Immunogenic Proteins of Group B Streptococcus—Potential Antigens in Immunodiagnostic Assay for GBS Detection

Streptococcus agalactiae (Group B Streptococcus, GBS) is an opportunistic pathogen, which asymptomatically colonizes the gastrointestinal and genitourinary tract of up to one third of healthy adults. Nevertheless, GBS carriage in pregnant women may lead to several health issues in newborns causing life threatening infection, such as sepsis, pneumonia or meningitis. Recommended GBS screening in pregnant women significantly reduced morbidity and mortality in infants. Nevertheless, intrapartum antibiotic prophylaxis, recommended following the detection of carriage or in case of lack of a carriage test result for pregnant women who demonstrate certain risk factors, led to the expansion of the adverse phenomenon of bacterial resistance to antibiotics. In our paper, we reviewed some immunogenic GBS proteins, i.e., Alp family proteins, β protein, Lmb, Sip, BibA, FsbA, ScpB, enolase, elongation factor Tu, IMPDH, and GroEL, which possess features characteristic of good candidates for immunodiagnostic assays for GBS carriage detection, such as immunoreactivity and specificity. We assume that they can be used as an alternative diagnostic method to the presently recommended bacteriological cultivation and MALDI.

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Developing a serocorrelate of protection against invasive group B streptococcus disease in pregnant women: a feasibility study

Health Technology Assessment ◽

10.3310/hta23670 ◽

2019 ◽

Vol 23 (67) ◽

pp. 1-40 ◽

Cited By ~ 1

Author(s):

Clara Carreras-Abad ◽

Madeleine Cochet ◽

Tom Hall ◽

Laxmee Ramkhelawon ◽

Asma Khalil ◽

...

Keyword(s):

Pregnant Women ◽

Feasibility Study ◽

Group B Streptococcus ◽

Serotype Distribution ◽

Invasive Group ◽

Streptococcal Disease ◽

Group B Streptococcal Disease ◽

Intrapartum Antibiotic ◽

Group B ◽

Operational Aspects

Background Group B streptococcus is the leading cause of infection in infants. Currently, intrapartum antibiotic prophylaxis is the major strategy to prevent invasive group B streptococcus disease. However, intrapartum antibiotic prophylaxis does not prevent maternal sepsis, premature births, stillbirths or late-onset disease. Maternal vaccination may offer an alternative strategy. Multivalent polysaccharide protein conjugate vaccine development is under way and a serocorrelate of protection is needed to expedite vaccine licensure. Objectives The ultimate aim of this work is to determine the correlate of protection against the major group B streptococcus disease-causing serotypes in infants in the UK. The aim of this feasibility study is to test key operational aspects of the study design. Design Prospective cohort study of pregnant women and their infants in a 6-month period (1 July to 31 December 2018). Setting Five secondary and tertiary hospitals from London and South England. National iGBS disease surveillance was conducted in all trusts in England and Wales. Participants Pregnant women aged ≥ 18 years who were delivering at one of the selected hospitals and who provided consent during the study period. There were no exclusion criteria. Interventions No interventions were performed. Main outcome measures (1) To test the feasibility of collecting serum at delivery from a large cohort of pregnant women. (2) To test the key operational aspects for a proposed large serocorrelates study. (3) To test the feasibility of collecting samples from those with invasive group B streptococcus. Results A total of 1823 women were recruited during the study period. Overall, 85% of serum samples were collected at three sites collecting only cord blood. At the two sites collecting maternal, cord and infant blood samples, the collection rate was 60%. A total of 614 women were screened for group B streptococcus with a colonisation rate of 22% (serotype distribution: 30% III, 25% Ia, 16% II, 14% Ib, 14% V and 1% IV). A blood sample was collected from 34 infants who were born to colonised women. Maternal and infant blood and the bacterial isolates for 15 newborns who developed invasive group B streptococcal disease during the study period were collected (serotype distribution: 29% III, 29% II, 21% Ia, 7% Ib, 7% IV and 7% V). Limitations Recruitment and sample collection were dependent on the presence of research midwives rather than the whole clinical team. In addition, individualised consent limited the number of women who could be approached each day, and site set-up for the national surveillance study and the limited time period of this feasibility study limited recruitment of all eligible participants. Conclusions We have verified the feasibility of collecting and processing rectovaginal swabs and blood samples in pregnant women, as well as samples from those with invasive group B streptococcal disease. We have made recommendations for the recruitment of cases within the proposed GBS3 study and for controls both within GBS3 and as an extension of this feasibility study. Future work A large case–control study comparing specific immunoglobulin G levels in mothers whose infants develop invasive group B streptococcal disease with those in colonised mothers whose infants do not develop invasive group B streptococcal disease is recommended. Trial registration Current Controlled Trials ISRCTN49326091; IRAS project identification number 246149/REC reference number 18/WM/0147. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 67. See the NIHR Journals Library website for further project information.

