Group B streptococcus.

During the 1990s the focus of group B streptococcus (GBS) disease research has shifted to prevention. Increased use of intrapartum antimicrobial prophylaxis in North America and Australia has led to substantial declines in perinatal disease. Vaccine development (initiated two decades earlier) has yielded results--for example, polysaccharide-protein conjugate vaccines given to women of reproductive age proved to be highly immunogenic and well tolerated. Also economic evaluations have assessed the cost-effectiveness of prevention strategies in different populations. Although GBS has traditionally been considered a perinatal pathogen, the burden of invasive GBS disease among nonpregnant adults has been measured. Adverse outcomes of pregnancy attributable to GBS were addressed through a multicentre study which confirmed the important role of heavy colonisation with GBS in preterm low-birthweight deliveries. Finally, the pathogen itself has continued to evolve: new capsular serotypes described in the past decade are now causing an important proportion of clinical infections.