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Shi H, Zhou M, Zhang Z, Hu Y, Song S, Hui R, Wang L, Li G, Yao L. Molecular epidemiology, drug resistance, and virulence gene analysis of Streptococcus agalactiae isolates from dairy goats in backyard farms in China. Front Cell Infect Microbiol 2023; 12:1049167. [PMID: 36699728 PMCID: PMC9868259 DOI: 10.3389/fcimb.2022.1049167] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023] Open
Abstract
Streptococcus agalactiae infections may lead to clinical or subclinical mastitis in dairy animals when it invades the mammary gland. In this study, 51 S. agalactiae strains were isolated from 305 milk samples that were collected from goats with mastitis in 13 provinces of China. The antimicrobial resistance of S. agalactiae was determined by disk diffusion methods against 18 antibiotics from six classes. In addition, multilocus sequence typing (MLST), and the presence of resistance and virulence genes was determined by PCR analysis. Seven sequence types in five clonal complexes were identified according to MLST; CC103 and CC67 strains were predominant, with rates of 45.1% and 39.2%, respectively. All isolates (100%) were multiresistant to three or more antimicrobial agents. S. agalactiae isolates had a 100% resistance rate to penicillin, oxacillin, and amoxicillin, followed by doxycycline (82.4%), tetracycline (76.5%), and amikacin (74.5%). The lowest resistance was observed for ciprofloxacin (29.4%), which varied in five different regions. The detection rates of six classes of antimicrobial-related genes were calculated as follows: 33 (64.7%) for β-lactam-related resistance gene, 12 (23.5%) for tetracyclines, 11 (21.6%) for quinolone-related resistance genes, 10 (19.6%) for aminoglycosides, 7 (13.7%) for macrolides (ermA, ermB, and mefA), and 3 (5.9%) for lincosamide (lnu(B)). Regarding virulence genes, profile 1 (bca cfb-cspA-cylE-hylB-bibA-pavA-fbsA-fbsB) was the most prevalent, with a detection rate of 54.9%. This work provides a primary source related to the molecular epidemiology of S. agalactiae in dairy goat herds in China and will aid in the clinical treatment, prevention, and control of mastitis.
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Affiliation(s)
- Hongfei Shi
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China,*Correspondence: Hongfei Shi, ; Lunguang Yao,
| | - Mengxiao Zhou
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China
| | - Zhengtian Zhang
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China
| | - Yun Hu
- College of Animal Husbandry and Medical Engineering, Nanyang Vocational College of Agriculture, Nanyang, China
| | - Shiyang Song
- Animal Husbandry and Fishery Department, Heilongjiang State 853 Farm Limited Company, Shuangyashan, China
| | - Ruiqing Hui
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China
| | - Long Wang
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China
| | - Guoguang Li
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China
| | - Lunguang Yao
- Henan Provincial Engineering and Technology Center of Animal Disease Diagnosis and Integrated Control, Henan Provincial Engineering Laboratory of Insects Bio-reactor, Nanyang Normal University, Nanyang, China,*Correspondence: Hongfei Shi, ; Lunguang Yao,
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Liu Z, Jiang X, Li J, Ji W, Zhou H, Gong X, Miao B, Meng S, Duan L, Shi Q, Han X, Gao P, Chang C, Dong A, Li J. Molecular characteristics and antibiotic resistance mechanisms of clindamycin-resistant Streptococcus agalactiae isolates in China. Front Microbiol 2023; 14:1138039. [PMID: 36937303 PMCID: PMC10014864 DOI: 10.3389/fmicb.2023.1138039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
Streptococcus agalactiae (Group B Streptococcus, GBS) is a major cause of neonatal infections with high morbidity and mortality, and clindamycin is the main antibiotic used to treat GBS infections in patients allergic to penicillin. We aimed to analyse the antibiotic sensitivity, sequence types, serotypes, virulence factors, and antibiotic resistance mechanisms of clinically isolated clindamycin-resistant S. agalactiae and provide basic data for the treatment, prevention, and control of clinical infection of S. agalactiae. A total of 110 strains of clindamycin-resistant S. agalactiae were collected from two tertiary hospitals in Hebei, China. We performed antibiotic sensitivity tests for 11 antibiotics on these strains and whole-genome sequencing analysis. All the strains were susceptible to penicillin, ampicillin, linezolid, vancomycin, tigecycline, and quinupristin-dalfopristin. Resistance to erythromycin, levofloxacin, tetracycline, and chloramphenicol were also observed. Genome sequence analysis revealed that all strains belonged to 12 sequence types (STs) related to six cloning complexes (CCs), namely CC10, CC19, CC23, CC651, CC1, and CC17. Five serotypes were identified, including IA, IB, II, III, and V. The most prominent resistance genes were mreA (100%) and ermB (81.8%). Furthermore, cfb, cylE, pavA and the gene cluster related to the pili were 100% present in all strains, followed by lmb (95.5%) and srr1 (67.2%). This study found that clindamycin-resistant S. agalactiae showed polymorphisms in molecular types and serotypes. Furthermore, multiple virulence factor genes have been identified in their genomes.
