Cell wall proteins of group B Streptococcus and low incidence of neonatal disease in southern Israel.

Objective: To determine the maternal group B Streptococcus (GBS) prevalence of carriage and serotype distribution and the neonatal disease incidence to formulate a policy for treatment and prevention regarding GBS diseases in southern Israel.

Study Design: A prospective study was conducted between January and October 2000. Cultures were obtained from 681 healthy, pregnant women and processed as recommended. Samples were cultured on blood-agar plates with and without added gentamicin. GBS was identified by beta-hemolysis and a positive CAMP test and confirmed by agglutination with specific antiserum. Serotyping was done by the Lancefield precipitin method using monospecific antisera to polysaccharides Ia, Ib and II-VIII and surface proteins C, R and X.

Results: Carriage prevalence of 12.3% and neonatal disease incidence of 0.095/1,000 live births were documented. Surface proteins C and R were found in 85.7% of positive cases. Serotypes Ia (17.8%), Ib (10.7%), II (27.4%), III (20.2%) and V (14.3%) were distributed as previously reported from developed countries.

Conclusion: Developing a pentavalent vaccine based on serotypes Ia, Ib, II, III and V in conjugation to a GBS cell wall protein transporter, such as C or R, has theoretical advantages in the southern Israeli population over vaccines that use foreign proteins.