For three decades, group B streptococcus (GBS) has been the most common cause of bacterial sepsis and meningitis in neonates in the United States (1,2). Prior to 1996, when guidelines for intrapartum antibiotics to prevent early GBS disease in neonates were first published, there were approx 7500 cases of neonatal disease yearly in the United States, and the mortality was almost 50% (3,4). Adoption of prevention guidelines by many hospitals resulted in a 70% decline in the incidence of early-onset GBS disease in neonates by the mid-1990s (5). Despite this remarkable progress, GBS remains a leading cause of neonatal mortality and morbidity (4).