Preventing Bacterial Infections with Pilus-Based Vaccines: the Group B Streptococcus Paradigm

Fetal bacterial infections are a common cause of fetal/neonatal morbidity and mortality. The pathologic correlates of congenital bacterial infection include acute chorioamnionitis, acute villitis, and acute intervillositis. The strength of the association of congenital bacterial infection differs among these pathologies. Acute chorioamnionitis results usually from an ascending infection, and damage to the fetus is thought to be cytokine driven rather than damage secondary to bacteremia. Acute villitis is strongly associated with fetal sepsis due to congenital infections. A much less common variant on acute villitis pattern has been described with additional presence of bacteria in the fetal capillaries of the chorionic villi. We describe the spectrum of bacteria that would induce this unique pattern. The histological archives were searched from 2 institutions for cases with intravascular bacteria present in the villous capillaries of the placenta. Thirteen cases were identified, of which 11 cases had acute chorioamnionitis and all cases showed an acute villitis. Eight cases had Escherichia coli identified and 3 cases had Group B Streptococcus. All cases were associated with fetal death. In 9 cases, the mother showed signs of a significant infection including 1 maternal death. We conclude that finding intravascular bacteria is a serious complication of congenital infection with serious fetal and maternal sequela.

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Characterization of Clinical and Carrier Streptococcus agalactiae and Prophage Contribution to the Strain Variability

Viruses ◽

10.3390/v12111323 ◽

2020 ◽

Vol 12 (11) ◽

pp. 1323

Author(s):

Aneta Lichvariková ◽

Katarina Soltys ◽

Tomas Szemes ◽

Livia Slobodnikova ◽

Gabriela Bukovska ◽

...

Keyword(s):

Streptococcus Agalactiae ◽

Bacterial Infections ◽

Group B Streptococcus ◽

Host Bacterium ◽

Phage Integrase ◽

Integration Sites ◽

Group A ◽

Pcr Method ◽

Group B

Streptococcus agalactiae (group B Streptococcus, GBS) represents a leading cause of invasive bacterial infections in newborns and is also responsible for diseases in older and immunocompromised adults. Prophages represent an important factor contributing to the genome plasticity and evolution of new strains. In the present study, prophage content was analyzed in human GBS isolates. Thirty-seven prophages were identified in genomes of 20 representative sequenced strains. On the basis of the sequence comparison, we divided the prophages into eight groups named A–H. This division also corresponded to the clustering of phage integrase, even though several different integration sites were observed in some relative prophages. Next, PCR method was used for detection of the prophages in 123 GBS strains from adult hospitalized patients and from pregnancy screening. At least one prophage was present in 105 isolates (85%). The highest prevalence was observed for prophage group A (71%) and satellite prophage group B (62%). Other groups were detected infrequently (1–6%). Prophage distribution did not differ between clinical and screening strains, but it was unevenly distributed in MLST (multi locus sequence typing) sequence types. High content of full-length and satellite prophages detected in present study implies that prophages could be beneficial for the host bacterium and could contribute to evolution of more adapted strains.

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Prevention of Influenza A(H7N9) and Bacterial Infections in Mice Using Intranasal Immunization With Live Influenza Vaccine and the Group B Streptococcus Recombinant Polypeptides

Virology Research and Treatment ◽

10.1177/1178122x17710949 ◽

2017 ◽

Vol 8 ◽

pp. 1178122X1771094 ◽

Cited By ~ 1

Author(s):

Yulia A Desheva ◽

Galina F Leontieva ◽

Tatiana A Kramskaya ◽

Tatiana A Smolonogina ◽

Kornelia B Grabovskaya ◽

...

Keyword(s):

