Immunoprophylaxis and immunotherapy of neonatal group B streptococcal infections.

With emphasis on work from our laboratory, this paper briefly reviews previous studies which have established the basis for immunity to group B streptococcal infections. Quantitative data are presented on the concentration of antibody to the type-specific polysaccharides of group B streptococci in normal adults and infected infants, the protective level in experimental animals, and the influence of prematurity on transplacental passage of antibody. The role of the polymorphonuclear leukocyte in immunity to group B streptococcal infections is critical as supported by in vitro and in vivo experiments as well as clinical observations. Strategies for prevention include antimicrobial chemoprophylaxis and active immunization. Alternative approaches to adjunctive therapy such as administration of specific immune globulin, polymorphonuclear leukocytes, and exchange transfusions are discussed.