scholarly journals Group B streptococcal infections in infants in Iceland: clinical and microbiological factors

2021 ◽  
Vol 70 (9) ◽  
Author(s):  
Birta Baeringsdottir ◽  
Helga Erlendsdottir ◽  
Erla Soffia Bjornsdottir ◽  
Elisabete R. Martins ◽  
Mário Ramirez ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Presentation ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Surface Protein ◽  
Clinical Information ◽  
Neonatal Infections ◽  
Presenting Symptoms ◽  
Intrapartum Antibiotic ◽  
Group B

Introduction. Group B streptococcus (GBS) is a leading cause of invasive neonatal infections. These have been divided into early-onset disease (EOD; <7 days) and late-onset disease (LOD; 7–89 days), with different GBS clonal complexes (CCs) associated with different disease presentations. Hypothesis. Different GBS CCs are associated with timing of infection (EOD or LOD) and clinical presentation (sepsis, meningitis or pneumonia). Aim. To study infant GBS infections in Iceland from 1975 to 2019. Are specific GBS CCs related to disease presentation? Is CC17 overrepresented in infant GBS infections in Iceland? Methodology. All culture-confirmed invasive GBS infections in infants (<90 days) in Iceland from 1975 to 2019 were included. Clinical information was gathered from medical records. Results. A total of 127 invasive GBS infections in infants were diagnosed, but 105 infants were included in the study. Of these, 56 had EOD and 49 had LOD. The incidence of GBS infections declined from 2000 onwards but increased again at the end of the study period. Furthermore, there was a significant increase in LOD over the study period (P=0.0001). The most common presenting symptoms were respiratory difficulties and fever and the most common presentation was sepsis alone. Approximately one-third of the cases were caused by GBS CC17 of serotype III with surface protein RIB and pili PI-1+PI-2b or PI-2b. CC17 was significantly associated with LOD (P<0.001). Conclusion. CC17 is a major cause of GBS infection in infants in Iceland. This clone is associated with LOD, which has been increasing in incidence. Because intrapartum antibiotic prophylaxis only prevents EOD, it is important to continue the development of a GBS vaccine in order to prevent LOD infections.

Group B Streptococcus (Streptococcus agalactiae)

2018 ◽  
Author(s):  
Kirsty Le Doare ◽  
Christine E. Jones ◽  
Paul T. Heath
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Neonatal Infection ◽  
Significant Risk Factor ◽  
Invasive Disease ◽  
Neurodevelopmental Outcomes ◽  
Intrapartum Antibiotic ◽  
Group B

Group B Streptococcus (GBS) is a leading cause of early neonatal infection and neonatal mortality, with long-term adverse neurodevelopmental outcomes in up to 50% of survivors of GBS meningitis. GBS has a likely underappreciated role in causing preterm birth and stillbirth. GBS colonizes the vagina and gastrointestinal tract of the pregnant woman, and transmission to the infant occurs during or just before delivery. Although the majority of these infants do not develop invasive disease, maternal colonization is a prerequisite for early onset disease (0–6 days of life, most commonly associated with sepsis and respiratory distress) and a significant risk factor for late onset disease (7–89 days of life, most commonly associated with sepsis and meningitis). The introduction of intrapartum antibiotic prophylaxis has resulted in significant declines in the incidence of early onset disease but provides no protection against late onset disease.

scholarly journals The impact of group B streptococcus prophylaxis on late-onset neonatal infections

2012 ◽  
Vol 33 (3) ◽  
pp. 206-211 ◽  
Author(s):  
K L Ecker ◽  
P K Donohue ◽  
K S Kim ◽  
J A Shepard ◽  
S W Aucott
Keyword(s):  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Infections ◽  
Group B ◽  
The Impact

scholarly journals Perinatal hormones favor CC17 group B Streptococcus intestinal translocation through M cells and hypervirulence in neonates

eLife ◽  
2019 ◽  
Vol 8 ◽  
Author(s):  
Constantin Hays ◽  
Gérald Touak ◽  
Abdelouhab Bouaboud ◽  
Agnès Fouet ◽  
Julie Guignot ◽  
...  
Keyword(s):  
Late Onset ◽  
Group B Streptococcus ◽  
Intestinal Barrier ◽  
Surface Protein ◽  
Neonatal Infection ◽  
M Cells ◽  
M Cell ◽  
Hormonal Exposure ◽  
Group B ◽  
The Impact

