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Scheftelowitz Cohen R, Chodik G, Eisenberg VH. Re-evaluating Perinatal Group B Streptococcal screening in Israel - Is it time for a change in policy? Prev Med 2021; 153:106716. [PMID: 34245779 DOI: 10.1016/j.ypmed.2021.106716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/10/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022]
Abstract
Group B streptococcal early-onset disease (EOGBSD) is a significant cause of morbidity and fatality in newborns. Current policy in Israel is risk-based management. Our aim was to re-evaluate the current screening policy for Group B Streptococcus (GBS), considering colonization and prevalence rates and costs estimates. This was a retrospective cohort study including term pregnancies between 2015 and 2016 insured by Maccabi Healthcare Services (MHS). A costs estimation model was performed comparing three approaches: universal culture-based screening, current policy in Israel and the current clinical scenario. Out of 54,759 pregnancies, 46.3% women undergo GBS culture-based screening. Overall GBS colonization rates in screened women were 21%. Six EOGBSD cases were identified, all offspring of mothers who were not screened. EOGBSD prevalence rate was 11 per 100,000. Universal culture-based screening was found to be 50% less costly than the current risk-based policy, and would have prevented 20.29 per 100,000 cases. Universal GBS culture-based screening was found to be more cost-effective, compared to the current policy and screening behaviors. Due to the clinical and economic benefits, we recommend that a change in policy should be considered.
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Affiliation(s)
| | - Gabriel Chodik
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Maccabitech, Maccabi Health Services, Tel Aviv, Israel
| | - Vered H Eisenberg
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
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Li L, Wang R, Huang Y, Huang T, Luo F, Huang W, Yang X, Lei A, Chen M, Gan X. High Incidence of Pathogenic Streptococcus agalactiae ST485 Strain in Pregnant/Puerperal Women and Isolation of Hyper-Virulent Human CC67 Strain. Front Microbiol 2018; 9:50. [PMID: 29467722 PMCID: PMC5808242 DOI: 10.3389/fmicb.2018.00050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 01/10/2018] [Indexed: 01/02/2023] Open
Abstract
Group B streptococcus (GBS) is the major pathogen causing diseases in neonates, pregnant/puerperal women, cows and fish. Recent studies have shown that GBS may be infectious across hosts and some fish GBS strain might originate from human. The purpose of this study is to investigate the genetic relationship of CC103 strains that recently emerged in cows and humans, and explore the pathogenicity of clinical GBS isolates from human to tilapia. Ninety-two pathogenic GBS isolates were identified from 19 patients with different diseases and their evolution and pathogenicity to tilapia were analyzed. The multilocus sequence typing revealed that clonal complex (CC) 103 strain was isolated from 21.74% (20/92) of patients and ST485 strain was from 14.13% (13/92) patients with multiple diseases including neonates. Genomic evolution analysis showed that both bovine and human CC103 strains alternately form independent evolutionary branches. Three CC67 isolates carried gbs2018-C gene and formed one evolutionary branch with ST61 and ST67 strains that specifically infect dairy cows. Studies of interspecies transmission to tilapia found that 21/92 (22.83%) isolates including all ST23 isolates were highly pathogenic to tilapia and demonstrated that streptococci could break through the blood-brain barrier into brain tissue. In conclusions, CC103 strains are highly prevalent among pathogenic GBS from humans and have evolved into the highly pathogenic ST485 strains specifically infecting humans. The CC67 strains isolated from cows are able to infect humans through evolutionary events of acquiring CC17-specific type C gbs2018 gene and others. Human-derived ST23 pathogenic GBS strains are highly pathogenic to tilapia.
