Distribution of pilus islands of group B streptococcus associated with maternal colonization and invasive disease in South Africa

The summary in Table 1 could be used as a mental checklist for the pediatrician who examines a child with fever. Whether the pediatrician opts to "keep the rules" or appropriately decides to "break the rules," knowledge of the guidelines will help him to focus his approach and to adopt attitudes of caution in certain circumstances. The body of knowledge of infectious agents chemotherapeutic agents has burgeoned over the past 40 years; the rules have changed very little. Thus, the rules might also serve as standards against which "new discoveries" that dictate departure from an established mode of clinical practice would have to be weighed. The adage, "Name the bug before you choose a drug," is especially germaine to pediatrics. Potential pathogens or "bugs" continually change as the patient's age, exposure, and immunity change. The serious diseases they cause mandate that initial treatment be given with the best "drugs." The age-related causes of bacterial meningitis presented in Table 2 could serve as a primer for age-related causes of other invasive disease as well. For bone, joint, and soft tissue infection as well as for septicemia without a focus the age line for group B Streptococcus and H influenzae would be extended upward and S aureus would be added for all ages. Although the relative importance of each pathogen for each clinical entity might vary, therapeutic considerations would be appropriately served by a schema such as this. Unfortunately, the susceptibility of pathogens to antimicrobial agents will continue to change. Fortunately, new and potentially better therapeutic agents will continue to be discovered or invented. When new problems of antibiotic resistance emerge or when superior therapeutic modalities are proved, the pediatrician must be knowledgeable of such events and be prepared for change.

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Fatal, Fulminant and Invasive Non-Typeable Haemophilus influenzae Infection in a Preterm Infant: A Re-Emerging Cause of Neonatal Sepsis

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed5010030 ◽

2020 ◽

Vol 5 (1) ◽

pp. 30 ◽

Cited By ~ 2

Author(s):

Sudipta Roy Chowdhury ◽

Srabani Bharadwaj ◽

Suresh Chandran

Keyword(s):

Haemophilus Influenzae ◽

Preterm Infant ◽

Neonatal Sepsis ◽

Group B Streptococcus ◽

Invasive Disease ◽

Preventative Measures ◽

Increased Risk ◽

Extremely Preterm ◽

Serotype B ◽

Group B

Early-onset neonatal sepsis (EOS) is a major cause of neonatal death and long-term neurodevelopmental disabilities among survivors. The common pathogens causing EOS are group B streptococcus (GBS) and Escherichia coli. Haemophilus influenzae (H. influenzae) is a Gram-negative coccobacillus that can cause severe invasive disease and can be divided into either typeable or non-typeable strains. H. influenzae serotype b (Hib) is the most virulent and the major cause of bacterial meningitis in young children prior to routine immunization against Hib. Hib infection rates have dramatically reduced since then. However, a number of studies have reported an increasing incidence of non-typeable H. influenzae (NTHi) sepsis in neonates worldwide and concluded that pregnant women may have an increased risk to invasive NTHi disease with poor pregnancy outcomes. We present a case of fulminant neonatal sepsis caused by NTHi in an extremely preterm infant and discuss potential preventative measures to reduce its re-emergence.

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Group B Streptococcus (Streptococcus agalactiae)

10.1093/med/9780190604813.003.0019 ◽

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.

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The Italian arm of the PREPARE study: an international project to evaluate and license a maternal vaccine against group B streptococcus

Italian Journal of Pediatrics ◽

10.1186/s13052-020-00923-3 ◽

2020 ◽

Vol 46 (1) ◽

Author(s):

Alberto Berardi ◽

◽

Tiziana Cassetti ◽

Roberta Creti ◽

Caterina Vocale ◽

...