Group B Streptococcus (GBS) is the leading cause of invasive bacterial neonatal infections. Late-onset diseases (LOD) occur between 7 and 89 days of life and are largely due to the CC17 GBS hypervirulent clone. We studied the impact of estradiol (E2) and progesterone (P4), which impregnate the fetus during pregnancy, on GBS neonatal infection in cellular and mouse models of hormonal exposure corresponding to concentrations found at birth (E2-P4 C0) and over 7 days old (E2-P4 C7). Using representative GBS isolates, we show that E2-P4 C7 concentrations specifically favor CC17 GBS meningitis following mice oral infection. CC17 GBS crosses the intestinal barrier through M cells. This process mediated by the CC17-specific surface protein Srr2 is enhanced by E2-P4 C7 concentrations which promote M cell differentiation and CC17 GBS invasiveness. Our findings provide an explanation for CC17 GBS responsibility in LOD in link with neonatal gastrointestinal tract maturation and hormonal imprint.

LATE-ONSET NEONATAL INFECTIONS CAUSED BY GROUP B STREPTOCOCCUS ASSOCIATED WITH VIRAL INFECTION

2007 ◽  
Vol 26 (10) ◽  
pp. 963-965 ◽  
Author(s):  
Josette Raymond ◽  
Jean Baptiste Armengaud ◽  
Cécile Lambe ◽  
Adelaïde Tchetchoua ◽  
Florence Moulin ◽  
...  
Keyword(s):  
Viral Infection ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Infections ◽  
Group B

scholarly journals The surface protein HvgA mediates group B streptococcus hypervirulence and meningeal tropism in neonates

2010 ◽  
Vol 207 (11) ◽  
pp. 2313-2322 ◽  
Author(s):  
Asmaa Tazi ◽  
Olivier Disson ◽  
Samuel Bellais ◽  
Abdelouhab Bouaboud ◽  
Nicolas Dmytruk ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Intestinal Barrier ◽  
Surface Protein ◽  
Oral Route ◽  
Neonatal Meningitis ◽  
Promising Target ◽  
Single Clone ◽  
Group B

Streptococcus agalactiae (group B streptococcus; GBS) is a normal constituent of the intestinal microflora and the major cause of human neonatal meningitis. A single clone, GBS ST-17, is strongly associated with a deadly form of the infection called late-onset disease (LOD), which is characterized by meningitis in infants after the first week of life. The pathophysiology of LOD remains poorly understood, but our epidemiological and histopathological results point to an oral route of infection. Here, we identify a novel ST-17–specific surface-anchored protein that we call hypervirulent GBS adhesin (HvgA), and demonstrate that its expression is required for GBS hypervirulence. GBS strains that express HvgA adhered more efficiently to intestinal epithelial cells, choroid plexus epithelial cells, and microvascular endothelial cells that constitute the blood–brain barrier (BBB), than did strains that do not express HvgA. Heterologous expression of HvgA in nonadhesive bacteria conferred the ability to adhere to intestinal barrier and BBB-constituting cells. In orally inoculated mice, HvgA was required for intestinal colonization and translocation across the intestinal barrier and the BBB, leading to meningitis. In conclusion, HvgA is a critical virulence trait of GBS in the neonatal context and stands as a promising target for the development of novel diagnostic and antibacterial strategies.

scholarly journals Group B streptococcal neonatal infections in Rio Grande do Sul, Brazil

2001 ◽  
Vol 43 (5) ◽  
pp. 243-246 ◽  
Author(s):  
Ernani MIURA ◽  
Maria Cristina MARTIN
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neurological Deficits ◽  
Neonatal Infections ◽  
Laboratory Findings ◽  
Early Onset Sepsis ◽  
Group B

