBS disease among nonpregnant US adults continues to rise, roughly tripling between 1990 and 2016 (from 3.6 to 10.9 cases per 100000). […] Given the severity of invasive GBS (94.6% of cases were hospitalized, 27.3% of cases required intensive care unit admission, and 5.6% of cases were fatal in 2016), this rise represents a clinical and public health concern. […] Surveillance data do not allow us to determine the direct cause of the rising incidence. However, the data suggest that the increase may be associated with certain serotypes because serotypes Ib, II, and IV accounted for three-quarters of the increase in incidence between 2008 and 2016. […] Our analysis found an increasing prevalence of obesity and diabetes among patients with invasive GBS over the study period. […] Ongoing surveillance to monitor future trends in serotype distribution and antibiotic resistance is warranted.

• #36

  https://link.springer.com/article/10.1007/s15010-024-02210-3

  Group B streptococcus (GBS) colonizes the gastrointestinal and vaginal mucosa in healthy adults, but has also become an increasing cause of invasive infection. The aims of this study were to describe the incidence and factors associated with the occurrence of invasive GBS disease in adults in Norway. […] A total of 3710 GBS episodes were identified. The age-standardized incidence rate increased steadily from 1.10 (95% CI 0.801.50) in 1996 to 6.70 (95% CI 5.907.50) per 100,000 person-years in 2019. The incidence rate had an average annual increase of 6.44% (95% CI 5.127.78). […] The incidence of invasive GBS disease in adults increased significantly from 1996 to 2019. The increasing age of the population with accompanying underlying comorbid conditions might contribute to the increasing burden of invasive GBS disease.

• #37 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  However, the incidence of late-onset disease (onset from 7 through 89 days of life) was not changed through maternal intrapartum antibiotic prophylaxis, remaining at approximately 0.27 per 1000 live births. Late, late-onset GBS disease occurs in infants older than 3 months of age and accounts for 7% to 13% of childhood GBS infections. Affected infants typically were born before 34 weeks gestation or have an underlying immunodeficiency or concomitant infection with human immunodeficiency virus (HIV). In the past 2 decades, 2-fold to 4-fold increases in the incidence of GBS disease have occurred in nonpregnant adults, mostly those who have underlying medical conditions or are 65 years of age or older. Residents of nursing homes have a markedly higher incidence of invasive group B streptococcal disease than community residents.

• #38 Group B Streptococcus (GBS) Infections: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/229091-overview

  The role of group B streptococci in the developing world is not well defined. However, a meta-analysis of GBS disease in 53 countries, published in 2017, showed a pooled incidence of invasive GBS disease of 0.49 per 1000 live births. […] GBS disease results in significant mortality in both neonates and adults. Although the mortality rate ranges from 9-47% in published reports, most studies have revealed it to be approximately 20%. […] The case fatality rate in the United States between 2008 and 2016 was found to be, on average, 6.5% for invasive GBS infection. […] GBS infection is more common in Black individuals than in White individuals and is much more common in older Black adults than in older White adults. […] Young and middle-aged women who undergo obstetric and gynecologic manipulation have an increased risk for GBS infection. […] The mean age of adult patients with GBS infection is 64 years.

• #39 Group B Strep Surveillance and Trends | Group B Strep | CDC

  https://www.cdc.gov/group-b-strep/php/surveillance/index.html

  CDC conducts active surveillance for invasive group B Streptococcus (group B strep, GBS) disease. […] GBS bacteria remain a leading cause of meningitis and bloodstream infections in newborns younger than 3 months old. […] CDC conducts active surveillance for invasive GBS disease through Active Bacterial Core surveillance (ABCs). ABCs is part of CDC’s Emerging Infections Program. […] Approximately 28,010 cases of invasive GBS disease occur annually in the United States in all age groups. […] GBS bacteria remain a leading cause of meningitis and bloodstream infections in newborns younger than 3 months old. […] As use of intrapartum prophylaxis increased, GBS disease declined by 80% in babies younger than one week old.

• #40 GBS | Surveillance | Group B Strep | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/groupbstrep/surveillance.html

  Group B Streptococcus (group B strep, GBS) emerged in the 1970s as the most common cause of sepsis in newborns. […] Active surveillance for invasive group B strep disease is ongoing in a multistate population of approximately 33 million, including approximately 450,000 live births annually. The disease is not reportable in most states. […] To be considered a case for this active surveillance system, the following case definition must be met: GBS must be isolated from a normally sterile site, such as blood, cerebrospinal fluid (CSF), pleural fluid, peritoneal fluid, pericardial fluid, bone, joint/synovial fluid, or internal body site (e.g., lymph node, brain). […] The following is an exception to this sterile site case definition and would be counted as cases for this surveillance system: GBS isolated from the placenta and/or amniotic fluid with fetal death.

