Invasive Group B Streptococcus disease in young infants: understanding host and pathogen immunity ito inform maternal GBS vaccination development

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Infections during the first month of life are the leading cause of death in Africa and Group B Streptococcus (GBS) is emerging as a major culprit. GBS is a bacterium living in the back passage and vagina of women. GBS can cause lethal infection in pregnant women, stillbirths and premature births. It can be passed from mother to baby at birth or in breastmilk. Once passed on, GBS either remains harmless or causes severe pneumonia, sepsis and meningitis in new born babies. One way a mother protects her baby is by passing antibody against GBS through the placenta and in breastmilk after birth. However, we do not yet know how much antibody needs to be passed in this way to protect babies from disease. It is also unclear what changes GBS undergoes to become a potentially fatal bacteria.At present, babies in the Africa are still dying or being born too early and too small because of infections like GBS. Our research group is dedicated to finding out why GBS passes from mother to child, what the "protective" antibody levels need to be passed through the placenta to stop babies from getting sick in the first place and how to prevent GBS disease through new treatments such as maternal vaccination. We use a variety of different ways to find out the answers - through doing fieldwork (where mother and their babies are followed up over three months from birth to see what effect GBS has on their health) or by developing laboratory tests to see how antibody works to protect against GBS.We will use these answers to change how we look after pregnant women and monitor their babies for signs of infection. We do this so that we can improve the health of women and their babies. We bring together a number of different ways of working with the single aim of preventing GBS infections in babies (and their mothers). Our planned work includes the following:1. Following mothers and babies in Uganda and collecting blood samples to work out how much antibody a mother needs to pass to her infant to protect against GBS infection;2. Collecting bacteria and blood samples from babies who get GBS disease (via public health agencies we work with already) in the UK, Netherlands and France to compare if the type of bacteria found in different populations affects the amount of antibody needed to protect babies against GBS disease. 3. Helping hospitals in Uganda to investigate infections in babies by strengthening diagnostic laboratory capacity and working with clinicians to investigate and treat infections early. 4. Engaging with women in the African sites to understand whether a vaccine given to pregnant women to prevent GBS-as is currently being developed- is likely to be taken up sufficiently to be effective.