Influenza Vaccine ◽

Messenger Rna ◽

Influenza A ◽

Bacterial Infections ◽

Influenza Infection ◽

Group B Streptococcus ◽

Infectious Dose ◽

Intranasal Immunization ◽

Group B ◽

Recombinant Polypeptides

We investigate the protective effect of combined vaccination based on live attenuated influenza vaccine (LAIV) and group B streptococcus (GBS) recombinant polypeptides against potential pandemic H7N9 influenza infection followed by GBS burden. Mice were intranasally immunized using 107 50% egg infectious dose (EID50) of H7N3 LAIV, the mix of the 4 GBS peptides (group B streptococcus vaccine [GBSV]), or combined LAIV + GBSV vaccine. The LAIV raised serum hemagglutination-inhibition antibodies against H7N9 in higher titers than against H7N3. Combined vaccination provided advantageous protection against infections with A/Shanghai/2/2013(H7N9)CDC-RG influenza and serotype II GBS. Combined vaccine significantly improved bacterial clearance from the lungs after infection compared with other vaccine groups. The smallest lung lesions due to combined LAIV + GBSV vaccination were associated with a prevalence of lung interferon-γ messenger RNA expression. Thus, combined viral and bacterial intranasal immunization using H7N3 LAIV and recombinant bacterial polypeptides induced balanced adaptive immune response, providing protection against potential pandemic influenza H7N9 and bacterial complications.

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Strategies for Preventing Neonatal Group B Streptococcal Disease

Infection Control and Hospital Epidemiology ◽

10.1017/s0195941700065693 ◽

1986 ◽

Vol 7 (S2) ◽

pp. 137-143 ◽

Cited By ~ 3

Author(s):

Donald A. Goldmann

Keyword(s):

Early Onset ◽

Bacterial Infections ◽

Late Onset ◽

Wide Spectrum ◽

Group B Streptococcus ◽

Case Fatality ◽

Chemotherapeutic Agents ◽

Life Threatening ◽

Additional Approach ◽

Group B

Despite increased awareness and the availability of potent chemotherapeutic agents, the Group B streptococcus remains the leading cause of life-threatening bacterial infections in the neonatal period. The majority of infections occur in the first few days of life. These so-called “early-onset” infections are often fulminant and are associated with a very high case fatality rate, ranging from more than 20% in recent reports to as high as 80% in older series. “Late-onset” disease occurs, by definition, after the first week of life. It usually presents with meningitis, although a wide spectrum of infections has been reported, including cellulitis, adenitis, septic arthritis, and osteomyelitis. Late-onset disease is usually less serious than early-onset disease, although deaths do occur and major sequelae are not rare. Accordingly, attempts to prevent group B streptococcal infections have concentrated on the more common and frequently lethal early-onset disease. Strategies that have been considered to date include antibiotic- and immuno-prophylaxis. In the preceding article, Easmon advocates an additional approach; topical use of the antiseptic Chlorhexidine gluconate in the vagina during labor.

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Group B Streptococcus in surgical site and non-invasive bacterial infections worldwide: A systematic review and meta-analysis

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2019.04.017 ◽

2019 ◽

Vol 83 ◽

pp. 116-129 ◽

Cited By ~ 6

Author(s):

Simon M. Collin ◽

Nandini Shetty ◽

Rebecca Guy ◽

Victoria N. Nyaga ◽

Ann Bull ◽

...

Keyword(s):

Systematic Review ◽

Bacterial Infections ◽

Meta Analysis ◽

Group B Streptococcus ◽

Non Invasive ◽

Group B

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The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital

Microorganisms ◽

10.3390/microorganisms9030526 ◽

2021 ◽

Vol 9 (3) ◽

pp. 526

Author(s):

Timothy A. Erickson ◽

Flor M. Munoz ◽

Catherine L. Troisi ◽

Melissa S. Nolan ◽

Rodrigo Hasbun ◽

...

Keyword(s):

Bacterial Meningitis ◽

Bacterial Infections ◽

Group B Streptococcus ◽

Significant Risk ◽

Viral Meningitis ◽

Third Generation ◽

Gram Negative ◽

E Coli ◽

Group B ◽

Third Generation Cephalosporins

Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients <90 days of age with meningitis at Texas Children’s Hospital from 2010–2017. Cases were confirmed using the National Healthcare Safety Network (NHSN) definition of meningitis. Results: Among 694 infants with meningitis, the most common etiology was viral (n = 351; 51%), primarily caused by enterovirus (n = 332; 95%). A quarter of cases were caused by bacterial infections (n = 190; 27%). The most common cause of bacterial meningitis was group B Streptococcus (GBS, n = 60; 32%), followed by Gram-negative rods other than E. coli (n = 40; 21%), and E. coli (n = 37; 19%). The majority of Gram-negative organisms (63%) were resistant to ampicillin, and nearly one-fourth of Gram-negative rods (23%) other than E. coli and 2 (6%) E. coli isolates were resistant to third-generation cephalosporins. Significant risk factors for bacterial meningitis were early preterm birth and the Black race. Conclusions: Enteroviruses most commonly caused viral meningitis in infants; GBS was the most common bacterial cause despite universal screening and intrapartum prophylaxis. The emergence of MRSA and resistance to third-generation cephalosporins in Gram-negative bacterial meningitis challenges the options for empirical antimicrobial therapy.