Group B Streptococcus is the most common pathogen found in neonatal sepsis in North America. OBJECTIVES: We describe 15 cases of neonatal infections by Group B Streptococcus (Streptococcus agalactiae) at a Neonatal Intensive Care Unit of a public and teaching hospital. METHODS: We conducted a study at Hospital de Clínicas de Porto Alegre, from January 1st, 1996 to June 30, 1999. Diagnosis of neonatal infection was established according to the findings of Group B Streptococcus in blood culture associated with alterations resembling sepsis on the basis of clinical picture and laboratory findings. RESULTS: Fifteen cases of neonatal infections by Group B Streptococcus were detected. Eleven cases consisted of early-onset sepsis, 2 cases of occult bacteremia and 2 cases of late-onset sepsis. Eight cases had septic shock (53%), 8 cases had pneumonia (53%), and 4 cases had meningitis (27%). Fourteen cases were diagnosed from a positive blood culture, and 1 case from evidence of these bacteria in pulmonary anatomopathological examination. Thirteen cases (87%) were diagnosed before 72 hours of life. We had 3 deaths (20%), and 3 cases of meningitis developing neurological deficits. CONCLUSIONS: Streptococcus Group B is one of the most important pathogens in the etiology of early-onset neonatal sepsis at our hospital, with high mortality and morbidity. However, we do not know the incidence of GBS neonatal infections at other hospitals. More data are needed to establish a basis for trials of different strategies to reduce these infections.

scholarly journals High prevalence of group B streptococcus ST17 hypervirulent clone among non-pregnant patients from a Hungarian venereology clinic

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Szilvia Kardos ◽  
Adrienn Tóthpál ◽  
Krisztina Laub ◽  
Katalin Kristóf ◽  
Eszter Ostorházi ◽  
...  
Keyword(s):  
Genetic Relatedness ◽  
Clinical Symptoms ◽  
Strong Association ◽  
Group B Streptococcus ◽  
Surface Protein ◽  
Surface Proteins ◽  
High Prevalence ◽  
Intrapartum Antibiotic ◽  
Group B ◽  
Open Question

Abstract Background Although Streptococcus agalactiae is the leading causative agent of neonatal sepsis and meningitis, recently it is increasingly isolated from non-pregnant adults. The relation between its presence in the genitourinary tract and manifested clinical symptoms of STD patients remains an open question. In this study, a complex epidemiological investigation of GBS isolates from a venerology clinic was performed. Methods Ninety-six GBS isolates were serotyped and their genetic relatedness determined by PFGE. MLST was also performed for a subset of 20 isolates. The antibiotic susceptibility was tested with agar dilution. Surface proteins and the ST-17 hypervirulent clone was detected by PCR. Results The serotype prevalence was the following: V (29.2%), III (27.1%), Ia (22.9%), IV (10.4%), II (5.2%) and Ib (4.2%). A strong association was demonstrated between surface protein genes and serotypes. All isolates were fully susceptible to penicillin, but erythromycin and clindamycin resistance was high (41.7 and 35.4%, respectively), and 8 phenotypically macrolide sensitive isolates carried the ermB gene. 21.9% of all strains belonged to the hypervirulent ST17 clone, most being of serotype III and all were rib +. We found a few serotype IV isolates belonging to several STs and one serotype V/ST110 strain, containing a 44-bp deletion in the atr allele. Conclusions The presence of silent ermB genes is of worry, as their expression upon macrolide exposure could lead to unforeseen therapeutic failure, while clindamycin is used for intrapartum antibiotic prophylaxis, in case of penicillin allergy. The other alarming result is the high prevalence of ST17 among these strains from STD patients, who could be sources of further infections. This is the first report from Hungary providing both serotyping and genotyping data of GBS isolates. These results could be helpful for vaccine production as the major vaccine candidates are capsular antigens or surface proteins.

scholarly journals Emergence of Invasive Serotype Ib Sequence Type 10 Group B Streptococcus Disease in Chinese Infants Is Driven by a Tetracycline-Sensitive Clone

