The Programme (PDF Version, 4mb)
09:00 – 09:05 Welcome and introduction: Nadine Dorries MP
Minister of State for Mental Health, Suicide Prevention and Patient Safety
Nadine Dorries was appointed Minister of State at the Department of Health and Social Care in May 2020, having been promoted from Parliamentary Under Secretary of State in the department, appointed on 27 July 2019. She was elected as the Conservative MP for Mid Bedfordshire in May 2005. She trained as a nurse at Warrington General Hospital. Nadine was previously an adviser to the former Shadow Home Secretary and Shadow Chancellor of the Exchequer Oliver Letwin MP. Nadine began her career as a nurse, then went on to set up her own business and later became a director at BUPA. She has also published a number of books.
09:05 – 09:10 Why are we having this conference? – Dr Edward Morris
President of the Royal College of Obstetricians & Gynaecologists, Chair of Group B Strep Support and morning Chair
Dr Edward Morris is a consultant in Obstetrics & Gynaecology at the Norfolk and Norwich University Hospital NHS Foundation Trust and Honorary Senior Lecturer at the Medical School, University of East Anglia. He is President of the Royal College of Obstetricians and Gynaecologists (RCOG), Vice President for Clinical Quality (2016-2019) and Fellows representative for the East of England on RCOG Council (2011-2016). In Norwich, he leads specialist menopause and tertiary endometriosis services.
09:10 – 09:50 Prevention of GBS in Mothers, Fetuses and Babies: A Vision
– Dr Carol J Baker, Professor of Pediatrics, McGovern Medical School, University of Texas, Sabin Gold Medal winner, National Academy of Sciences, USA
Fifty years ago the global burden of perinatal GBS disease was unknown but when finally recognized, prevention was sought. Some methods failed, others were more successful but unacceptable to practitioners or impractical for resource limited settings. Only one targets disease prevention in pregnant women, fetuses, neonates and young infants.
Carol Baker is adjunct professor of pediatrics at McGovern Medical School, Houston, Texas. Her work has focused on all aspects of perinatal group B Streptococcal (GBS) infections with a focus on prevention through pregnancy screening and prophylaxis and maternal immunization. She is a member of the National Academy of Medicine.
09:50 – 10:15 Insights from surveillance of infant GBS disease in England
– Dr Theresa Lamagni, Senior Epidemiologist, Healthcare-Associated Infection & Antimicrobial Resistance, Public Health England
Using national surveillance for invasive GBS infection, I will describe trends in disease incidence and antibiotic resistance along with current distribution of capsular serotypes. I will outline findings from recent genomic investigations assessing frequency of neonatal clusters of iGBS infection in the UK.
Theresa Lamagni is a Section Head in Public Health England (soon to be UKHSA) and designated epidemiologist for the WHO Collaborating Centre for Streptococcal Diseases. As lead epidemiologist for streptococcal diseases, she oversees surveillance activities, outbreak and incident response and development of an evidence base to inform disease prevention programmes.
10:15 – 10:25 BREAK: 10 minutes
10:25 – 10:50 Group B Streptococcus (GBS) screening recommendation and evidence gaps
– Professor Anne Mackie, Director of Screening for Public Health England. Director of Programmes for the UK National Screening Committee
In this talk, Anne Mackie will summarise the current UK National Screening Committee recommendation regarding GBS screening in late pregnancy. Anne will highlight the evidence-based reasons behind this recommendation and the key evidence gaps that need to be addressed to better inform the next GBS screening recommendation.
Anne Mackie is the Director of Screening for Public Health England. Anne has worked in Public Health for nearly 20 years across London and the South East. Previous roles have included Medical Director of the National Specialist Commissioning Advisory Group, Director of Public Health in Kent and Director of Public Health in South West London. Latterly Anne was Director of Public Health for London SHA before taking on her current post in August 2007. She lives in London with her partner and their daughter.
10:50 – 11:00 Royal College of Obstetricians & Gynaecologists Guideline on the Prevention of Early‐onset Neonatal Group B Streptococcal Disease
– Professor Philip Steer, Emeritus Professor of Obstetrics and Gynaecology in the Faculty of Medicine, Imperial College London. Representative of the RCOG’s 2017 Guidelines Group
The 2017 RCOG GBS guideline update made important new recommendations, including recommending intravenous penicillin to all women in preterm labour, and offering enriched medium culture to detect GBS carriage in women pregnant again following a previous pregnancy in which GBS carriage had been detected. Other new recommendations will be described.