Keyword(s):

Low Income ◽

Pregnancy Outcomes ◽

Group B Streptococcus ◽

Invasive Disease ◽

Low Income Countries ◽

International Project ◽

Main Body ◽

Non Profit ◽

Maternal Vaccination ◽

Group B

Abstract Background Group B streptococcus (GBS) is a leading cause of sepsis, pneumonia and meningitis in infants, with long term neurodevelopmental sequelae. GBS may be associated with poor pregnancy outcomes, including spontaneous abortion, stillbirth and preterm birth. Intrapartum antibiotic prophylaxis (IAP) is currently the only way to prevent early-onset disease (presenting at 0 to 6 days of life), although it has no impact on the disease presenting over 6 days of life and its implementation is challenging in resource poor countries. A maternal vaccine against GBS could reduce all GBS manifestations as well as improve pregnancy outcomes, even in low-income countries. Main body The term “PREPARE” designates an international project aimed at developing a maternal vaccination platform to test vaccines against neonatal GBS infections by maternal immunization. It is a non-profit, multi-center, interventional and experimental study (promoted by the St George University of London. [UK]) with the aim of developing a maternal vaccination platform, determining pregnancy outcomes, and defining the extent of GBS infections in children and mothers in Africa. PREPARE also aims to estimate the protective serocorrelates against the main GBS serotypes that cause diseases in Europe and Africa and to conduct two trials on candidate GBS vaccines. PREPARE consists of 6 work packages. In four European countries (Italy, UK, Netherlands, France) the recruitment of cases and controls will start in 2020 and will end in 2022. The Italian PREPARE network includes 41 centers. The Italian network aims to collect: GBS isolates from infants with invasive disease, maternal and neonatal sera (cases); cord sera and GBS strains from colonized mothers whose infants do not develop GBS infection (controls). Short conclusion PREPARE will contribute information on protective serocorrelates against the main GBS serotypes that cause diseases in Europe and Africa. The vaccine that will be tested by the PREPARE study could be an effective strategy to prevent GBS disease.

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Group B Streptococcus Serotypes in Pregnant Women From the Western Cape Region of South Africa

Frontiers in Public Health ◽

10.3389/fpubh.2018.00356 ◽

2018 ◽

Vol 6 ◽

Cited By ~ 6

Author(s):

Charlene W. J. Africa ◽

Eveline Kaambo

Keyword(s):

South Africa ◽

Pregnant Women ◽

Group B Streptococcus ◽

Western Cape ◽

Group B

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Population structure of group B streptococcus from a low-incidence region for invasive neonatal disease

Microbiology ◽

10.1099/mic.0.27826-0 ◽

2005 ◽

Vol 151 (6) ◽

pp. 1875-1881 ◽

Cited By ~ 36

Author(s):

Naiel Bisharat ◽

Nicola Jones ◽

Dror Marchaim ◽

Colin Block ◽

Rosalind M. Harding ◽

...

Keyword(s):

Population Structure ◽

Disease Incidence ◽

Group B Streptococcus ◽

Invasive Disease ◽

Multilocus Genotype ◽

Neonatal Disease ◽

Strain Collection ◽

Low Incidence ◽

Group B ◽

Sequence Types

The population structure of group B streptococcus (GBS) from a low-incidence region for invasive neonatal disease (Israel) was investigated using multilocus genotype data. The strain collection consisted of isolates from maternal carriage (n=104) and invasive neonatal disease (n=50), resolving into 46 sequence types. The most prevalent sequence types were ST-1 (17·5 %), ST-19 (10·4 %), ST-17 (9·7 %), ST-22 (8·4 %) and ST-23 (6·5 %). Serotype III was the most common, accounting for 29·2 % of the isolates. None of the serotypes was significantly associated with invasive neonatal disease. burst analysis resolved the 46 sequence types into seven lineages (clonal complexes), from which only lineage ST-17, expressing serotype III only, was significantly associated with invasive neonatal disease. Lineage ST-22 expressed mainly serotype II, and was significantly associated with carriage. The distribution of the various sequence types and lineages, and the association of lineage ST-17 with invasive disease, are consistent with the results of analyses from a global GBS isolate collection. These findings could imply that the global variation in disease incidence is independent of the circulating GBS populations, and may be more affected by other risk factors for invasive GBS disease, or by different prevention strategies.