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Affiliation(s)
- Liping Li
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China.,Bacteria Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Rui Wang
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China.,Institute of Animal Science and Technology, Guangxi University, Nanning, China
| | - Yan Huang
- Bacteria Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Ting Huang
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China
| | - Fuguang Luo
- Liuzhou's Aquaculture Technology Extending Station, Liuzhou, China
| | - Weiyi Huang
- Institute of Animal Science and Technology, Guangxi University, Nanning, China
| | - Xiuying Yang
- School of Public Health, National Medical College of Right Rivers, Baise, China
| | - Aiying Lei
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China
| | - Ming Chen
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China.,Bacteria Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China.,Institute of Animal Science and Technology, Guangxi University, Nanning, China
| | - Xi Gan
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China
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Health and morbidity among Bedouin women in southern Israel: a descriptive literature review of the past two decades. J Community Health 2015; 39:819-25. [PMID: 24492991 DOI: 10.1007/s10900-014-9832-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this paper we describe health and morbidity characteristics of Bedouin women in southern Israel, based on papers published over the past 20 years. This is a unique population whose customs, tradition, singular circumstances as a population "in transit", and underprivileged socio-economic status are reflected in mental illness, pregnancy course, perinatal morbidity and mortality rates, and acute and chronic disease. Recognition of these characteristics can help the medical team treat various health problems in this population as well as other populations with similar characteristics.
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Antibody-mediated complement C3b/iC3b binding to group B Streptococcus in paired mother and baby serum samples in a refugee population on the Thailand-Myanmar border. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:319-26. [PMID: 25589553 DOI: 10.1128/cvi.00803-14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Streptococcus agalactiae (group B streptococcus [GBS]) is the leading cause of neonatal sepsis and meningitis. In this study, we determined antibody-mediated deposition of complement C3b/iC3b onto the bacterial cell surface of GBS serotypes Ia, Ib, II, III, and V. This was determined for 520 mother and umbilical cord serum sample pairs obtained at the time of birth from a population on the Thailand-Myanmar border. Antibody-mediated deposition of complement C3b/iC3b was detected to at least one serotype in 91% of mothers, despite a known carriage rate in this population of only 12%. Antibody-mediated C3b/iC3b deposition corresponded to known carriage rates, with the highest levels of complement deposition observed onto the most prevalent serotype (serotype II) followed by serotypes Ia, III, V, and Ib. Finally, neonates born to mothers carrying serotype II GBS at the time of birth showed higher antibody-mediated C3b/iC3b deposition against serotype II GBS than neonates born to mothers with no serotype II carriage. Assessment of antibody-mediated C3b/iC3b deposition against GBS may provide insights into the seroepidemiology of anti-GBS antibodies in mothers and infants in different populations.
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Usein CR, Militaru M, Cristea V, Străuţ M. Genetic diversity and antimicrobial resistance in Streptococcus agalactiae strains recovered from female carriers in the Bucharest area. Mem Inst Oswaldo Cruz 2014; 109:189-96. [PMID: 24676662 PMCID: PMC4015262 DOI: 10.1590/0074-0276140431] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 01/29/2014] [Indexed: 11/23/2022] Open
Abstract
For the first time, we used multilocus sequence typing (MLST) to understand how
Romanian group B streptococcus (GBS) strains fit into the global GBS population
structure. Colonising isolates recovered from adult human females were tested for
antibiotic resistance, were molecularly serotyped based on the capsular
polysaccharide synthesis (cps) gene cluster and further
characterised using a set of molecular markers (surface protein genes, pilus-encoded
islands and mobile genetic elements inserted in the scpB-lmb
intergenic region). Pulsed-field gel electrophoresis was used to complement the MLST
clonal distribution pattern of selected strains. Among the 55 strains assigned to six
cps types (Ia, Ib, II-V), 18 sequence types (STs) were identified
by MLST. Five STs represented new entries to the MLST database. The prevalent STs
were ST-1, ST-17, ST-19 and ST-28. Twenty molecular marker profiles were identified.
The most common profiles (rib+GBSi1+PI-1,
rib+GBSi1+PI-1, PI-2b and alp2/3+PI-1, PI-2a) were
associated with the cps III/ST-17 and cps V/ST-1
strains. A cluster of fluoroquinolone-resistant strains was detected among the
cps V/ST-19 members; these strains shared alp1
and IS1548 and carried PI-1, PI-2a or both. Our results
support the usefulness of implementing an integrated genotyping system at the
reference laboratory level to obtain the reliable data required to make comparisons
between countries.