• #41 GBS | Surveillance | Group B Strep | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/groupbstrep/surveillance.html

  Group B Streptococcus (group B strep, GBS) emerged in the 1970s as the most common cause of sepsis in newborns. […] Active surveillance for invasive group B strep disease is ongoing in a multistate population of approximately 33 million, including approximately 450,000 live births annually. The disease is not reportable in most states. […] To be considered a case for this active surveillance system, the following case definition must be met: GBS must be isolated from a normally sterile site, such as blood, cerebrospinal fluid (CSF), pleural fluid, peritoneal fluid, pericardial fluid, bone, joint/synovial fluid, or internal body site (e.g., lymph node, brain). […] The following is an exception to this sterile site case definition and would be counted as cases for this surveillance system: GBS isolated from the placenta and/or amniotic fluid with fetal death.

• #42 Group B streptococcus: Beyond pregnancy and neonatal infections | Medical Laboratory Observer

  https://www.mlo-online.com/disease/infectious-disease/article/53061966/group-b-streptococcus-beyond-pregnancy-and-neonatal-infections

  Since the ABCs began tracking GBS in 1997, the overall rate of GBS has increased 42% from 6.2 per 100,000 to 8.8 per 100,000 in 2021, the last year of data currently available. […] The ABCs surveillance network also performs additional characterization of GBS isolates from selected surveillance areas using whole genome sequencing. Performing whole genome sequencing allows epidemiologists to determine capsular serotypes, multi-locus sequence typing, and phylogenetic clustering to identify transmission events. […] Infections due to GBS in nonpregnant persons is high. In the United States, the incidence among all persons was estimated to be 11 cases per 100,000 persons in 2016. […] Several NAAT test manufacturers are approved for testing following a broth enrichment step and do not require culture confirmation of negative results.

• #43 Group B streptococcus: Beyond pregnancy and neonatal infections | Medical Laboratory Observer

  https://www.mlo-online.com/disease/infectious-disease/article/53061966/group-b-streptococcus-beyond-pregnancy-and-neonatal-infections

  Streptococcus agalactiae, also known as Group B streptococcus (GBS), is a gram-positive coccus that was first differentiated from other beta-hemolytic streptococcal species by renowned microbiologist Rebecca Lancefield, PhD, in the early 1930s. […] In 1996, the Centers for Disease Control and Prevention (CDC), in collaboration with key stakeholders and several professional societies published the first guidelines on preventing GBS disease. These guidelines were subsequently updated in 2002 and again in 2010. […] In many state public health jurisdictions, reporting of GBS infections is not required. Beginning in the late 1990s, the CDC began active surveillance for GBS through the Active Bacterial Core surveillance (ABCs) network. The ABCs is a multistate, population-based surveillance system for invasive bacterial pathogens, including GBS.

• #44 Group B Strep (GBS) Infection | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/invasive-and-respiratory-diseases-and-conditions/streptococcal-strep-diseases/group-b-strep-gbs-infection

  GBS is no longer a reportable condition in Texas. […] The number of invasive GBS cases reported in Texas has increased 457.8% over the past fifteen years, increasing from 464 (1.5 cases per 100,000 population) in 2005 to 2,124 (7.3 cases per 100,000 population) in 2019. […] Among the cases in 2019, 68.3% of the GBS cases in Texas occurred in adults aged 50 years or more. […] The highest age-specific incidence rates of invasive GBS in Texas are seen in children less than one year of age (52.6 cases per 100,000 population) followed by adults aged 60 years or more (19.5 cases per 100,000 population).

• #45

  https://www.oregon.gov/oha/ph/diseasesconditions/diseasesaz/pages/group-b-strep.aspx

  Group B Streptococcus (GBS) is a bacterium that causes illness in newborn babies, pregnant women, the elderly, and adults with other illnesses, such as diabetes or liver disease. GBS is the most common cause of life-threatening infections in newborns. […] Oregon’s Public Health Division conducts surveillance for GBS in the Portland tri-county area (Multnomah, Clackamas and Washington counties). […] Group B Streptococcus (GBS) is not an officially reportable disease.

• #46 Group B Streptococcal Disease – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/other/groupbstreptococcaldisease/

  Group B Streptococcus (GBS) is a bacteria commonly found in the gut or genital tract (vagina). GBS can occasionally cause serious infections in vulnerable people, in particular newborn babies. Invasive GBS (iGBS) is an infection where the bacteria is isolated or detected from a normally sterile body site, such as blood or spinal fluid. iGBS disease in infants under 90 days is a notifiable disease in Ireland. […] The number of invasive Group B streptococcal (iGBS) disease notifications in 2018 […] The national notification rate per 100,000 population in 2018.