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Association between maternal Group B Streptococcus surface-protein antibody concentrations and invasive disease in their infants

Expert Review of Vaccines ◽

10.1586/14760584.2015.1085307 ◽

2015 ◽

Vol 14 (12) ◽

pp. 1651-1660 ◽

Cited By ~ 12

Author(s):

Ziyaad Dangor ◽

Gaurav Kwatra ◽

Alane Izu ◽

Peter Adrian ◽

Clare L Cutland ◽

...

Keyword(s):

Group B Streptococcus ◽

Surface Protein ◽

Invasive Disease ◽

Group B

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Galleria mellonellaas an infection model for the multi-host pathogenStreptococcus agalactiaereflects hypervirulence of ST283

10.1101/407171 ◽

2018 ◽

Author(s):

Anne Six ◽

Sakranmanee Kranjangwong ◽

Margaret Crumlish ◽

Ruth Zadoks ◽

Daniel Walker

Keyword(s):

Low Cost ◽

Group B Streptococcus ◽

Systemic Infection ◽

Invasive Disease ◽

Larval Survival ◽

Infection Model ◽

Virulence Determinants ◽

Bacterial Replication ◽

Group B ◽

Dose Dependent

AbstractStreptococcus agalactiae, or group B streptococcus (GBS), infects diverse hosts including humans, economically important livestock and fishes. In the context of human health, GBS is a major cause of neonatal infections and an emerging cause of invasive disease in adults. Here we show that GBS is able to establish a systemic infection inG. mellonellalarvae that is associated with extensive bacterial replication and dose dependent larval survival. This infection model is suitable for use with GBS isolates from both homeothermic and poikilothermic hosts and a hypervirulent sequence type (ST) associated with invasive human disease, ST283, shows increased virulence in this model, indicating it may be useful in studying GBS virulence determinants. In addition, we demonstrate that larval survival can be afforded by antibiotic treatment and so the model may also be useful in the development of novel anti-GBS strategies. The use ofG. mellonellain GBS research has the potential to provide a low cost infection model that could reduce the number of vertebrates used in the study of GBS infection.

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An empirical Bayes method for serotype case-carrier ratios, with an application to Group B streptococcus

10.1101/421412 ◽

2018 ◽

Author(s):

Joseph A. Lewnard ◽

Lauren A. Cowley

Keyword(s):

Empirical Bayes ◽

Ad Hoc ◽

Late Onset ◽

Group B Streptococcus ◽

Invasive Disease ◽

Random Effects Model ◽

Bayes Method ◽

Disease States ◽

Invasive Infections ◽

Group B

ABSTRACTBackgroundCase-carrier ratios quantifying the relative pathogenicity of serotypes can inform vaccine formulations for antigenically-diverse pathogens. However, sparse serotype-specific counts in epidemiologic datasets may undermine such analyses, most notably for rare serotypes that pose emergence risks in vaccinated populations. This challenge is well-illustrated in Group B streptococcus (GBS), where serotype III dominates in both carriage and disease.MethodsWe develop an empirical Bayes random-effects model based on conjugate Dirichlet-multinomial distributions of serotype frequencies in carriage and disease states. We validate the model using simulated datasets, and apply it to data from 15 paired sets of GBS isolates from intrapartum rectovaginal colonization (n=3403) and neonatal invasive disease (NID; n=1088), 16 from blood (n=2352) and cerebrospinal fluid (n=780) neonatal specimens, and 3 from fatal (n=173) and non-fatal (n=1684) neonatal invasive infections.ResultsOur method accurately recovers parameters in simulated datasets. Using this approach, we confirm that GBS serotype III exhibits the greatest invasiveness, followed by serotype Ia with a 75.3% (95%CrI: 43.7-93.8%) lower estimate. Enhanced invasiveness of serotypes III and Ia is most evident in late-onset disease. Non–hexavalent-vaccine serotypes, which are rare in carriage and disease, generally show lower invasiveness; serotype IX/non-typeable GBS, the most prevalent cause of non–vaccine-preventable disease, is 98.7% (81.7-99.9%) and 94.2% (13.9-99.6%) less invasive than serotypes III and Ia, respectively.ConclusionsWe present a strategy for measuring associations of serotype with carrier and disease states in the presence of sparse counts, avoiding biases that exist in common ad-hoc approaches.

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