Group B <i>Streptococcus</i> Early-Onset Disease: New Preventive and Diagnostic Tools to Decrease the Burden of Antibiotic Use
Charlotte M. Nusman,
Linde Snoek,
Lisanne M. van Leeuwen,
Thomas H. Dierikx,
Bo M. van der Weijden,
Niek B. Achten,
Merijn W. Bijlsma,
Douwe H. Visser,
Marlies A. van Houten,
Vincent Bekker,
Tim G. J. de Meij,
Ellen van Rossem,
Mariet Felderhof,
Frans B. Plötz
Affiliations
Charlotte M. Nusman
Department of Paediatrics, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Linde Snoek
Department of Neurology, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Lisanne M. van Leeuwen
Department of Paediatrics and Department of Vaccin, Infection and Immunology, Spaarne Hospital, Boerhaavelaan 22, 2035 RC Haarlem, The Netherlands
Thomas H. Dierikx
Department of Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Bo M. van der Weijden
Department of Paediatrics, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Niek B. Achten
Department of Paediatrics, Erasmus University Medical Centre, Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
Merijn W. Bijlsma
Department of Paediatrics, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Douwe H. Visser
Department of Neonatology, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Marlies A. van Houten
Department of Paediatrics and Department of Vaccin, Infection and Immunology, Spaarne Hospital, Boerhaavelaan 22, 2035 RC Haarlem, The Netherlands
Vincent Bekker
Division of Neonatology, Department of Pediatrics, Willem Alexander Children’s Hospital, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
Tim G. J. de Meij
Department of Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Ellen van Rossem
Department of Paediatrics, Flevo Hospital, Hospitaalweg 1, 1315 RA Almere, The Netherlands
Mariet Felderhof
Department of Paediatrics, Flevo Hospital, Hospitaalweg 1, 1315 RA Almere, The Netherlands
Frans B. Plötz
Department of Paediatrics, Emma Children’s Hospital, Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
The difficulty in recognizing early-onset neonatal sepsis (EONS) in a timely manner due to non-specific symptoms and the limitations of diagnostic tests, combined with the risk of serious consequences if EONS is not treated in a timely manner, has resulted in a low threshold for starting empirical antibiotic treatment. New guideline strategies, such as the neonatal sepsis calculator, have been proven to reduce the antibiotic burden related to EONS, but lack sensitivity for detecting EONS. In this review, the potential of novel, targeted preventive and diagnostic methods for EONS is discussed from three different perspectives: maternal, umbilical cord and newborn perspectives. Promising strategies from the maternal perspective include Group B Streptococcus (GBS) prevention, exploring the virulence factors of GBS, maternal immunization and antepartum biomarkers. The diagnostic methods obtained from the umbilical cord are preliminary but promising. Finally, promising fields from the newborn perspective include biomarkers, new microbiological techniques and clinical prediction and monitoring strategies. Consensus on the definition of EONS and the standardization of research on novel diagnostic biomarkers are crucial for future implementation and to reduce current antibiotic overexposure in newborns.
