Prevention of Neonatal Group B Streptococcal Disease

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Group B streptococci (GBS) are facultative anaerobic, gram-positive cocci that colonize the gastrointestinal and urogenital tracts of humans. GBS strains are serologically divided into 10 types (Ia, Ib, and II through IX) according to their capsular polysaccharides. Serotypes Ia, Ib, II, III, and V account for approximately 85% of global GBS disease cases in infants younger than 3 months [1]. Serotype III alone accounts for almost 50% of cases of infant GBS disease [1]. GBS are a major cause of neonatal sepsis. Early-onset (EO) neonatal disease is defined as that which occurs in the first 6 days of life, and results from vertical transmission from a colonized mother to an infant. In contrast to EO disease, the causes of late-onset (LO) disease (7-89 days old) are not well understood. LO disease can develop through vertical or horizontal transmission. The incidence of neonatal GBS disease differs between countries. In the US, EO and LO disease rates were 1.4/1,000 live births and 0.4/1,000 live births, respectively, in the early 1990s [2]. The incidence of EO and LO disease in the UK during 2000–2001 was reported to be 0.47 and 0.25 per 1,000 live births, respectively [3]. Australia has reported an EO disease rate of 2.0/1,000 live births [4]. The neonatal GBS disease burden in Korea has not been known, because GBS is not a notifi-able disease in Korea and there have been no nationwide population-based surveillance studies. GBS has been considered to be a rare pathogen in neonatal sepsis in Korea, especially in EO disease, according to clinical experience. However , a recent study has revealed that GBS have become the most common cause of bacterial meningitis and LO sepsis in infants aged younger than 3 months in Korea [5]. Several clinical trials conducted in the mid-1980s demonstrated that intrapartum antibiotic prophylaxis (IAP) with am-picillin or penicillin in women at risk of transmitting GBS to their infants effectively prevented EO disease. After the introduction of the guidelines for preventing perinatal GBS disease in the US, the incidence of EO disease decreased by approximately 70% between 1996 and 1998 [6]. Australia also reported that the incidence of EO disease decreased from 1.43/1,000 live births in 1993 to 0.25/1,000 live births in 2001 as a result of the introduction of the guidelines [7]. Although maternal …