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Late-onset brain abscess due to group B Streptococcus

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2016-0005 ◽

2016 ◽

Vol 5 (2) ◽

pp. 165-167

Author(s):

Antonietta Giannattasio ◽

Francesco Raimondi ◽

Alessandra D’Amico ◽

Silvia Lama ◽

Maria Immacolata Spagnuolo

Keyword(s):

Brain Abscess ◽

Bacterial Infections ◽

Late Onset ◽

Group B Streptococcus ◽

Clinical Manifestations ◽

Type I ◽

Csf Analysis ◽

Long Term Follow Up ◽

Group B

Abstract Background: Group B Streptococcus (GBS) is the most common pathogen responsible for perinatal bacterial infections. While the early-onset (EO) disease typically presents with pneumonia or sepsis, bacteremia and meningitis represent usual presentation of late-onset (LO) disease. Other clinical manifestations are relatively rare. Highlights: Here we describe an infant with a brain abscess due to a late-onset, GBS serotype I infection. A previously healthy 42-day-old baby presented with insufficient sucking, vomiting, irritability and fever. Cerebrospinal fluid (CSF) analysis, cultures and magnetic resonance imaging (MRI) confirmed the diagnosis of type I group B streptococcal meningitis with brain abscess. The patient made full recovery after a 4-week course of treatment with meropemen and ampicillin. No surgical drainage of the abscess was required. At a 3-year follow-up, the patient had a normal global development with no neurological sequelae. Conclusions: Brain abscess due to GBS late-onset infection is very rarely described. Furthermore, type I GBS is infrequent in late-onset disease. Therapeutic choices in these neonates are challenging because of lack of standards. A long-term follow-up of late-onset disease survivors is mandatory to exclude late developmental impairment.

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Group B Streptococcus suppression of phagocyte functions by protein-mediated engagement of human Siglec-5

Journal of Experimental Medicine ◽

10.1084/jem.20090691 ◽

2009 ◽

Vol 206 (8) ◽

pp. 1691-1699 ◽

Cited By ~ 103

Author(s):

Aaron F. Carlin ◽

Yung-Chi Chang ◽

Thomas Areschoug ◽

Gunnar Lindahl ◽

Nancy Hurtado-Ziola ◽

...

Keyword(s):

Bacterial Infections ◽

Capsular Polysaccharide ◽

Group B Streptococcus ◽

Protein Tyrosine Phosphatases ◽

Human Leukocyte ◽

Bacterial Survival ◽

Independent Manner ◽

Lectin Receptor ◽

Β Protein ◽

Group B

Group B Streptococcus (GBS) is a leading cause of invasive bacterial infections in human newborns. A key GBS virulence factor is its capsular polysaccharide (CPS), displaying terminal sialic acid (Sia) residues which block deposition and activation of complement on the bacterial surface. We recently demonstrated that GBS Sia can bind human CD33-related Sia-recognizing immunoglobulin (Ig) superfamily lectins (hCD33rSiglecs), a family of inhibitory receptors expressed on the surface of leukocytes. We report the unexpected discovery that certain GBS strains may bind one such receptor, hSiglec-5, in a Sia-independent manner, via the cell wall–anchored β protein, resulting in recruitment of SHP protein tyrosine phosphatases. Using a panel of WT and mutant GBS strains together with Siglec-expressing cells and soluble Siglec-Fc chimeras, we show that GBS β protein binding to Siglec-5 functions to impair human leukocyte phagocytosis, oxidative burst, and extracellular trap production, promoting bacterial survival. We conclude that protein-mediated functional engagement of an inhibitory host lectin receptor promotes bacterial innate immune evasion.

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Prevalence of Group B Streptococcus Colonization among Pregnant Women and Feto-Maternal Outcomes in a Tertiary Health Institution, North-Western Nigeria

Annals of Basic and Medical Sciences ◽

10.51658/abms.202122.1 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Ibrahim UA ◽

Panti AA ◽

Mohammed Y ◽

Tunau KA ◽

Adamu A ◽

...

