scholarly journals Epidemiological Characterization of Group B Streptococcus Infections in Alberta, Canada: An Update from 2014 to 2020

2021 ◽  
Author(s):  
Angela Ma ◽  
L. Alexa Thompson ◽  
Thomas Corsiatto ◽  
Donna Hurteau ◽  
Gregory J. Tyrrell
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Content Type ◽  
Adult Disease ◽  
Invasive Infections ◽  
Group B ◽  
Epidemiological Characterization

This work describes the epidemiology of invasive infections caused by the bacterium group B Streptococcus (GBS) in Alberta, Canada. We show that rates of invasive GBS disease have increased from 2014 to 2020 for both adult disease and late-onset disease in neonates, whereas the rate of early onset disease in neonates has decreased. We also show that the rate of resistance to erythromycin (an antibiotic used to treat GBS) has also increased in this time.

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.

scholarly journals Comparison of the Panther Fusion and BD MAX Group B Streptococcus (GBS) Assays for Detection of GBS in Prenatal Screening Specimens

2019 ◽  
Vol 57 (11) ◽  
Author(s):  
Gregory J. Berry ◽  
Fan Zhang ◽  
Ryhana Manji ◽  
Stefan Juretschko
Keyword(s):  
Late Onset ◽  
Clinical Performance ◽  
Group B Streptococcus ◽  
Turnaround Time ◽  
Nucleic Acid Amplification ◽  
Kappa Statistics ◽  
Loading Capacity ◽  
Content Type ◽  
Return Visits ◽  
Group B

ABSTRACT Streptococcus agalactiae or group B Streptococcus (GBS) is the cause of early- and late-onset GBS disease in neonates and can present as septicemia, meningitis, and pneumonia. Our objective was to compare the performance of two FDA-approved nucleic acid amplification tests (NAATs), the Panther Fusion and BD MAX systems, for detection of GBS in vaginal-rectal screening specimens. A total of 510 vaginal-rectal prepartum specimens were tested simultaneously in both NAATs following broth enrichment. Assay agreement was calculated using kappa statistics. Overall agreement between assays was 99.0% (505/510; 95% confidence interval, 0.951 to 0.997; kappa = 0.974). Discordant results were retested with both assays and by standard culture. The assays were also compared for workflow characteristics, including time to first results (TFR), total turnaround time (TAT), number of return visits to load additional specimens, and hands-on time (HoT). Using a standard run size of 60 specimens/day, the Panther Fusion assay had a longer TFR (2.4 versus 2.0 h) but showed a shorter overall TAT for all 60 samples (3.98 versus 7.18 h) due to an increased initial sample loading capacity, and it required less labor (35.0 versus 71.3 s/sample) and fewer return visits for loading additional specimens (0 versus 2). The Panther Fusion system also had a larger sample loading capacity (120 versus 24 samples) and greater 8-h throughput (335 versus 96 samples). In summary, the Panther Fusion GBS assay has clinical performance comparable to that of the BD MAX GBS assay but provides a faster TAT, less HoT, and higher throughput.

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 Late Onset Streptococcus agalactiae Meningitis following Early Onset Septicemia: A Preventable Disease?

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Kam Lun Hon ◽  
King Hang Chan ◽  
Pak Long Ko ◽  
King Woon So ◽  
Alexander K. C. Leung
Keyword(s):  
Streptococcus Agalactiae ◽  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Cost Effective ◽  
Rapid Onset ◽  
Current Treatment ◽  
Effective Solution ◽  
Birth Canal ◽  
Group B

We report a neonate who presented with early onset Streptococcus agalactiae or group B streptococcus (GBS) septicemia within 24 hours of birth. After discharge at day 14, she went on to develop late onset GBS meningitis at 36 days of age. The infant was treated with intravenous antibiotics on both occasions and eventually discharged home with no apparent sequelae. We address issues associated with GBS infection in infancy including the demographics, risk factors, and the risk of late onset GBS meningitis following an early onset GBS infection. The major source of GBS in early onset GBS disease is maternal birth canal GBS colonization. On the other hand, nosocomial cross-infection is an important source of GBS in late onset disease. Penicillin remains the current treatment of choice for GBS infection. Given the rapid onset and progression within hours of birth and lack of an effective solution for preventing late onset GBS, administration of an effective GBS vaccine in pregnancy could provide a sensible and cost-effective solution in all settings.