2021 ◽  
Vol 11 ◽  
Author(s):  
Li Zhang ◽  
Wen-Juan Kang ◽  
Lei Zhu ◽  
Li-Jun Xu ◽  
Chao Guo ◽  
...  
Keyword(s):  
Late Onset ◽  
Medical Center ◽  
Group B Streptococcus ◽  
Surface Protein ◽  
Sequence Type ◽  
Genetic Lineage ◽  
Clinical Complications ◽  
Invasive Infections ◽  
Severe Infections ◽  
Group B

BackgroundGroup B streptococcus (GBS) is a leading cause of serious infections in infants. The extensive use of tetracycline has led to the selection of specific resistant and infectious GBS clones. The sequence type (ST) 10 GBS strain, causing invasive infections in infants, is becoming prevalent in China. We aimed to understand the clinical and microbiological characteristics of this GBS strain.MethodsWe conducted a retrospective study on infants with invasive GBS disease from the largest women’s and children’s medical center in Shanxi and collected data between January 2017 and October 2020. GBS isolates were analyzed by capsule serotyping, genotyping, antibiotic resistance, and surface protein genes.ResultsAll ST10 isolates belonged to serotype Ib; type Ib/ST10 strains were responsible for 66.7% (14/21, P &lt; 0.05) of infant invasive GBS infections during the period and all resulted in late-onset (LOD) and late LOD disease (14/14). Infants with type Ib/ST10 GBS disease had significantly higher rates of meningitis (9/14, 64.3%, p &lt; 0.05) and clinical complications (5/14, 35.7%, p &lt; 0.05). The Ib/ST10 GBS isolates had limited genetic diversity, clustered in the CC10/bca/PI-1 + PI-2a genetic lineage, showed resistance to erythromycin, lincomycin, and fluoroquinolones and sensitivity to tetracycline, and possessed genes ermT, ermB, and amino acid changes in gyrA and parC.ConclusionsThe probable clonal expansion can result in severe infections in infants and ongoing emergence of multi-drug resistant isolates. Continued monitoring for type Ib/ST10 GBS infections is warranted.

Pyomyositis as a manifestation of late‐onset group B Streptococcus disease

2021 ◽  
Author(s):  
Akihiko Shimizu ◽  
Mariko Shimizu ◽  
Shigeru Nomura ◽  
Yoshiyuki Yamada
Keyword(s):  
Late Onset ◽  
Group B Streptococcus ◽  
Group B ◽  
Onset Group

scholarly journals Trends in molecular characteristics and antimicrobial resistance of group B streptococci: a multicenter study in Serbia, 2015–2020

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dusan Kekic ◽  
Ina Gajic ◽  
Natasa Opavski ◽  
Milan Kojic ◽  
Goran Vukotic ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Disease Rate ◽  
Molecular Characteristics ◽  
Group B Streptococci ◽  
Live Births ◽  
Invasive Infections ◽  
Group B

AbstractGroup B Streptococcus (GBS) is a major cause of neonatal morbidity and mortality. Serbia has not fully implemented preventive measures against GBS neonatal diseases. Therefore, we aimed to assess the maternal GBS colonisation and invasive neonatal disease rate, to reveal the trends of antimicrobial resistance and serotype distribution of GBS from various patient groups. Randomly selected non-invasive (n = 991) and all invasive GBS (n = 80) collected throughout Serbia from 2015 to 2020 were tested for antimicrobial susceptibility, capsular typing, and hvgA detection. Overall, 877/5621 (15.6%) pregnant women were colonised with GBS. Invasive GBS infections incidence in infants (0.18/1000 live births) showed a decreasing trend (0.3 to 0.1/1000 live births). Type III was overrepresented in infants with invasive infections (n = 35, 58.3%), whereas type V predominated among colonised adults (n = 224, 25.5%) and those with noninvasive (n = 37, 32.5%) and invasive infections (n = 8, 40%). The hypervirulent clone III/ST17 was highly associated with invasive infections (n = 28, 35%), particularly late-onset disease (n = 9, 47.4%), showing an increase from 12.3 to 14.8%. The GBS resistance to erythromycin and clindamycin was 26.7% and 22.1%, respectively, with an upward trend. The emergence of the hypervirulent clone III/ST17 and the escalation in GBS resistance highlight an urgent need for continuous monitoring of GBS infections.

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