What is this project about?
This project investigates the cause of a progressive rise in neonatal meningitis caused by group B Streptococcus (GBS) in the Netherlands between 1987 and 2011 and will for the first time describe the whole genome pathology and epidemiology of this world wide cause of meningitis. Ultimately this will lead to initiate policy change in neglected areas of significant infant mortality.
Why is it important?
Worldwide 40% of child mortality occurs in the neonatal period with meningitis being amongst the commonest causes of death. Group B Streptococcus (GBS or Streptococcus agalactiae) and E.coli are the two most common micro-organisms causing about 60% of all meningitis cases in neonates and infants up to 3 months of age. Also in developed countries, bacterial meningitis remains a major cause of death in this early age range. Treatment of this serious condition requires hospital admission for intravenous antibiotics. Despite increased awareness over the last decades, long term sequelae are still a major cause of morbidity following meningitis.
Understanding neonatal susceptibility to GBS and a change in bacterial virulence factors will lead to approaches to improve the current prevention strategies. Alternatively, protection by prior multivalent GBS vaccination of pregnant women is being considered a novel strategy to improve immunity in neonates, where success will depend on the correct selection of the vaccine components, which may be used to boost immunity in-vivo.
In the Netherlands, we have identified a progressive increase in the incidence of GBS neonatal meningitis between 1987 and 2011, which was accompanied by changes in genotype distribution of the infectious agent. The introduction of risk-based GBS preventive treatment guidelines in 1999, (consisting of intravenous antibiotic prophylaxis during fever at delivery, premature labour or prolonged rupture of membranes) did not result in the expected decline of GBS disease incidence.