Moving maternal Group B Streptococcal vaccines into clinical effectiveness trials.

在非洲，出生后第一个月内的感染是导致死亡的主要原因，B族链球菌（GBS）正在成为一种主要病原体。GBS是一种细菌，通常生活在健康女性的肠道和阴道中。GBS可导致孕妇致命感染，并导致死胎和早产。它可以在出生时从母亲传给婴儿或通过母乳传播。一旦传播，GBS要么保持无害，要么在新生儿中引起严重的肺炎，败血症和脑膜炎。母亲保护婴儿的一种方法是通过胎盘和出生后的母乳传递抗GBS的抗体。然而，我们还不知道需要以这种方式传递多少抗体才能保护婴儿免受疾病侵害。目前还不清楚GBS细菌如何从无害的殖民者变成潜在的致命细菌。目前，非洲的婴儿仍然因为感染GBS而死亡或出生过早和太小。我们的研究小组致力于找出为什么GBS从母亲传给孩子，需要通过胎盘传递什么水平的“保护性”抗体才能阻止婴儿首先生病，以及如何通过新的治疗方法预防GBS疾病，如母亲接种疫苗。在给孕妇接种疫苗之前，我们需要确保它是安全和可接受的。我们还需要确保不同国家的“保护性抗体”数量相同，并注意可能使疫苗效力降低的潜在问题。我们将利用这些答案来改变我们照顾孕妇和监测婴儿感染迹象的方式。我们这样做是为了改善妇女及其婴儿的健康，预防GBS感染。我们计划的工作包括以下几个方面：1.开发一个统计模型，以了解不同类型的细菌如何改变我们在感染后产生的抗体量2。在乌干达跟踪婴儿，并采集血液样本，以确定哪种类型的GBS（和其他感染）会使婴儿生病，以及母亲需要传递多少抗体给婴儿以保护他们免受感染;3.与乌干达妇女接触，了解目前正在开发的为孕妇提供的预防GBS的疫苗是否可能受到欢迎，并被充分接受，使其有效。4.利用医院电子病历建立孕期疫苗接种监控系统

Infections during the first month of life are a leading cause of death in Africa and Group B Streptococcus (GBS) is emerging as a major pathogen. GBS is a bug (bacterium) that normally lives in the gut and vagina of otherwise healthy women. GBS can cause lethal infections in pregnant women and also leads to 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 newborn 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 how the GBS bacterium changes from harmless coloniser to potentially fatal bacteria.At present, babies in 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 levels of "protective" antibody 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. Before a vaccine can be given to pregnant women, we need to make sure that it is safe and acceptable. We also need to make sure that the amount of "protective antibody" is the same in different countries and look out for potential problems that would make a vaccine less effective.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 and prevent GBS infections. Our planned work includes the following:1. Developing a statistical model to understand how different types of bacteria might change the amount of antibody we make following infection2. Following babies in Uganda and taking blood samples to work out what types of GBS (and other infections) make babies sick and how much antibody a mother needs to pass to her baby to protect them against infection;3. Engaging with women in the Uganda to understand whether a vaccine given to pregnant women to prevent GBS - which is currently being developed - is likely to be well received and taken up sufficiently for it to be effective. 4. Using the hospital electronic medical records to develop a system to monitor vaccines given in pregnancy