• #47 National case definition: Group B streptococcal disease of the newborn – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/group-b-streptococcal/health-professionals/national-case-definition.html

  Only confirmed cases of disease should be notified. […] Routine case-by-case notification to the federal level. […] Isolates should be forwarded to the National Microbiology Laboratory reference centre for further characterization. […] Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes. […] Group B Streptococcal disease in the United States, 1990: report from a multistate active surveillance system. […] Prevention of perinatal group B streptococcal disease. […] Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis.

• #48 Disease burden of neonatal invasive Group B Streptococcus infection in the Netherlands | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216749

  Group B Streptococcus (GBS) is the leading cause of neonatal sepsis and meningitis worldwide. […] Surveillance of neonatal invasive GBS occurs at the National Reference Laboratory for Bacterial Meningitis, where culture isolates from cerebrospinal fluid and blood are sent by diagnostic laboratories. […] An estimated 97 cases and 6.5 deaths occurred in the Netherlands in 2017 due to culture positive neonatal invasive GBS infection. […] In conclusion, neonatal invasive GBS infection currently causes a substantial disease burden in the Netherlands. […] Surveillance data show an increasing trend of neonatal invasive GBS infections, as reported before in the Netherlands and the UK. […] The current risk factor-based GBS prevention strategy appears inadequate to halt the increase of neonatal GBS sepsis.

• #49 Epidemiology and bacterial characteristics of invasive group B streptococcus disease: a population-based study in Japan in 2010–2020 | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-and-bacterial-characteristics-of-invasive-group-b-streptococcus-disease-a-populationbased-study-in-japan-in-20102020/01C1F0A0BBED05C2F5382788EDDC992B

  Accurate up-to-date information on the incidence of invasive GBS disease is fundamental in estimating vaccine efficacy and decision-making for GBS vaccine management as applicable country wise. However, limited information is available regarding the population-based incidence of invasive GBS disease among children in Japan. […] In this study, the incidence and clinical manifestations of invasive GBS disease in children in Chiba Prefecture, Japan, were investigated and the serotypes and drug susceptibility of isolated GBS strains during the study period of 11 years analysed. […] In Japan, notification under the Infectious Diseases Control Law is not obligatory for invasive GBS disease. Although there are several surveys based on questionnaires, they were reports based on the number of births at the target facilities, and the population-based incidence was not accurately reported. This is the first report on a prospective population-based study of invasive GBS disease among children aged 15 years in Japan.

• #50 Group B Streptococcus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–group-b-streptococcus/id/418093

  Group B streptococcus (GBS) remains the leading cause of neonatal mortality in the United Kingdom (UK) (incidence 0.94/1000 live births) and the United States of America (USA) (0.22/1000 live births). Globally, invasive GBS disease is estimated to affect 319,000 infants with 10,000 with neurodevelopmental disability after meningitis. In low- and middle-income countries, less is known about the role of GBS in these deaths. […] GBS invasive disease has two forms, EO, within 6 days of life, which commonly presents as pneumonia or sepsis and LO, which presents after day 6, often with meningitis and focal infections. Most cases of infant invasive GBS disease are EO. Globally, 15% of live births are estimated to be exposed to maternal GBS colonization at delivery. Five serotypes (Ia, Ib, II, III, and V) are responsible for 97% of isolates in invasive disease globally.

• #51 Group B Streptococcus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–group-b-streptococcus/id/418093

  Maternal colonization is a major risk factor for EO-GBS disease in infants. In order to estimate the true burden of GBS disease, it is useful to determine the maternal colonization rate by region along with the prevalence of serotypes. The overall prevalence of maternal GBS colonization worldwide is 15%. Estimated prevalence rates in developed countries is 18.4%, however, prevalence rates from countries in Western Africa seem to be lower (14%), and the lowest colonization rates are seen in Southern Asia and Eastern Asia (13 and 11%, respectively). The overall prevalence of colonizing serotype III is 25%, but lower prevalence of serotype III is seen in South Eastern Asia and South Asia. […] Intrapartum antibiotics (IAP) can prevent EO-GBS disease, and in a number of resource-rich countries, EO-GBS disease is significantly less common following the introduction of IAP strategies. These strategies include both universal and risk-based screening of pregnant women. In the USA, women between 36 and 38 weeks of pregnancy are screened for GBS and if GBS is identified they are offered high-dose intravenous benzylpenicillin in labor, alongside at-risk women whose GBS status is unknown. This strategy is thought to result in reduced incidence of GBS disease.

• #52

  https://link.springer.com/article/10.1007/s10096-021-04396-y

  The four leading disease-causing serotypes III, Ia, Ib, and V represented 95% of the available serotypes. […] A multivariate regression analysis showed that prematurity (p=0.029) and antepartum maternal GBS colonization (p=0.032) were significantly associated with risk for the recurrence. […] Our findings indicated that GBS disease burden still remains with considerable mortality and morbidity in Japan, and provided important information for developing better strategies for the prevention of GBS disease, including maternal vaccination.

