Neonatal Group B Streptococcal Diseases

Choi, Chang Won

Abstract

Group B streptococcus (GBS) causes invasive infection in newborn infants, and affected newborn infants acquire GBS from their mothers colonized with GBS. In the United States, early-onset GBS disease, in which the signs of infection occur within the first 7 days after birth was a significant medical and socio-economic burden. However, due to joint efforts of related academic societies and governmental institution (Center for Disease Control and Prevention, CDC) to combat early-onset GBS disease resulted in an establishment of guideline for intrapartum antibiotic prophylaxis (IAP) for GBS on the basis of scientific evidences. The IAP for GBS was widely implemented in hospitals and individual clinics in the United States. Within several years after the IAP guideline was proclaimed, the incidence of early-onset GBS disease in the United States has been reduced dramatically. In Korea, GBS was not a major causative organism for invasive infections during neonatal period until recently. However, very recent serial reports indicate that now, GBS has emerged as one of the important organisms in invasive bacterial infections of neonates. In contrary to the United States, where early-onset GBS disease, which is closely related to maternal GBS colonization status, occurs more frequently than late-onset disease, late-onset GBS disease, on which infection process is not clearly delineated yet, takes place much more often in Korea. Moreover, we have few epidemiologic data on the incidence and current status of neonatal GBS diseases in Korea. Therefore, it is still controversial whether or not a guideline for GBS prophylaxis is needed in our country. Some hospitals and private clinics have already implemented IAP just as it is practiced in the United States. However, it is not advisable to follow the IAP guideline of the United States in Korea in terms of cost-benefit, because the current status of neonatal GBS disease is not known yet. The efforts to evaluate medical and socio-economic burden of neonatal GBS diseases in Korea by establishing a nationwide continuous monitoring system for neonatal infections should be preceded.