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Affiliation(s)
- Zeliang Liu
- Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Xueqi Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Jie Li
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Haijian Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Xinyi Gong
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Beibei Miao
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Shuang Meng
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Like Duan
- Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
| | - Qiyuan Shi
- Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiao Han
- Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
| | - Pengfang Gao
- Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
| | - Chienyi Chang
- Faculty of Medical Sciences, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Aiying Dong
- Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
- *Correspondence: Aiying Dong,
| | - Juan Li
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
- Juan Li,
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Zhang L, Kang WJ, Zhu L, Xu LJ, Guo C, Zhang XH, Liu QH, Ma L. Emergence of Invasive Serotype Ib Sequence Type 10 Group B Streptococcus Disease in Chinese Infants Is Driven by a Tetracycline-Sensitive Clone. Front Cell Infect Microbiol 2021; 11:642455. [PMID: 34055663 PMCID: PMC8162377 DOI: 10.3389/fcimb.2021.642455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/26/2021] [Indexed: 01/31/2023] Open
Abstract
Background Group 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. Methods We 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. Results All ST10 isolates belonged to serotype Ib; type Ib/ST10 strains were responsible for 66.7% (14/21, P < 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 < 0.05) and clinical complications (5/14, 35.7%, p < 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. Conclusions The 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.
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Affiliation(s)
- Li Zhang
- Department of Clinical Laboratory, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Wen-Juan Kang
- Department of Clinical Laboratory, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Lei Zhu
- Department of Clinical Laboratory, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Li-Jun Xu
- Department of Clinical Laboratory, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Chao Guo
- Department of Clinical Laboratory, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Xin-Hua Zhang
- Department of Neonatology Department, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Qing-Hua Liu
- Department of Pathophysiology, Shanxi Medical University, Taiyuan, China
| | - Lan Ma
- Department of Clinical Laboratory, Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital, Taiyuan, China
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Motallebirad T, Fazeli H, Jalalifar S, Shokri D, Moghim S, Nasr Esfahani B. Molecular Characterization of Hospital- and Community-Acquired Streptococcus agalactiae Isolates among Nonpregnant Adults in Isfahan, Iran. Adv Biomed Res 2021; 9:44. [PMID: 33457327 PMCID: PMC7792884 DOI: 10.4103/abr.abr_25_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/30/2020] [Accepted: 06/28/2020] [Indexed: 11/14/2022] Open
Abstract
Background: The increasing incidence of Group B Streptococcus (GBS) infection among nonpregnant adults has become of growing clinical and public health concern. The current study investigated the distribution of important virulence determinants and antibiotic susceptibility of GBS isolates causing community acquired (CA) and hospital acquired (HA) infections among nonpregnant adults. Materials and Methods: A total of 62 GBS, including 31 CA GBS and 31 HA GBS, were collected from a teaching hospital in Isfahan, Iran. Capsular polysaccharide genotypes (CPS), PI 1, PI 2a, PI 2b, and hypervirulent GBS adhesin (hvgA) virulence genes and antibiotic resistance profiling were determined. Results: There were 19 (30.6%) cases of underlying disease that diabetes mellitus (20.9%) was most common. The rate of multidrug resistant GBS strains was accounted for 29%. Distribution of macrolide resistant phenotypes was as follows: constitutive macrolides, lincosamides, and streptogramin B (MLSB) (15 isolates); inducible resistance to MLSB; and L phenotype (each 5 isolates) and M phenotype (1 isolate). V and Ia serotypes were the most predominant capsular type in HA GBS and CA GBS isolates, respectively. The most frequent pilus types were PI 1, PI 1+PI 2a, PI 1+PI 2b, and PI 2a. PI 1 and PI 1+PI 2a had significantly different distributions between CA and HA GBS isolates. Three CA GBS isolates (9.6%) were positive for hvgA gene that belonged to clonal complex 17/sequence type 17/CPS III/PI 1+PI 2b lineage. Conclusion: There was a significant difference in the distribution of PIs among CA GBS and HA GBS isolates in our region.