• #53 Group B Streptococcus Infections in Non-Pregnant Adults, Italy, 2015–2019

  https://www.mdpi.com/2076-0817/13/9/807

  Group B Streptococcus (GBS, Streptococcus agalactiae) is a pathogen of increasing importance in adults. Severe and invasive cases in non-pregnant adults were collected during the period 2015–2019 by voluntary-based surveillance. […] This nationwide study confirmed the need for monitoring the GBS epidemiology in non-pregnant adults through continuous surveillance of GBS infections. […] In many parts of the world, an increasing incidence of iGBS infections in adults, compared to neonates and infants, has been reported. […] The prevalence of GBS serotypes may vary geographically and over time, but different distributions have been demonstrated by age and between colonizing and invasive isolates. […] This study showed a statistically significant increase in GBS serotype IV in the last period of the survey. […] Continuous surveillance of the GBS pathogenic dynamics, also by the implementation of genomic surveillance, will be essential to develop accurate disease prevention.

• #54 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  The public health burden of invasive GBS disease among nonpregnant adults is substantial and continues to increase. Chronic diseases, such as obesity and diabetes, may contribute. […] The incidence of invasive GBS disease among nonpregnant US adults continues to rise, roughly tripling between 1990 and 2016 (from 3.6 to 10.9 cases per 100000). […] Given the severity of invasive GBS (94.6% of cases were hospitalized, 27.3% of cases required intensive care unit admission, and 5.6% of cases were fatal in 2016), this rise represents a clinical and public health concern. […] Surveillance data do not allow us to determine the direct cause of the rising incidence. However, the data suggest that the increase may be associated with certain serotypes because serotypes Ib, II, and IV accounted for three-quarters of the increase in incidence between 2008 and 2016. […] Our analysis found an increasing prevalence of obesity and diabetes among patients with invasive GBS over the study period. […] Ongoing surveillance to monitor future trends in serotype distribution and antibiotic resistance is warranted.

• #55 Population genomics of Group B Streptococcus reveals the genetics of neonatal disease onset and meningeal invasion | Nature Communications

  https://www.nature.com/articles/s41467-022-31858-4

  We show that genomic variation within and outside the capsule biosynthesis locus region influences disease onset time and CNS invasion of GBS in neonates. […] These findings highlight the critical role of the capsule and other genomic loci in the pathogenicity of GBS, implicating them as potential candidates for the development of capsule- and protein-based vaccines, diagnostics, and treatments to reduce the neonatal GBS burden and mortality globally. […] We found five capsular serotypes relatively less common among the isolates associated with late-onset disease than early-onset disease, namely serotype Ia, Ib, II, and V. […] Overall, more late-onset disease isolates were associated with CNS disease compared to early-onset disease, a pattern supported by epidemiological studies. […] Our findings show that certain GBS isolates infecting the CNS harbour genetic variation within the capsule biosynthetic locus, which may influence meningeal invasion by modulating translocation across the blood-brain-barrier into CNS.

• #56 Population genomics of Group B Streptococcus reveals the genetics of neonatal disease onset and meningeal invasion | Nature Communications

  https://www.nature.com/articles/s41467-022-31858-4

  We show that genomic variation within and outside the capsule biosynthesis locus region influences disease onset time and CNS invasion of GBS in neonates. […] These findings highlight the critical role of the capsule and other genomic loci in the pathogenicity of GBS, implicating them as potential candidates for the development of capsule- and protein-based vaccines, diagnostics, and treatments to reduce the neonatal GBS burden and mortality globally. […] We found five capsular serotypes relatively less common among the isolates associated with late-onset disease than early-onset disease, namely serotype Ia, Ib, II, and V. […] Overall, more late-onset disease isolates were associated with CNS disease compared to early-onset disease, a pattern supported by epidemiological studies. […] Our findings show that certain GBS isolates infecting the CNS harbour genetic variation within the capsule biosynthetic locus, which may influence meningeal invasion by modulating translocation across the blood-brain-barrier into CNS.

• #57 Population genomics of Group B Streptococcus reveals the genetics of neonatal disease onset and meningeal invasion | Nature Communications

  https://www.nature.com/articles/s41467-022-31858-4

  We show that genomic variation within and outside the capsule biosynthesis locus region influences disease onset time and CNS invasion of GBS in neonates. […] These findings highlight the critical role of the capsule and other genomic loci in the pathogenicity of GBS, implicating them as potential candidates for the development of capsule- and protein-based vaccines, diagnostics, and treatments to reduce the neonatal GBS burden and mortality globally. […] We found five capsular serotypes relatively less common among the isolates associated with late-onset disease than early-onset disease, namely serotype Ia, Ib, II, and V. […] Overall, more late-onset disease isolates were associated with CNS disease compared to early-onset disease, a pattern supported by epidemiological studies. […] Our findings show that certain GBS isolates infecting the CNS harbour genetic variation within the capsule biosynthetic locus, which may influence meningeal invasion by modulating translocation across the blood-brain-barrier into CNS.

