TY - JOUR
T1 - Group B Streptococcus Early-Onset Disease
T2 - New Preventive and Diagnostic Tools to Decrease the Burden of Antibiotic Use
AU - Nusman, Charlotte M.
AU - Snoek, Linde
AU - van Leeuwen, Lisanne M.
AU - Dierikx, Thomas H.
AU - van der Weijden, Bo M.
AU - Achten, Niek B.
AU - Bijlsma, Merijn W.
AU - Visser, Douwe H.
AU - van Houten, Marlies A.
AU - Bekker, Vincent
AU - de Meij, Tim G. J.
AU - van Rossem, Ellen
AU - Felderhof, Mariet
AU - Plötz, Frans B.
N1 - Publisher Copyright: © 2023 by the authors.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - The difficulty in recognizing early-onset neonatal sepsis (EONS) in a timely manner due to non-specific symptoms and the limitations of diagnostic tests, combined with the risk of serious consequences if EONS is not treated in a timely manner, has resulted in a low threshold for starting empirical antibiotic treatment. New guideline strategies, such as the neonatal sepsis calculator, have been proven to reduce the antibiotic burden related to EONS, but lack sensitivity for detecting EONS. In this review, the potential of novel, targeted preventive and diagnostic methods for EONS is discussed from three different perspectives: maternal, umbilical cord and newborn perspectives. Promising strategies from the maternal perspective include Group B Streptococcus (GBS) prevention, exploring the virulence factors of GBS, maternal immunization and antepartum biomarkers. The diagnostic methods obtained from the umbilical cord are preliminary but promising. Finally, promising fields from the newborn perspective include biomarkers, new microbiological techniques and clinical prediction and monitoring strategies. Consensus on the definition of EONS and the standardization of research on novel diagnostic biomarkers are crucial for future implementation and to reduce current antibiotic overexposure in newborns.
AB - The difficulty in recognizing early-onset neonatal sepsis (EONS) in a timely manner due to non-specific symptoms and the limitations of diagnostic tests, combined with the risk of serious consequences if EONS is not treated in a timely manner, has resulted in a low threshold for starting empirical antibiotic treatment. New guideline strategies, such as the neonatal sepsis calculator, have been proven to reduce the antibiotic burden related to EONS, but lack sensitivity for detecting EONS. In this review, the potential of novel, targeted preventive and diagnostic methods for EONS is discussed from three different perspectives: maternal, umbilical cord and newborn perspectives. Promising strategies from the maternal perspective include Group B Streptococcus (GBS) prevention, exploring the virulence factors of GBS, maternal immunization and antepartum biomarkers. The diagnostic methods obtained from the umbilical cord are preliminary but promising. Finally, promising fields from the newborn perspective include biomarkers, new microbiological techniques and clinical prediction and monitoring strategies. Consensus on the definition of EONS and the standardization of research on novel diagnostic biomarkers are crucial for future implementation and to reduce current antibiotic overexposure in newborns.
KW - Group B Streptococcus
KW - antibiotics
KW - biomarkers
KW - blood culture
KW - early-onset neonatal sepsis
KW - guidelines
KW - molecular culture techniques
UR - http://www.scopus.com/inward/record.url?scp=85151353575&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85151353575&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36978356
U2 - https://doi.org/10.3390/antibiotics12030489
DO - https://doi.org/10.3390/antibiotics12030489
M3 - Review article
C2 - 36978356
SN - 2079-6382
VL - 12
JO - Antibiotics
JF - Antibiotics
IS - 3
M1 - 489
ER -