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Prevalence and antibiotic sensitivity of Group B Streptococcus (GBS) infection among antenatal women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181475 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1768

Author(s):

Nishita Shettian ◽

Shetty Theertha Shankar ◽

Manjunath Kamath Ammembal

Keyword(s):

Pregnant Women ◽

Group B Streptococcus ◽

Antibiotic Sensitivity ◽

Neonatal Morbidity ◽

Vaginal Swab ◽

Drug Of Choice ◽

Nasal Swabs ◽

Vaginal Swabs ◽

Life Threatening ◽

Group B

Background: Group B Streptococcus (GBS) infection in pregnant women is a major concern as it causes septicemia in neonates which is fatal and potentially life threatening. Objectives of present study were to study the distribution of Group B streptococcus infection among pregnant women at term, to understand if penicillin is still effective as the drug of choice, to determine the alternate drug of choice in women with Group B streptococcus infection if resistant to penicillin and analyze the proportion of Group B Streptococcus infection as a vaginal commensal.Methods: This is a hospital based prospective study comprising of 350 pregnant women at term gestation. Vaginal swabs as well as neonatal nasal swabs following delivery were collected under aseptic precautions and sent for culture and sensitivity.Results: Vaginal swab culture reports of 308 women out of 350 showed a growth. Candida albicans (23.8%), Enterococcus (5.6%), Escherichia coli (4.2%), MRSA (4.2%), Staphylococcus aureus (1.4%) and Group B Streptococcus (1.4%) were the organisms isolated. Penicillin is still the drug of choice for group B Streptococcal infection in antenatal women with Linezolid being the alternate drug of choice. None of the neonatal nasal swabs revealed any growth on culture and sensitivity.Conclusions: This study does not recommend routine screening for Group B Streptococcus in all pregnant women unless they have a positive history in previous pregnancies. Our study also revealed various other organisms which could be responsible for increasing the risk of maternal and neonatal morbidity.

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Uncertainties in Screening and Prevention of Group B Streptococcus Disease

Clinical Infectious Diseases ◽

10.1093/cid/ciy1069 ◽

2018 ◽

Vol 69 (4) ◽

pp. 720-725 ◽

Cited By ~ 2

Author(s):

Kirsty Le Doare ◽

Paul T Heath ◽

Jane Plumb ◽

Natalie A Owen ◽

Peter Brocklehurst ◽

...

Keyword(s):

Pregnant Women ◽

Point Of Care ◽

Group B Streptococcus ◽

Research Priorities ◽

Term Infant ◽

Department Of Health ◽

Health And Social Care ◽

Intrapartum Antibiotic ◽

Group B ◽

The Impact

Abstract In autumn 2016, the UK Department of Health (now Department of Health and Social Care) convened 2 meetings to discuss how to address research evidence gaps in order to minimize the impact of infant group B streptococcus (GBS) disease in the United Kingdom. At that meeting, a number of research priorities were highlighted, including improving the screening for GBS colonization in pregnant women, offering intrapartum antibiotic prophylaxis and point-of-care testing, and understanding the effect of widespread intrapartum antibiotic use on long-term infant health. Further discussions involved investigating the feasibility of a large prospective study of pregnant women and their infants in order to understand the role of antibodies in the protection against GBS disease in infancy following maternal exposure to GBS colonization. Here, we summarize the research uncertainties identified at that meeting.

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Maternal Group B Streptococcus colonisation

Microbiology Australia ◽

10.1071/ma17049 ◽

2017 ◽

Vol 38 (3) ◽

pp. 134

Author(s):

Lucy Furfaro ◽

Barbara Chang ◽

Matthew Payne

Keyword(s):

Pregnant Women ◽

Capsular Polysaccharide ◽

Group B Streptococcus ◽

Bacteriophage Therapy ◽

Treatment Regimens ◽

Vaginal Swabs ◽

Minimal Data ◽

Intrapartum Antibiotic ◽

Group B ◽

Western Australian

Streptococcus agalactiae, commonly known as Group B Streptococcus (GBS), is an important neonatal pathogen known to cause sepsis, meningitis and pneumonia. Australian pregnant women undergo screening during pregnancy in an effort to eradicate GBS before delivery where transmission to the neonate can occur. Preventative treatment includes intrapartum antibiotic prophylaxis and results in widespread treatment of the 10–40% of pregnant women colonised. GBS are separated into ten different capsular polysaccharide serotypes and previous studies have suggested associations between specific serotypes and disease. At present, however, minimal data exist on serotype distribution within Western Australian-pregnant women, information that may play an important role in future prophylactic treatment regimens. Our preliminary data, obtained from GBS isolated from vaginal swabs from 191 pregnant women, suggests that GBS serotype distributions in Western Australia are different to other parts of Australasia. In particular, compared to the eastern Australian states and New Zealand, in our cohort, serotype Ib prevalence was 7–17 times lower, II was 2–6 times greater and VI was 2–12 times greater. In addition, serotype IX represented 6.3% of all serotypes. Understanding which serotypes are present in our population will provide valuable data for future targeted treatment regimens such as vaccination and bacteriophage therapy.