• #58 Genomic epidemiology of Streptococcus agalactiae ST283 in Southeast Asia | Scientific Reports

  https://www.nature.com/articles/s41598-022-08097-0

  Streptococcus agalactiae, also known as Lancefield Group B Streptococcus (GBS), is typically regarded as a neonatal pathogen; however, several studies have shown that the bacteria are capable of causing invasive diseases in non-pregnant adults as well. […] The majority of documented cases were from Southeast Asian countries, and the most common genotype found was ST283, which is also known to be able to infect fish. […] GBS has been recognized as a pathogen of non-pregnant adults since the early 2000s. […] Compared to other genotypes, sequence type 283 (ST283), belonging to CC10, is one of the most common strains causing invasive diseases in adults in Southeast Asia and Hong Kong, with the first patient dated back to 1995. […] In 2015, there was a human outbreak of GBS ST283 in Singapore.

• #59 Genomic epidemiology of Streptococcus agalactiae ST283 in Southeast Asia | Scientific Reports

  https://www.nature.com/articles/s41598-022-08097-0

  Epidemiological analyses suggested that the outbreak was significantly associated with consumption of raw freshwater fish, but not consumption of sashimi, sushi, or raw shellfish, or exposure to fish-related activities. […] The epidemiological history of human GBS ST283 circulating in Southeast Asians was inferred, including the timing of the bacterial origin, its past population dynamics, and past geographical transmission history. […] Our analyses estimated the rate of evolution of GBS ST283 to be 1.26103 (95% HPD: 1.051031.51103) substitutions per SNP site per year. […] The results showed that, for the first 6 to 7 years of the epidemic, the bacterial effective population size increased rapidly, but then the expansion rate dropped significantly, and the population size remained relatively constant after the early 2000s.

• #60 Genomic epidemiology of Streptococcus agalactiae ST283 in Southeast Asia | Scientific Reports

  https://www.nature.com/articles/s41598-022-08097-0

  Epidemiological analyses suggested that the outbreak was significantly associated with consumption of raw freshwater fish, but not consumption of sashimi, sushi, or raw shellfish, or exposure to fish-related activities. […] The epidemiological history of human GBS ST283 circulating in Southeast Asians was inferred, including the timing of the bacterial origin, its past population dynamics, and past geographical transmission history. […] Our analyses estimated the rate of evolution of GBS ST283 to be 1.26103 (95% HPD: 1.051031.51103) substitutions per SNP site per year. […] The results showed that, for the first 6 to 7 years of the epidemic, the bacterial effective population size increased rapidly, but then the expansion rate dropped significantly, and the population size remained relatively constant after the early 2000s.

• #61 Genomic epidemiology of Streptococcus agalactiae ST283 in Southeast Asia | Scientific Reports

  https://www.nature.com/articles/s41598-022-08097-0

  The drop in the population growth rate coincided with multiple losses of the tet(M) gene, suggestive of a link between the two phenomena. […] In terms of geographical location, our analyses suggested that the origin of the outbreak was most likely in Singapore. […] The bacteria subsequently spread to Vietnam in the late 2000s. […] Multiple cross-country transmissions between Singapore, Thailand and Laos in 2010s were also inferred. […] GBS ST283 has become increasingly recognized as an important pathogen in Southeast Asia. […] This suggested that the bacteria could readily spread across geographical regions, and is not confined to specific locations. […] This pattern is consistent with multiple cross-country transmissions of the bacteria. […] While the ultimate origin of human pathogenic GBS is still unknown, it has been observed that, for many expanded GBS clones, onset of their initial spread coincided with the acquisition of tet(M), a tetracycline resistance gene.

• #62 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  ABSTRACT: Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture of membranes. In the absence of intrapartum antibiotic prophylaxis, 12% of those newborns will develop GBS EOD. Other risk factors include gestational age of less than 37 weeks, very low birth weight, prolonged rupture of membranes, intraamniotic infection, young maternal age, and maternal black race. The key obstetric measures necessary for effective prevention of GBS EOD continue to include universal prenatal screening by vaginalrectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation.

