---
title: "Rethinking Prevention of Neonatal Group B Streptococcal Disease"
id: "pubmed-42747473"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42747473"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42747473/"
doi: "10.1007/s00281-026-01080-1"
published_at: "2026-09-16T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Rethinking Prevention of Neonatal Group B Streptococcal Disease
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42747473
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42747473/)
- **DOI:** [10.1007/s00281-026-01080-1](https://doi.org/10.1007%2Fs00281-026-01080-1)
- **Published At:** 2026-09-16T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Group B Streptococci (GBS) are common colonizers of humans and also cause invasive disease in newborns; prevention strategies require reassessment. - The widespread use of **intrapartum antibiotic prophylaxis (IAP)** has substantially reduced early-onset GBS sepsis but has not decreased **late-onset sepsis**, which may represent up to **50%** of neonatal GBS cases. - IAP alters infant microbiome development, notably reducing the abundance of **Bifidobacterium** and **Bacteroides** species; these shifts may be linked to longer-term outcomes including asthma and obesity. - Multiple GBS virulence factors mediate adhesion, barrier disruption, and immune evasion; examples cited include **GBS pilus islands**, the pore-forming toxin **ß-hemolysin**, **capsular polysaccharide**, and membrane glycolipids. - Neonatal host defense and GBS pathogenicity interact: GBS factors promote translocation and invasion while neonatal immune responses—whose metabolic programming (for example, **glycolytic capacity**)—vary by GBS strain and influence disease progression. - Because of the benefits and unintended consequences of IAP, alternative or complementary prevention strategies warrant consideration, including **vaccination** and **probiotic supplementation**. - The review calls for further research focused on modulating the developing **immune–microbiome interplay** and the neonatal metabolic milieu to protect vulnerable newborns. - The article emphasizes tailored prevention approaches that account for GBS strain diversity and neonatal immune-metabolic status rather than one-size-fits-all antibiotic prophylaxis.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Campus Lübeck, Clinic for Pediatric and Adolescent Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany. * 2 Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany. * 3 Center for Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany. * 4 Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany. * 5 Institute for Infection Prevention and Control, University Hospital Freiburg, Freiburg, Germany. * 6 Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany. haertel_c1@ukw.de. * 7 Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany. haertel_c1@ukw.de. * PMID: **42747473** * DOI: [ 10.1007/s00281-026-01080-1 ](https://doi.org/10.1007/s00281-026-01080-1) Item in Clipboard Review # Time to rethink prevention of neonatal group B streptococcal disease Jana Lucia Teuscher et al. Semin Immunopathol. 2026. Show details Display options Display options Format Abstract PubMed PMID Semin Immunopathol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Semin+Immunopathol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Semin+Immunopathol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) . 2026 Sep 16;48(1):17. doi: 10.1007/s00281-026-01080-1. ### Authors [Jana Lucia Teuscher](https://pubmed.ncbi.nlm.nih.gov/?term=Teuscher+JL&cauthor_id=42747473)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-1 "Campus Lübeck, Clinic for Pediatric and Adolescent Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-2 "Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany."), [Florens Lohrmann](https://pubmed.ncbi.nlm.nih.gov/?term=Lohrmann+F&cauthor_id=42747473)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-3 "Center for Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-4 "Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany."), [Egbert Herting](https://pubmed.ncbi.nlm.nih.gov/?term=Herting+E&cauthor_id=42747473)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-1 "Campus Lübeck, Clinic for Pediatric and Adolescent Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany."), [Fumi Sugihara](https://pubmed.ncbi.nlm.nih.gov/?term=Sugihara+F&cauthor_id=42747473)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-2 "Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany."), [Philipp Henneke](https://pubmed.ncbi.nlm.nih.gov/?term=Henneke+P&cauthor_id=42747473)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-5 "Institute for Infection Prevention and Control, University Hospital Freiburg, Freiburg, Germany.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-4 "Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany."), [Christoph Härtel](https://pubmed.ncbi.nlm.nih.gov/?term=H%C3%A4rtel+C&cauthor_id=42747473)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-6 "Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany. haertel_c1@ukw.de.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42747473/#short-view-affiliation-7 "Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany. haertel_c1@ukw.de.") ### Affiliations * 1 Campus Lübeck, Clinic for Pediatric and Adolescent Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany. * 2 Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany. * 3 Center for Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany. * 4 Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany. * 5 Institute for Infection Prevention and Control, University Hospital Freiburg, Freiburg, Germany. * 6 Department of Pediatrics, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany. haertel_c1@ukw.de. * 7 Specialist Network Infectious Diseases, Netzwerk Universitätsmedizin, Berlin, Germany. haertel_c1@ukw.de. * PMID: **42747473** * DOI: [ 10.1007/s00281-026-01080-1 ](https://doi.org/10.1007/s00281-026-01080-1) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Group B Streptococci (GBS) are both natural colonizers and important invasive pathogens in newborns. The introduction of intrapartum antibiotic prophylaxis has led to a significant decrease in the incidence of early onset sepsis. In contrast, late onset sepsis, which accounts for up to 50% of cases, has not declined. IAP impacts microbiome development during infancy, specifically it reduces the abundance of Bifidobacterium and Bacteroides spp., which might be associated with long-term health outcomes such as asthma development and obesity. This review highlights the challenges and risks associated with GBS colonization in neonates, including the role of virulence factors and specific contribution of host immunity. Bacterial pathogenicity factors involved in adhesion and colonization, e.g. GBS pilus islands, barrier disruption, e.g. pore-forming toxin ß-hemolysin, or evasion of neonatal immune defense mediated by GBS capsular polysaccharide and membrane glycolipids are important targets to suppress the translocation of GBS and progression to invasive disease. In line with this, metabolic programming of neonatal immune cells, e.g. glycolytic capacity, is GBS strain-specific which also argues for a more tailored strategy of prevention. Given the benefits and risks of IAP, it is important to rethink strategies of preventing GBS disease including alternative strategies such as vaccination and probiotic supplementation. Further studies need to focus on modulating the developing immune-microbiome interplay including the metabolic milieu to the advantage of the vulnerable newborn. **Keywords:** Antibiotics; GBS; Group B streptococcus; Immunity; Intrapartum prophylaxis; Microbiome; Neonate. © 2026. The Author(s). [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Conflict of interest: No potential conflict of interest was reported by the authors. ## References 1. 1. 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Int J Med Microbiol 297(3):133–150. - [DOI](https://doi.org/10.1016/j.ijmm.2006.11.008) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/17400023/) Show all 212 references ## Publication types * Review Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Review%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Review) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) ## MeSH terms * Animals Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Animals%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Animals) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Anti-Bacterial Agents / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-Bacterial+Agents%2Ftherapeutic+use%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-Bacterial+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Antibiotic Prophylaxis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antibiotic+Prophylaxis%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Antibiotic+Prophylaxis) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Host-Pathogen Interactions / immunology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Host-Pathogen+Interactions%2Fimmunology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Host-Pathogen+Interactions) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Infant, Newborn Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Infant%2C+Newborn%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Infant%2C+Newborn) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Microbiota Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Microbiota%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Microbiota) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42747473/) * Streptococcal Infections* / epidemiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Streptococcal+Infections%2Fepidemiology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term
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