Philip Steer MD FRCOG is Chair of the Group B Strep Support Medical Advisory Panel. He is Emeritus Professor of obstetrics at Imperial College and a past President of the British Association of Perinatal Medicine and the Obstetrics & Gynaecology section of the Royal Society of Medicine. Until 2014, he was a consultant obstetrician at the Chelsea and Westminster Hospital in London. He is editor emeritus of BJOG – an International Journal of Obstetrics and Gynaecology.
11:00 – 11:10 Group B Strep prevention in the UK: past, present and future
– Professor Philip Steer, Emeritus Professor of Obstetrics and Gynaecology in the Faculty of Medicine, Imperial College London
– Jane Plumb MBE, Chief Executive & Founder of Group B Strep Support
Jane Plumb and Professor Philip Steer will talk about history of group B Strep prevention in the UK and of the charity, Group B Strep Support, where we are now, and how in future we can make group B Strep history.
Jane Plumb is Group B Strep Support’s Chief Executive & co-founder, Vice-Chair of the Royal College of Obstetricians & Gynaecologists Women’s Network, member of WHO’s Extended Technical Taskforce on Defeating Meningitis By 2030, contributed to the WHO’s Roadmap to Defeat Meningitis by 2030, and Europe Africa Regional Leader for the Confederation of Meningitis Organisations.
Philip Steer MD FRCOG is Chair of the Group B Strep Support Medical Advisory Panel. He is Emeritus Professor of obstetrics at Imperial College and a past President of the British Association of Perinatal medicine and the section of O&G of the Royal Society of Medicine. Until 2014, he was a consultant obstetrician at the Chelsea and Westminster Hospital in London. He is editor emeritus of BJOG – an International Journal of Obstetrics and Gynaecology.
11:10 – 11:30 QUESTIONS and discussion: Chaired by Edward Morris, with Theresa Lamagni, Anne Mackie, Philip Steer and Jane Plumb, 20 minutes
11:30 – 11:40 BREAK: 10 minutes
11:40 – 11:55 Accuracy of a rapid test in early labour for maternal group B Strep colonisation and its potential to reduce antibiotic usage in mothers with risk factors – the GBS2 study
– Professor Shakila Thangaratinam, Professor of Maternal and Perinatal Health, University of Birmingham, Joint Director of WHO Collaborating Centre for Global Women’s Health
GBS2 is a prospective cohort study of the accuracy of rapid testing (Cepheid GeneXpert) for GBS colonisation among women presenting to labour wards with risk factors associated with GBS transmission, against the reference standard of selective enrichment culture, to assess whether such testing can reduce maternal and neonatal antibiotic usage.
Shakila Thangaratinam is a Professor of maternal and perinatal health at University of Birmingham and is co-Director of the Women’s Health WHO Collaborating Centre in Birmingham. Her work focuses on prediction, prevention and treatment of pre-diabetes, eclampsia, epilepsy, and obesity. She is the chief investigator of the GBS2 trial.
11:55 – 12:10 The NIHR-funded national trial comparing testing pregnant women for group B Strep vs current UK practice – GBS3 trial
– Professor Jane Daniels, Professor of Clinical Trials, University of Nottingham
– Dr Kate Walker, Associate Professor of Obstetrics and consultant obstetrician, University of Nottingham
This talk sets out the rationale and the protocol for the first randomised controlled trial of routine testing for Group B Strep in late pregnancy versus a risk-factor based approach.
Jane Daniels is a Professor of Clinical Trials and Deputy Director of the Nottingham Clinical Trials Unit. She undertakes translation and definitive randomised controlled trials and test evaluations, systematic reviews and meta-analyses. Her portfolio of research is principally in women’s health, and she has led previous trials of rapid group B Strep tests.
Kate Walker is a Clinical Associate Professor in Obstetrics at the University of Nottingham. She divides her time equally between research (at Nottingham Clinical Trials Unit) and clinical work (at Nottingham University Hospitals NHS Trust). Her research work is focused on randomised controlled trials in obstetrics, gynaecology and neonatology.
12:10 – 12:20 Parent’s view – Lynsey White
Lynsey White is a mother of 3, who became involved with Group B Strep Support following the death of her son, Frankie, in 2014 aged 4 days old due to GBS Septicemia. Lynsey is hugely passionate about raising awareness of this usually preventable infection.