• #63 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation. […] Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. In the absence of intrapartum antibiotic prophylaxis, 12% of those newborns will develop GBS EOD. […] Indications for intrapartum antibiotic prophylaxis are listed in Table 1. […] All women whose vaginalrectal culture at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis, unless a prelabor cesarean birth is performed in the setting of intact membranes. […] Women with reported or known GBS colonization status in a previous pregnancy and who present in labor at 37 0/7 weeks of gestation or more with unknown culture status in the current pregnancy also should be considered candidates to receive antibiotic prophylaxis intrapartum.

• #64 Group B Streptococcus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–group-b-streptococcus/id/418093

  Maternal colonization is a major risk factor for EO-GBS disease in infants. In order to estimate the true burden of GBS disease, it is useful to determine the maternal colonization rate by region along with the prevalence of serotypes. The overall prevalence of maternal GBS colonization worldwide is 15%. Estimated prevalence rates in developed countries is 18.4%, however, prevalence rates from countries in Western Africa seem to be lower (14%), and the lowest colonization rates are seen in Southern Asia and Eastern Asia (13 and 11%, respectively). The overall prevalence of colonizing serotype III is 25%, but lower prevalence of serotype III is seen in South Eastern Asia and South Asia. […] Intrapartum antibiotics (IAP) can prevent EO-GBS disease, and in a number of resource-rich countries, EO-GBS disease is significantly less common following the introduction of IAP strategies. These strategies include both universal and risk-based screening of pregnant women. In the USA, women between 36 and 38 weeks of pregnancy are screened for GBS and if GBS is identified they are offered high-dose intravenous benzylpenicillin in labor, alongside at-risk women whose GBS status is unknown. This strategy is thought to result in reduced incidence of GBS disease.

• #65 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Implementation of national guidelines for intrapartum antibiotic prophylaxis has resulted in a reduction in the incidence of GBS EOD of more than 80%, from 1.8 newborns per 1,000 live births in the 1990s to 0.23 newborns per 1,000 live births in 2015. […] The primary risk factor for neonatal GBS EOD is maternal vaginalrectal colonization with GBS during the intrapartum period. Other risk factors include gestational age less than 37 weeks, very low birth weight, prolonged rupture of membranes, intraamniotic infection, young maternal age, and maternal black race. […] Vaginalrectal colonization with GBS at the time of labor onset is the most important risk factor for neonatal GBS EOD, and a universal culture-based screening strategy for identifying candidates for GBS intrapartum antibiotic prophylaxis was demonstrated to be superior to risk-based screening protocols for the prevention of GBS EOD.

• #66 Group B Streptococcus (GBS) in pregnancy and newborn babies | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/group-b-streptococcus-gbs-in-pregnancy-and-newborn-babies/

  In the UK, the NHS does not routinely offer all pregnant women screening for GBS. […] The UK National Screening Committee does not recommend testing all pregnant women for the presence of GBS using vaginal and rectal swabs. This is because many women carry the GBS bacteria and, in the majority of cases, their babies are born safely and do not develop an infection. Screening all women late in pregnancy cannot accurately predict which babies will develop GBS infection. No screening test is entirely accurate: a negative swab test does not guarantee that you do not carry GBS. Many babies who are severely affected by GBS infection are born preterm, before the suggested time for screening (35-37 weeks). Giving antibiotics to all women who carry GBS would mean that a very large number of women would receive treatment they do not need.

• #67

  https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/group-b-streptococcus-(gbs)

  Group B Streptococcus (GBS) is a leading cause of neonatal and infant sepsis and meningitis globally. GBS was estimated to have caused 319,000 cases of neonatal disease annually (2015), resulting in 90000 deaths and at least 57,000 stillbirths. The highest burden is in Africa, where 54% of estimated invasive GBS cases, and 65% of all fetal/infant deaths occur. […] An average of 18% (with regional variation) of pregnant women carry GBS worldwide. Administration of intrapartum antibiotic prophylaxis (IAP) to pregnant women with GBS colonization can substantially reduce the incidence of early-onset GBS disease, but IAP does not prevent late-onset GBS disease, which in most cases are transmitted postnatally. […] The development of Group B Streptococcus (GBS) vaccines for maternal immunization has been identified by the Product Development for Vaccines Advisory Committee (PDVAC) as a priority, because of the major public health burden posed by GBS in LMIC.

• #68

  https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/group-b-streptococcus-(gbs)

  Efficacy studies for GBS vaccine will require a large number of participants, therefore initial vaccine licensure based on immunological correlates of protection (CoP) should be explored, followed by post licensure studies to assess effectiveness and to evaluate the reduction in disease burden. […] Group B Streptococcus infection causes an estimated 150,000 preventable stillbirths and infant deaths every year.