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

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.

Group B Streptococcus

1986 ◽  
Vol 7 (S2) ◽  
pp. 135-137 ◽  
Author(s):  
Charles S.F. Easmon
Keyword(s):  
United States ◽  
Early Onset ◽  
Western Europe ◽  
Late Onset ◽  
Group B Streptococcus ◽  
The United States ◽  
Group B Streptococci ◽  
Neonatal Group ◽  
Group B ◽  
Portal Of Entry

Over the past 25 years group B streptococci have become established as one of the main bacterial pathogens of the neonate in Western Europe and the United States. The attack rate of 0.25/1,000 live births found by Mayon White in Great Britain1 appears typical of many European countries. However, in some centers in the United States attack rates can be over 10 times higher.Two types of neonatal group B streptococcus (GBS) diseases exist, “early” and “late” onset. Early onset disease usually presents within the first few days of life. Often the most serious infections are present at birth or seen within a few hours. Early onset disease presents with pneumonia, respiratory distress and shock. Bacteremia is normally present and meningitis may occur. Mortality is high (50% to 75%). The portal of entry is probably the respiratory tract. Infants normally acquire the infecting organism from their mothers. Heavy maternal and infant colonization, prolonged rupture of membranes, prematurity, and obstetric complications are all risk factors.Delayed onset disease, as its name suggests, presents after the first week of life, primarily with bacteremia and meningitis. Mortality is much lower than for the early onset form, but still appreciable for a bacterial infection (14% to 18%). Its epidemiology is uncertain.

Strategies for Preventing Neonatal Group B Streptococcal Disease

1986 ◽  
Vol 7 (S2) ◽  
pp. 137-143 ◽  
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.

scholarly journals In VitroActivity of Solithromycin against Erythromycin-Resistant Streptococcus agalactiae

2013 ◽  
Vol 58 (3) ◽  
pp. 1693-1698 ◽  
Author(s):  
Giorgio Piccinelli ◽  
Prabhavathi Fernandes ◽  
Carlo Bonfanti ◽  
Francesca Caccuri ◽  
Arnaldo Caruso ◽  
...  
Keyword(s):  
Streptococcus Agalactiae ◽  
Group B Streptococcus ◽  
Phenotypic Characterization ◽  
Content Type ◽  
Resistant Strains ◽  
Group B ◽  
Microdilution Broth

ABSTRACTThein vitroantibacterial activity of solithromycin (CEM-101) against macrolide-resistant isolates (n= 62) ofStreptococcus agalactiae(group B streptococcus [GBS]) was determined. Phenotypic characterization of macrolide-resistant strains was performed by double-disc diffusion testing. A multiplex PCR was used to identify theerm(B),erm(TR), andmef(A/E) genes, capsular genotypes, and alpha-like (Alp) protein genes from the GBS strains. Determination of MIC was carried out using the microdilution broth method. The Etest method was used for penicillin, azithromycin, clarithromycin, and erythromycin. Solithromycin had a MIC50of ≤0.008 μg/ml and a MIC90of 0.015 μg/ml against macrolide-susceptibleS. agalactiae. These MICs were lower than those displayed by penicillin (MIC50of 0.032 μg/ml and MIC90of 0.047 μg/ml), the antibiotic agent of choice for prophylaxis and treatment of GBS infections. Against macrolide-resistantS. agalactiae, solithromycin had a MIC50of 0.03 μg/ml and a MIC90of 0.125 μg/ml. Againsterm(B) strains, solithromycin had a MIC50of 0.03 μg/ml and a MIC90of 0.06 μg/ml, while againstmef(A) strains, it had a MIC50of 0.03 μg/ml and a MIC90of 0.125 μg/ml. Most erythromycin-resistant GBS strains were of serotype V (64.5%) and associated significantly withalp2-3. Moreover, a statistically significant association was observed between the constitutive macrolide-lincosamide-streptogramin B resistance (cMLSB) phenotype and theerm(B) gene-carrying strains, thealp2-3gene and the M phenotype, and themef(A/E) gene andepsilon. Overall, our results show that solithromycin had lower or similar MICs than penicillin and potent activity against macrolide-resistant strains independent of their genotype or phenotype, representing a valid therapeutic alternative where β-lactams cannot be used.