12:20 – 12:40 QUESTIONS and discussion: Dr Edward Morris, with Shakila Thangaratinam, Jane Daniels and Lynsey White, 20 minutes
12:40 – 13:10 LUNCH: 30 minutes
13:10 – 13:15 Introduction to the afternoon session: Dr Kathryn Gutteridge
President of the Royal College of Midwives, Trustee of Group B Strep Support and Afternoon Chair
Kathryn Gutteridge is President of the Royal College of Midwives (RCM). She has worked as a Consultant Midwife and has a long history of clinical care and advocacy for women in the NHS. She has worked in diverse settings including neonatal services and community midwifery and has been an expert advisor to both the RCM and the Royal College of Obstetricians & Gynaecologists.
13:15 – 13:20 Learning from when things go wrong with detection, escalation and treatment of group B Strep in maternity care
– Annette Anderson RM, Head of Early Notification Scheme (clinical), NHS Resolution
Annette will describe the early themes and key learning in relation to group B Strep incidents that have been collated following the strengthening of neonatal coding at NHS Resolution.
Annette Anderson is a Midwife with extensive experience in midwifery and patient safety gained from working as a senior midwife and maternity clinical risk manager. Annette has been Head of the Early Notification Clinical team at NHS Resolution since June 2019, and is passionate about improving safety in maternity services.
13:20 – 13:45 How best to detect group B Strep – technique of taking samples, culture methods and PCR tests
– Professor Androulla Efstratiou, Professor, Imperial College London and Director, WHO Global Collaborating Centre for Diphtheria & Streptococcal Infections
This talk outlines how best to detect group B Strep – the technique of taking samples (high vaginal swabs vs low vaginal and rectal swabs), culture methods (standard vs enriched media), PCR and rapid test systems (prepartum and intrapartum).
Androulla Efstratiou is the Director of WHO’s Global Collaborating Centre for Reference & Research on Diphtheria & Streptococcal Infections, Consultant Public Health Microbiologist at Public Health England, Professor to the Faculty of Medicine, Dept of Infectious Diseases, Imperial College, London, Visiting Professor, University of Cyprus Medical School, WHO Technical Working Group on GBS Infections member, Main Supervisor for the ECDC European Public Health Microbiology (EUPHEM) fellowship training programme at PHE, and project lead for various European programmes.
13:45 – 14:05 Do differences between strains of group B Strep matter?
– Professor Kirsty Le Doare, Professor of Vaccinology and Immunology, St George’s University of London
This talk describes the global epidemiology of disease and colonising GBS strains and what turns GBS from healthy coloniser to disease causing menace. She will summarise what is known about different strains of GBS and what we can do now and in the future to protect babies from GBS disease.
Kirsty Le Doare is a Professor of Vaccinology and Immunology and chief investigator for several Group B Streptococcal (GBS) maternal vaccines and seroepidemiology studies. Her groups in Uganda and the UK use a variety of approaches to study GBS, ranging from clinical studies, whole genome sequencing, to complex immunology.
14:05 – 14:25 Using Whole Genome Sequencing (WGS) to study the evolution and genetic diversity of Group B Streptococcus
– Dr Dorota Jamrozy, Postdoctoral Fellow, the Wellcome Sanger Institute
Analysis of whole genome sequence data has the potential to provide clear answers to many of the important questions around GBS disease and vaccine development. In this talk I’ll give an overview of our WGS studies investigating the evolution and global genomic diversity of GBS.
Dorota Jamrozy works at the Sanger Institute and she is the project manager for the Juno study. Her background is in bacterial genomics and application of whole genome sequencing to study pathogen evolution.
14:25 – 14:45 QUESTIONS and discussion: Kathryn Gutteridge, with Annette Anderson, Androulla Efstratiou and Kirsty Le Doare, 20 minutes
14:45 – 14:55 BREAK: 10 minutes
14:55 – 15:10 Detecting group B Strep infection in the newborn
– Dr Alison Bedford Russell, Consultant Neonatologist, Liverpool Neonatal Partnership
Early detection of GBS sepsis is often challenging for healthcare professionals and parents. Knowledge of GBS, and an awareness of early warning signs is crucial. Healthcare professionals can be guided by NICE guidelines, Neonatal Early Warning Track and Trigger tool, (NEWTT – BAPM), the Sepsis Risk Calculator, and Pulse Oximetry.
Alison Bedford Russell has a strong interest in neonatal infection, and passion to ensure the best quality of care is provided for babies and their mothers. She has been a consultant for 27 years, with previous consultant appointments at St George’s, Chelsea and Westminster, Birmingham Women’s and Children’s and Qatar.