• #69

  https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/vaccine-impact-value/group-b-streptococcus-full-value-of-vaccine-assessment

  Group B streptococcus (GBS) is an important cause of disease burden in every region worldwide, contributing to neonatal/ infant infection, deaths, disability, stillbirths and maternal infection. […] The World Health Organization (WHO) identified the development of GBS vaccines suitable for maternal immunization in pregnancy and use in low- and middle-income countries (LMICs) as a priority in 2015. […] The WHO Full value of vaccines assessment of Group B streptococcus vaccines published on 3 November 2021 describes the global public health rationale for developing vaccines against disease caused by GBS for maternal immunization, to inform decision making across the continuum of vaccine development and uptake with a line of sight to sustainable public health impact.

• #70 Group B Streptococcus neonatal infections, the ongoing history | Enfermedades Infecciosas y Microbiología Clínica

  https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-group-b-streptococcus-neonatal-infections-S0213005X2200012X

  The follow-up of these recommendations brought an important change in the clinical practice in Spain, and a significant reduction (more than 85%) in the rate of GBS EOD. The incidence of EOD in Spain dropped from 1.23 per 1000 live births in 1996 to 0.32 in 2002 and to 0.17 in 2018. […] Despite the success of measures recommended in guidelines in preventing EOD, IAP is not effective in preventing LOD, and also GBS cause stillbirths and preterm births.

• #71 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  The public health burden of invasive GBS disease among nonpregnant adults is substantial and continues to increase. Chronic diseases, such as obesity and diabetes, may contribute. […] The incidence of invasive GBS disease among nonpregnant US adults continues to rise, roughly tripling between 1990 and 2016 (from 3.6 to 10.9 cases per 100000). […] Given the severity of invasive GBS (94.6% of cases were hospitalized, 27.3% of cases required intensive care unit admission, and 5.6% of cases were fatal in 2016), this rise represents a clinical and public health concern. […] Surveillance data do not allow us to determine the direct cause of the rising incidence. However, the data suggest that the increase may be associated with certain serotypes because serotypes Ib, II, and IV accounted for three-quarters of the increase in incidence between 2008 and 2016. […] Our analysis found an increasing prevalence of obesity and diabetes among patients with invasive GBS over the study period. […] Ongoing surveillance to monitor future trends in serotype distribution and antibiotic resistance is warranted.

• #72 Microbiological and clinical characteristics of invasive Group B Streptococcal blood stream infections in children and adults from Qatar | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07801-9

  Group B Streptococci (GBS) colonize almost one third of human gastrointestinal and genitourinary tracts, particularly in females. The aim of this study is to evaluate the epidemiology, microbiological characteristics, and clinical outcomes of invasive GBS disease in Qatar from all age groups. […] During the four years period, the incidence steadily rose from 1.48 to 2.09 cases per 100.000 population. […] There is a rising trend of Group B Streptococcal blood stream infections in Qatar with significantly high clindamycin and erythromycin resistance rates. Universal susceptibility rates were demonstrated for penicillin, ceftriaxone, and vancomycin. […] The global epidemiology of GBS disease is variable since the average estimate of maternal colonization is about 20% with regional variations ranging between 11% (lower estimates) and 35% (higher estimates), with lower prevalence in Southern and Eastern Asia at 11% and 12.5% respectively.

• #73 Epidemiology of group B streptococcus in Korean pregnant women | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-group-b-streptococcus-in-korean-pregnant-women/E5547D828E603C61A2D8CA766A534967

  Between January 2006 and May 2008, 2624 pregnant S. Korean women between 3537 weeks gestation were screened for group B streptococcus (GBS). Overall, 8% of pregnant women were colonized. Serotype III was the predominant serotype (438%), followed by serotypes V (203%), Ia (121%), and Ib (95%). GBS was frequently resistant to clindamycin (540%) and erythromycin (256%); 37% were resistant to cefazolin. More than three-quarters of serotype V were resistant to clindamycin or erythromycin or both, and 71% of serotype III were resistant to clindamycin but only 12% were resistant to erythromycin. GBS prevalence exceeded earlier reports by one-third. This is the first report of cefazolin resistance in Korea. These results underscore the need to establish screening measures and chemoprophylaxis guidelines regarding GBS infections in Korea.

• #74 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  The public health burden of invasive GBS disease among nonpregnant adults is substantial and continues to increase. Chronic diseases, such as obesity and diabetes, may contribute. […] The incidence of invasive GBS disease among nonpregnant US adults continues to rise, roughly tripling between 1990 and 2016 (from 3.6 to 10.9 cases per 100000). […] Given the severity of invasive GBS (94.6% of cases were hospitalized, 27.3% of cases required intensive care unit admission, and 5.6% of cases were fatal in 2016), this rise represents a clinical and public health concern. […] Surveillance data do not allow us to determine the direct cause of the rising incidence. However, the data suggest that the increase may be associated with certain serotypes because serotypes Ib, II, and IV accounted for three-quarters of the increase in incidence between 2008 and 2016. […] Our analysis found an increasing prevalence of obesity and diabetes among patients with invasive GBS over the study period. […] Ongoing surveillance to monitor future trends in serotype distribution and antibiotic resistance is warranted.