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Affiliation(s)
- Codruţa-Romaniţa Usein
- Molecular Epidemiology Laboratory, Cantacuzino National Institute of Research/Development for Microbiology and Immunology, Bucharest, Romania
| | - Mădălina Militaru
- Molecular Epidemiology Laboratory, Cantacuzino National Institute of Research/Development for Microbiology and Immunology, Bucharest, Romania
| | | | - Monica Străuţ
- Molecular Epidemiology Laboratory, Cantacuzino National Institute of Research/Development for Microbiology and Immunology, Bucharest, Romania
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Weiman S, Uchiyama S, Lin FYC, Chaffin D, Varki A, Nizet V, Lewis AL. O-Acetylation of sialic acid on Group B Streptococcus inhibits neutrophil suppression and virulence. Biochem J 2010; 428:163-8. [PMID: 20334627 PMCID: PMC3640289 DOI: 10.1042/bj20100232] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
GBS (Group B Streptococcus) requires capsular Sia (sialic acid) for virulence and partially modifies this sugar by O-acetylation. In the present paper we describe serotype-specific patterns of GBS Sia O-acetylation that can be manipulated by genetic and biochemical means. In vitro and in vivo assays demonstrate that this subtle modification attenuates GBS Sia-mediated neutrophil suppression and animal virulence.
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Affiliation(s)
- Shannon Weiman
- Department of Pediatrics, Glycobiology Research and Training Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093-0687, U.S.A
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Population structure of human isolates of Streptococcus agalactiae from Dakar and Bangui. J Clin Microbiol 2008; 47:800-3. [PMID: 19109468 DOI: 10.1128/jcm.01103-08] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Multilocus sequence types of 163 human Streptococcus agalactiae strains isolated in Bangui and Dakar were analyzed. We identified local specificities in the distribution of sequence types and capsular serotypes. However, the overall population structure is similar to that in the United States and Europe, suggesting that few specific clones colonize humans.
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Slotved HC, Kong F, Lambertsen L, Sauer S, Gilbert GL. Serotype IX, a Proposed New Streptococcus agalactiae Serotype. J Clin Microbiol 2007; 45:2929-36. [PMID: 17634306 PMCID: PMC2045254 DOI: 10.1128/jcm.00117-07] [Citation(s) in RCA: 169] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 03/30/2007] [Accepted: 07/06/2007] [Indexed: 11/20/2022] Open
Abstract
We identified three isolates of Streptococcus agalactiae (group B streptococcus [GBS]), of human origin, which failed to react with antisera against any of the nine known GBS serotypes. Polyclonal rabbit antisera raised against these isolates and standard GBS typing sera were used in capillary precipitation and Ouchterlony tests to compare the strains with known GBS serotype reference strains. All three previously nontypeable isolates reacted with all three new antisera, producing lines of identity in the Ouchterlony test. Weak cross-reactions with antisera against several GBS serotypes were observed but were removed by absorption with corresponding antigens. The new antisera were used to test 227 GBS isolates that had been nontypeable or difficult to type using standard antisera. Of these, five reacted with the new antisera. These results suggested that all eight isolates belong to the previously unrecognized GBS serotype. They were tested by Western blotting for the Calpha and Cbeta proteins and by PCR to identify molecular serotypes and surface protein antigen genes. Two segments of the cps gene cluster (3' end of cpsE-cpsF and 5' end of cpsG, approximately 700 bp; 3' end of cpsH and 5' end of cpsM, approximately 560 bp) were sequenced. All eight isolates expressed Calpha, and seven expressing the Cbeta protein and the corresponding genes, bca and bac, respectively, were identified. They all share the same, unique partial cps sequence. These results indicate that these eight isolates represent a new S. agalactiae serotype, which we propose should be designated serotype IX.
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Affiliation(s)
- Hans-Christian Slotved
- Neisseria and Streptococcus Reference Laboratory, Department for Bacteriology, Mycology and Parasitology, Statens Serum Institut, Copenhagen, Denmark.
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