15:10 – 15:30 Do antibiotics given in labour for group B Strep have a harmful effect on the neonatal microbiome?
– Dr Mark Turrentine, Professor, Baylor College of Medicine Department of Obstetrics & Gynecology, Houston, Texas
This talk provides a brief overview of factors reported to affect the neonatal gut microbiome, with a review of the data of the effect of intrapartum antibiotic prophylaxis for group B Streptococcus (GBS) on the neonatal gut microbiome, and finally a discussion of the neonatal benefits versus risk to the neonatal gut microbiome with intrapartum antibiotic treatment for GBS.
Mark Turrentine, MD is a professor in the Department of Obstetrics and Gynecology at the Baylor College of Medicine in Houston, Texas. He is one of the co-authors of the United States national guidelines on the Prevention of Group B Streptococcal Early-Onset Disease in Newborns.
15:30 – 15:50 QUESTIONS and discussion: Kathryn Gutteridge, with Alison Bedford Russell and Philip Steer, 20 minutes
15:50 – 16:00 BREAK: 10 minutes
16:00 – 16:10 Parent’s view – Frances Hill, 10 minutes
Frances is mother of 17 year old Rebecca, who contracted GBS meningitis when she was 2 weeks old. In 2008, Frances and Rebecca moved from London to Northern Ireland where Frances juggled working full time as the Bank of England’s main representative with raising Rebecca as a single mum. She has since married Ruan and has 15 year old twin stepdaughters. Frances is keen to make people aware of some of the day-to-day impacts of living with meningitis.
16:10 – 16:30 20 million pregnant women worldwide with GBS: deaths and new data on long-term outcomes
– Professor Joy Lawn, Professor of Maternal, Reproductive and Child Health, Director of the London School of Hygiene & Tropical Medicine Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre
Worldwide, an estimated 20 million pregnant women are colonised with group B strep each year. We have previously estimated at least 409,000 invasive GBS cases with 147,000 (Uncertainty Ratio 47,000–273,000) stillbirths and infant deaths annually. New data now show the increased long-term risk for infant survivors after GBS sepsis as well as meningitis.
Joy Lawn is Professor of Maternal, Reproductive and Child Health, Director of the London School of Hygiene & Tropical Medicine Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre. She and her research team work on newborn health, stillbirths and child development worldwide, including NEST360 and group B Streptococcus. She is a member of the UK Academy of Medical Sciences and USA National Academy of Medicine.
16:30 – 16:50 Progress towards a Group B Strep vaccine: Trials & Tribulations
– Professor Paul Heath, Professor of Paediatric Infectious Diseases at St George’s University of London
The need for an effective antenatal GBS vaccine is clear. Polysaccharide-protein conjugate vaccines against all relevant serotypes as well as protein vaccines based on conserved surface proteins have been developed, and studies in pregnant women have established the immunogenicity and safety of several candidates. Generation of robust data to support serological correlates of protection could now facilitate their licensure and rapid implementation.
Paul Heath is a Professor and Honorary Consultant in Paediatric Infectious Diseases at St George’s, University of London, where he co-leads the Paediatric Infectious Diseases Research Group and is Director of the Vaccine Institute. His training in paediatrics and infectious diseases was at the Royal Children’s Hospital, Melbourne, the John Radcliffe Hospital, Oxford and St George’s Hospital, London.
16:50 – 17:05 Progress in developing a six valent vaccine for the prevention of neonatal Group B streptococcal invasive disease
– Dr Annaliesa S Anderson, Chief Scientific Officer Bacterial Vaccines, Pfizer
A maternal six valent polysaccharide conjugate vaccine is under development for the prevention of Group B streptococcal disease. Preclinical and early clinical data demonstrate that the vaccine induces protective responses in preclinical maternal models of infection. Results provide optimism for vaccine development that can potentially prevent neonatal GBS infections.
Annaliesa Anderson, PhD, FAAM, has over 20 years of pharmaceutical research experience and is currently the Chief Scientific Officer for both the Bacterial Vaccines Research and Development Unit and The Hospitals Business Unit at Pfizer Inc. Her responsibilities include infectious disease vaccine R&D and implementation of Pfizer’s anti-infective portfolio strategy.
17:05 – 17:30 Final questions, summary and conclusions: Dr Edward Morris and Kathryn Gutteridge, with Frances Hill, Joy Lawn, Paul Heath, Annaliesa Anderson and Carol Baker
17:30 Conference ends
The full programme is recorded and the recorded sessions will be made available to those who have registered.