• #75 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Local and national health agencies should maintain or establish surveillance systems to monitor the incidence of GBS EOD, the emergence of infection in women and their newborns that is caused by resistant organisms, and other complications of widespread maternal antibiotic administration, such as severe maternal allergic reactions and the long-term health influences on the pediatric microbiome.

• #76 Group B Streptococcus Infections in Non-Pregnant Adults, Italy, 2015–2019

  https://www.mdpi.com/2076-0817/13/9/807

  Group B Streptococcus (GBS, Streptococcus agalactiae) is a pathogen of increasing importance in adults. Severe and invasive cases in non-pregnant adults were collected during the period 2015–2019 by voluntary-based surveillance. […] This nationwide study confirmed the need for monitoring the GBS epidemiology in non-pregnant adults through continuous surveillance of GBS infections. […] In many parts of the world, an increasing incidence of iGBS infections in adults, compared to neonates and infants, has been reported. […] The prevalence of GBS serotypes may vary geographically and over time, but different distributions have been demonstrated by age and between colonizing and invasive isolates. […] This study showed a statistically significant increase in GBS serotype IV in the last period of the survey. […] Continuous surveillance of the GBS pathogenic dynamics, also by the implementation of genomic surveillance, will be essential to develop accurate disease prevention.

• #77 Genomic epidemiology of Streptococcus agalactiae ST283 in Southeast Asia | Scientific Reports

  https://www.nature.com/articles/s41598-022-08097-0

  Our analysis suggested that human GBS ST283 independently lost the tet(M) gene at least four times within a very short period of time at around early 2000s. […] This further supported the probable roles of tet(M) in the bacterial expansion. […] The continuous expansion of fish farming in the region, together with the facts that the bacteria can readily spread across countries and potentially also across different host species causing invasive diseases, highlights the need for continual surveillance and monitoring of GBS ST283 in Southeast Asia to more effectively control the disease.

• #78 Group B Streptococcus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–group-b-streptococcus/id/418093

  Although the epidemiology of GBS in high-income countries is well documented, its contribution to the burden of neonatal infection in LMIC has proven more difficult to assess. Six studies from five countries (Malawi, South Africa, Kenya, Nigeria, Zimbabwe) report estimates of invasive neonatal disease with an overall pooled disease rate of 4% of neonatal infection. Estimates of LO-GBS disease in LMIC range from 14 per 1000 live births. The ratio of EO to LO-GBS disease is the highest in Asia (5.99), and the lowest in Africa (1.02). Of the 90,000 estimated infant deaths due to invasive GBS disease worldwide, 54,000 were attributed to Africa, 31,000 to Asia, and only 800 to developed countries. […] Recent studies have shown a significant morbidity associated with invasive GBS disease in low- and middle-income countries. Neurodevelopmental impairment is 5.5611 times more common in survivors of GBS disease in studies in South Africa and Mozambique. Furthermore, emotional and behavioral outcomes were observed to be worse in invasive GBS disease survivors than unaffected infants in a study of five low- and middle-income countries in Africa, Asia, and Latin America.

• #79 Epidemiology of Invasive Group B Streptococcal Infections Among Nonpregnant Adults in the United States, 2008-2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6450309/

  The public health burden of invasive GBS disease among nonpregnant adults is substantial and continues to increase. Chronic diseases, such as obesity and diabetes, may contribute. […] The incidence of invasive GBS disease among nonpregnant US adults continues to rise, roughly tripling between 1990 and 2016 (from 3.6 to 10.9 cases per 100000). […] Given the severity of invasive GBS (94.6% of cases were hospitalized, 27.3% of cases required intensive care unit admission, and 5.6% of cases were fatal in 2016), this rise represents a clinical and public health concern. […] Surveillance data do not allow us to determine the direct cause of the rising incidence. However, the data suggest that the increase may be associated with certain serotypes because serotypes Ib, II, and IV accounted for three-quarters of the increase in incidence between 2008 and 2016. […] Our analysis found an increasing prevalence of obesity and diabetes among patients with invasive GBS over the study period. […] Ongoing surveillance to monitor future trends in serotype distribution and antibiotic resistance is warranted.

• #80 Population genomics of Group B Streptococcus reveals the genetics of neonatal disease onset and meningeal invasion | Nature Communications

  https://www.nature.com/articles/s41467-022-31858-4

  Our findings highlight the importance of the cps and other genomic loci in the pathogenicity and virulence of GBS, implicating them as potential targets for the development of capsule- and protein-based vaccines, treatments, and diagnostics to reduce the short- and long-term neonatal GBS disease burden and death toll globally.

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