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Group B streptococcal disease in infants 0–3 months in The Netherlands, 1987–2023: a nationwide genomic and epidemiological surveillance study

  • Marleen A. Groenveld
  • , Dorota Jamrozy
  • , Douwe H. Visser
  • , Matthijs C. Brouwer
  • , Diederik van de Beek
  • , Merijn W. Bijlsma*
  • , Nina M. van Sorge
  • , Ron van Beek
  • , Vincent Bekker
  • , Maartje van den Berg
  • , Geert Jan Blok
  • , Mijke Breukels
  • , Alwin F.J. Brouwer
  • , Renske J.P.M. Cornelisse-van Vugt
  • , Luçan C. Delemarre
  • , Anouk Dings
  • , Rienus A. Doedens
  • , Stefan M. van Dorth
  • , Hester M. Havers
  • , Jojanneke Heidema
  • Marieke A.C. Hemels, Maartje E.N. van den Heuvel, Marlies A. van Houten, Monique A.M. Jacobs, Arieke Janse, Miranda de Jong, Anton H. van Kaam, Ageeth Kaspers, Merel N. van Kassel, Anne A.M.W. van Kempen, Kristine Klúčovská, Karen Korbeek, René F. Kornelisse, Anke G. Kuijpers, Taco W. Kuijpers, Elizabeth van Leeuwen, Jeannette von Lindern, Carmen Lorente Flores, Karen Van Mechelen, Clemens B. Meijssen, Jeroen Noordzij, Annemarie Oudshoorn, Frans B. Plötz, Maarten Rijpert, Linde Snoek, Nina M. van Sorge, Jacqueline U.M. Termote, Wouter J. de Waal, Tom F.W. Wolfs, Angela C.M. van Zijl,
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Group B Streptococcus (GBS) is the leading cause of sepsis and meningitis in infants. The molecular epidemiology and potential vaccine coverage of GBS disease in infants was assessed in the Netherlands over a 37-year period. Methods: This nationwide observational study identified infants aged 0–89 days with GBS culture-positive sepsis or meningitis between July 1987 and June 2024, through Dutch surveillance. Serotype was determined by latex agglutination. Whole-genome sequencing determined the clonal complex (CC) using multi-locus sequence typing (MLST) and identified virulence factors associated with meningitis. Strain coverage by the maternal vaccines GBS6 and GBS-AlpN were analysed. Findings: 2212 episodes were identified; 1307 (59%) early onset disease (0–6 days) and 905 (41%) late onset disease (7–89 days). Mean annual incidence was 0·33 per 1000 live births and significantly increased from 0·19 in 1987 to 0·57 in 2023 due to an increase in sepsis cases (p < 0·0001). Serotype data was available for 2163 (98%) of 2212 isolates, of which serotype III was most common (1316/2163; 61%), followed by Ia (383/2163; 18%) and II (123/2163; 6%). MLST data was available for 1723 (78%) isolates; CC17 was most common (705/1723; 41%). CC17 increased from 29% (90/308) in 1987–1996 to 49% (262/538) in 2014–2023 (p < 0·0001). 97% (2095/2163) of cases would be covered by the GBS6 vaccine, and 99% (1709/1723) by GBS-AlpN. Interpretation: GBS disease is still increasing in the Netherlands. The GBS6 and GBS-AlpN vaccines would potentially prevent >96% of cases. Funding: Netherlands Organisation for Health Research and Development (ZonMW) and ItsME foundation.

Original languageEnglish
Article number101711
JournalThe Lancet Regional Health - Europe
Volume66
DOIs
Publication statusPublished - Jul 2026
Externally publishedYes

Keywords

  • Bacterial meningitis
  • Early-onset disease
  • Group B Streptococcus
  • Infants
  • Late-onset disease
  • Maternal vaccination
  • Neonates

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