scholarly journals Molecular Characteristics of Group B Streptococci Isolated from Adults with Invasive Infections in Japan

2016 ◽  
Vol 54 (11) ◽  
pp. 2695-2700 ◽  
Author(s):  
Miyuki Morozumi ◽  
Takeaki Wajima ◽  
Misako Takata ◽  
Satoshi Iwata ◽  
Kimiko Ubukata
Keyword(s):  
Amino Acid ◽  
Group B Streptococcus ◽  
Antibiotic Use ◽  
Molecular Characteristics ◽  
Amino Acid Substitutions ◽  
Group B Streptococci ◽  
Content Type ◽  
Invasive Infections ◽  
Primary Focus ◽  
Group B

Streptococcus agalactiae(group B streptococcus) isolates (n= 443) obtained from Japanese adults with invasive infections between April 2010 and March 2013 were analyzed for capsular serotype, multilocus sequence type (ST), antibiotic susceptibility, and resistance genes. Among these cases, bacteremia without primary focus was the most common variety of infection (49.9%), followed by cellulitis (12.9%) and pneumonia (9.0%). Concerning patient age (18 to 59, 60 to 69, 70 to 79, 80 to 89, and 90 years old or older), the incidence of pneumonia increased in patients in their 70s and 80s (P< 0.001), while younger patients (18 to 59 and 60 to 69 years old) were more likely to have abscesses (P< 0.05). The mortality rate was 10.2% for all ages. The most common capsular serotype was Ib (39.5%), followed by V (16.0%), III (13.8%), VI (9.5%), and Ia (8.6%). The main ST of serotype Ib strains was ST10, which belonged to clonal complex 10 (88.0%). The predominant clonal complexes of serotypes V and III, respectively, were 1 (78.9%) and 19 (75.4%). Among these isolates, 9 strains (2.0%) were identified as group B streptococci with reduced penicillin susceptibility, reflecting amino acid substitutions in penicillin-binding protein 2X (PBP2X). In addition, 19.2% of all strains possessedmef(A/E),erm(A), orerm(B) genes, which mediate macrolide resistance, while 40.2% of strains were resistant to quinolones resulting from amino acid substitutions in GyrA and ParC. Our data argue strongly for the continuous surveillance of microbial characteristics and judicious antibiotic use in clinical practice.

Associations between capsular serotype, multilocus sequence type, and macrolide resistance inStreptococcus agalactiaeisolates from Japanese infants with invasive infections

2013 ◽  
Vol 142 (4) ◽  
pp. 812-819 ◽  
Author(s):  
M. MOROZUMI ◽  
T. WAJIMA ◽  
Y. KUWATA ◽  
N. CHIBA ◽  
K. SUNAOSHI ◽  
...  
Keyword(s):  
Clonal Complex ◽  
Vaccine Development ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Sequence Type ◽  
Macrolide Resistance ◽  
Invasive Infections ◽  
Resistant Strains ◽  
Group B ◽  
Sequence Types

SUMMARYStreptococcus agalactiae(group B streptococcus; GBS) isolates (n = 150) from infants with invasive infections between 2006 and 2011 were analysed for capsular serotype, multilocus sequence type, and antibiotic susceptibility. In cases with late-onset disease (n = 115), primary meningitis was predominant (62·6%), but represented only 39·1% in cases with early-onset disease (n = 23). The most common serotype was III (58·7%), followed by Ia (21·3%) and Ib (12·7%). Sequence types (STs) of serotype III strains included ST17 (50·0%), ST19 (26·1%), ST335 (18·2%), ST27 (4·5%), and ST1 (1·1%). Predominant STs of serotypes Ia and Ib were ST23 (81·3%) and ST10 (84·2%), respectively. No penicillin-resistant strains were detected, but 22·0% of strains hadmef(A/E),erm(A), orerm(B) genes, which mediate macrolide resistance. A new ST335, possessing anmef(A/E) gene belonging to clonal complex 19 gradually increased in frequency. Improved prevention of invasive GBS infections in infants requires timely identification, and ultimately vaccine development.

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