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Clinical and Microbiological Characteristics of Group B Streptococcus from Pregnant Women and Diseased Infants in Intrapartum Antibiotic Prophylaxis Era in Taiwan

Scientific Reports ◽

10.1038/s41598-019-49977-2 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Chien-Chung Lee ◽

Jen-Fu Hsu ◽

Rajendra Prasad Janapatla ◽

Chyi-Liang Chen ◽

Ying-Li Zhou ◽

...

Keyword(s):

Antibiotic Prophylaxis ◽

Pregnant Women ◽

Group B Streptococcus ◽

Intrapartum Antibiotic Prophylaxis ◽

Microbiological Characteristics ◽

Intrapartum Antibiotic ◽

Group B

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Group B Streptococcus CAMP Factor Does Not Contribute to Interactions with the Vaginal Epithelium and Is Dispensable for Vaginal Colonization in Mice

Microbiology Spectrum ◽

10.1128/spectrum.01058-21 ◽

2021 ◽

Author(s):

Mallory B. Ballard ◽

Vicki Mercado-Evans ◽

Madelynn G. Marunde ◽

Hephzibah Nwanosike ◽

Jacob Zulk ◽

...

Keyword(s):

Preterm Birth ◽

Antibiotic Prophylaxis ◽

Pregnant Women ◽

Group B Streptococcus ◽

Vaginal Epithelium ◽

Content Type ◽

Vaginal Colonization ◽

Camp Factor ◽

Intrapartum Antibiotic ◽

Group B

Group B Streptococcus (GBS) remains a pervasive pathogen for pregnant women and their newborns. Maternal screening and intrapartum antibiotic prophylaxis to GBS-positive mothers have reduced, but not eliminated GBS neonatal disease, and have not impacted GBS-associated preterm birth or stillbirth.

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Biomarkers for a histological chorioamnionitis diagnosis in pregnant women with or without group B streptococcus infection: a case-control study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03731-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jie Ren ◽

Zhe Qiang ◽

Yuan-yuan Li ◽

Jun-na Zhang

Keyword(s):

Cord Blood ◽

Pregnant Women ◽

Peripheral Blood ◽

Group B Streptococcus ◽

Diagnostic Value ◽

Adverse Outcomes ◽

Intercellular Adhesion Molecule ◽

Tnf Α ◽

Group B ◽

The Impact

Abstract Background Chorioamnionitis may cause serious perinatal and neonatal adverse outcomes, and group B streptococcus (GBS) is one of the most common bacteria isolated from human chorioamnionitis. The present study analyzed the impact of GBS infection and histological chorioamnionitis (HCA) on pregnancy outcomes and the diagnostic value of various biomarkers. Methods Pregnant women were grouped according to GBS infection and HCA detection. Perinatal and neonatal adverse outcomes were recorded with a follow-up period of 6 weeks. The white blood cell count (WBC), neutrophil ratio, and C-reactive protein (CRP) level from peripheral blood and soluble intercellular adhesion molecule-1 (sICAM-1), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α) levels from cord blood were assessed. Results A total of 371 pregnant women were included. Pregnant women with GBS infection or HCA had a higher risk of pathological jaundice and premature rupture of membranes and higher levels of sICAM-1, IL-8, and TNF-α in umbilical cord blood. Univariate and multivariate regression analysis revealed that sICMA-1, IL-8, TNF-α, WBC, and CRP were significantly related to an increased HCA risk. For all included pregnant women, TNF-α had the largest receiver operating characteristic (ROC) area (area: 0.841; 95% CI: 0.778–0.904) of the biomarkers analyzed. TNF-α still had the largest area under the ROC curve (area: 0.898; 95% CI: 0.814–0.982) for non-GBS-infected pregnant women, who also exhibited a higher neutrophil ratio (area: 0.815; 95% CI: 0.645–0.985) and WBC (area: 0.849; 95% CI: 0.72–0.978), but all biomarkers had lower value in the diagnosis of HCA in GBS-infected pregnant women. Conclusion GBS infection and HCA correlated with several perinatal and neonatal adverse outcomes. TNF-α in cord blood and WBCs in peripheral blood had diagnostic value for HCA in non-GBS-infected pregnant women but not GBS-infected pregnant women.

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Poor Adherence to the Screening-Based Strategy of Group B Streptococcus Despite Colonization of Pregnant Women in Greece

Pathogens ◽

10.3390/pathogens10040418 ◽

2021 ◽

Vol 10 (4) ◽

pp. 418

Author(s):

Maria Maroudia Berikopoulou ◽

Aikaterini Pana ◽

Theodota Liakopoulou-Tsitsipi ◽

Nikos F. Vlahos ◽

Vasiliki Papaevangelou ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Pregnant Women ◽

Late Onset ◽

Group B Streptococcus ◽

Culture Collection ◽

Carrier Status ◽

Cross Sectional ◽

Screening Guidelines ◽

Group B

Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks’ gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients’ records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures (p = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.

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