Group B Streptococcus: global incidence and vaccine development

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Abstract
Streptococcus agalactiae or Group B Streptococcus (GBS) is an important pathogen that affects neonates, peripartum women and the elderly worldwide. Prenatal maternal screening for GBS and antibiotic treatment has reduced the rate of neonatal GBS disease but the best long-term solution for control of the disease is vaccination. Several GBS vaccine candidates have been developed, including conjugate vaccines prepared by linking purified capsular polysaccharide to proteins. Conjugate vaccines have been prepared against all nine currently identified GBS serotypes. Human clinical trials with several conjugate vaccines have successfully completed phase I and II testing with promising results. In addition, a type III conjugate vaccine has been found to be safe and immunogenic in pregnant women. Reverse vaccinology has revealed new GBS protein antigens that are immunogenic and efficacious in preclinical studies involving mice. Further advances in GBS vaccine development are likely through combining genomics with newer proteomic technologies.