Keyword(s):

Pregnant Women ◽

Bacterial Infections ◽

Single Case ◽

Group B Streptococcus ◽

Neonatal Resuscitation ◽

Perinatal Outcomes ◽

University Teaching ◽

Maternal Outcomes ◽

Group B ◽

Tract Infections

Background: Group B Streptococcus (GBS) infection is a major cause of bacterial infections in the peri-natal period. These include amnionitis, urinary tract infections and endometritis. At birth, 50-60% of the neonates born to colonized mothers have positive cultures taken from mucus membranes and the skin. Aim: The aim of this study is to determine prevalence of GBS colonization and compare the maternal and perinatal outcomes among GBS positive and GBS negative women within 7 days postpartum. Methodology: This was a longitudinal study among pregnant women between 35-37 weeks gestation attending antenatal clinic at Usman Danfodiyo University Teaching Hospital, Sokoto. Vaginal and rectal swabs were taken from the participants and cultured for growth of Group B Streptococcus within 24 hours. The participants were followed up to 7 days post-delivery with their newborns to determine the maternal and early neonatal outcomes. Results: One hundred and eighty five (185) women were recruited and 159 (85.9%) participants were available for follow-up to determining feto-maternal outcomes. Among the participants, 3.8% (7) had GBS vaginal colonization. There was no single case of early neonatal infection, intensive neonatal resuscitation nor neonatal mortality among both GBS positive and GBS negative women. Conclusion: It has been found that the prevalence of maternal GBS colonization during pregnancy was low and neither GBS colonization nor GBS non-colonization was associated with poor maternal or poor fetal outcomes.

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145. Liver Steatosis as a Risk Factor for Invasive Group B Streptococcus Infection in Non-Pregnant Adults

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.220 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S100-S100

Author(s):

Neven Papic ◽

Branimir Gjurasin ◽

Adriana Vince

Keyword(s):

Liver Disease ◽

Hospital Mortality ◽

Bacterial Infections ◽

Liver Steatosis ◽

Group B Streptococcus ◽

University Hospital ◽

Control Group ◽

Nonalcoholic Fatty Liver ◽

Group B ◽

The Impact

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease associated with metabolic syndrome and systemic changes in immune response. However, the impact of NAFLD on bacterial infections is unknown. Group B Streptococcus (GBS) infection is a significant cause of invasive disease among adult non-pregnant patients with high mortality rates, associated with diabetes mellitus and obesity as the most common underlying conditions. The aim of this study was to analyze the association of liver steatosis with invasive GBS disease outcomes. Methods A retrospective, cohort study of all non-pregnant adult patients diagnosed with invasive GBS infection (GBS isolated from the normally sterile site) was conducted at the University Hospital for Infectious Diseases Zagreb during a 14-year period. Results Of the 127 patients with invasive GBS, 90 had complete data and were included in the study. Disease primarily presented as bacteremia without focus (34; 37.8%), cellulitis/erysipelas (27; 30.0%), pneumonia (11; 12.2%) and endocarditis (8; 8.9%). The most common co-morbidities were diabetes (36; 40.0%), dyslipidemia (35; 38.9%), cardiovascular (32; 35.6%), peripheral vascular disease (18; 20.0%) and malignancy (16; 17.8%). Based upon the results of abdominal US the patients were divided into two groups: with steatosis (39; 43.3%) and without steatosis (51; 56.6%). The patients with liver steatosis were younger (63 ± 13 vs. 71 ± 14 years, P = 0.01), had higher AST (45.0; IQR 30–71 vs. 28.5; IQR 20–71, P = 0.047) and ALT (38; 25.5–55.5 vs. 21.5; 14–40, P = 0.009). There were no differences in clinical presentation and comorbidities between groups. The in-hospital mortality was 43.5% in patients with steatosis (17/39) and 17.6% (9/51) in control group (P = 0.009). Logistic regression analysis showed that endocarditis (OR 200.8; 95% CI 11.5–3512.5), primary bacteremia (6.5; 1.7–25.0), qSOFA ≥2 (20.2; 4.2–97.6) and liver steatosis (8.4; 2.0–35.1) were associated with in-hospital mortality. Conclusion Our findings showed that invasive GBS disease has significant mortality, which is independently associated with liver steatosis. Disclosures All authors: No reported disclosures.

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