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NeoReviews Vol.5 No.11 2004 e467
© 2004 American Academy of Pediatrics

Historical perspectives

Group B Streptococcus in Neonatal Sepsis: Emergence as an Important Pathogen

	The Preantibiotic Era

 
In the preantibiotic era, the group A beta-hemolytic Streptococcus was much more likely to be associated with serious bacterial infection of women and infants than was group B beta-hemolytic Streptococcus (GBS). Soon after the introduction of penicillin and other antibiotics, the most likely organisms to be cultured from neonates who had sepsis were gram-negative bacilli, most notably Escherichia coli. When penicillin-resistant staphylococci emerged, Staphylococcus aureus became prominent.

By 1958, a review of neonatal sepsis (septicemia) indicated that GBS could be a devastating organism. (1) Between 1933 and 1943, two cases of neonatal sepsis due to GBS (also called S agalactiae) were reported, and four more were seen between 1943 and 1947. Of the six infants, four had meningitis and two had pneumonia; all died. (1)

	Emergence of GBS

 
Over the next few years, the importance of GBS in perinatal infection began to emerge. First documented as an important organism in the perinatal period (for both women and infants) by Hood and associates in 1961, (2) early-onset meningitis caused by GBS was reported in 1962, (3) and the role of GBS in neonatal infection was emphasized by Eickhoff and colleagues in 1964. (4) During the next decade, the ascendancy of GBS continued, to the extent that by 1973, McCracken (5) considered it to be "the new challenge" and a year later, with a colleague, described a wide spectrum of disease resulting from GBS infection. (6)

The emergence of GBS infection was not limited to the United States; it appeared to be widespread throughout Europe. In the early 1970s, there were reports of infection in the language of the country from Bulgaria, France, Germany, Hungary, and the United Kingdom. (7) At about this time, the idea of "early-"and . . . [Full Text of this Article]

Alistair G.S. Philip, MD, FRCPE

Professor of Pediatrics
Stanford University School of Medicine
Palo Alto, Calif

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