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Affiliation(s)
- Tahereh Motallebirad
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Fazeli
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saba Jalalifar
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Darioush Shokri
- Department of Microbiology, Faculty of Biological Sciences and Technology, Shahid Ashrafi Esfahani University, Isfahan, Iran
| | - Sharareh Moghim
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Nasr Esfahani
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Streptococcus agalactiae strains isolated from cancer patients in Rio de Janeiro, Brazil. Braz J Microbiol 2021; 52:303-310. [PMID: 33398672 DOI: 10.1007/s42770-020-00419-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022] Open
Abstract
Streptococcus agalactiae is a recognized pathogen associated with infections in neonates, elderly, and immunocompromised adults, particularly those with cancer. In the present investigation, clinical-epidemiological features, multidrug resistance profiles, and virulence genes of S. agalactiae strains isolated from cancer patients were investigated. S. agalactiae capsular distribution assays demonstrated that Ia (43.6%) and V (23.6%) types were predominantly detected among 55 clinical isolates tested; only one strain (GBS1428) was capsular type III/ST-17. The fbsB and hylB genes were detected in all isolates, while the iag, lmb, and fbsA genes were detected in 94.5%, 91%, and 91% of oncological isolates, respectively. The combination of PI-1 and PI-2a was the most common (60%) among S. agalactiae strains isolated from oncologic patients. S. agalactiae strains were resistant to tetracycline (85.5%), erythromycin (9%), and clindamycin (5.5%). Norfloxacin non-susceptible was detected in 7.3% of S. agalactiae strains. Our findings reinforce the need for S. agalactiae control measures in Brazil, including cancer patients.
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Mitsuboshi S, Date J, Tsuruma N, Yamaga H, Watanabe K, Kijima H, Nakashita M, Hosokawa H, Tsugita M. Does Quinolone- or Macrolide-Resistant Streptococcus agalactiae Bacteremia Affect Patient Outcome? A Multicenter Cohort Study. Jpn J Infect Dis 2020; 74:240-244. [PMID: 33132300 DOI: 10.7883/yoken.jjid.2020.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of quinolone- and macrolide-resistant Group B Streptococcus (GBS) is increasing worldwide, but the relationship between the resistance of GBS to these antibiotics and patient outcome remains unclear. Therefore, we evaluated whether blood stream infection caused by quinolone- or macrolide-resistant GBS is associated with high mortality. Our findings in 77 patients with GBS bacteremia demonstrate that quinolone and macrolide resistance may not be risk factors for 30-day mortality.
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Affiliation(s)
| | | | - Naoki Tsuruma
- Department of Pharmacy, Sado General Hospital, Japan
| | | | - Kazuya Watanabe
- Department of Pharmacy, Nagaoka Chuo General Hospital, Japan
| | | | | | | | - Masami Tsugita
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Sciences, Japan
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Genovese C, D'Angeli F, Di Salvatore V, Tempera G, Nicolosi D. Streptococcus agalactiae in pregnant women: serotype and antimicrobial susceptibility patterns over five years in Eastern Sicily (Italy). Eur J Clin Microbiol Infect Dis 2020; 39:2387-2396. [PMID: 32700131 PMCID: PMC7669783 DOI: 10.1007/s10096-020-03992-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/15/2020] [Indexed: 12/14/2022]
Abstract
Streptococcus agalactiae (also known Group B Streptococcus or GBS) represents the main pathogen responsible for early- and late-onset infections in newborns. The present study aimed to determine the antimicrobial susceptibility pattern and the capsular serotypes of GBS isolated in Eastern Sicily over 5 years, from January 2015 to December 2019. A total of 3494 GBS were isolated from vaginal swabs of pregnant women (37–39 weeks), as recommended by the Centers for Disease Control and Prevention. Capsular polysaccharide’s typing of GBS was determined by a commercial latex agglutination test containing reagents to serotypes I–IX. The antimicrobial resistance pattern of GBS was determined through the disk diffusion method (Kirby-Bauer) and the double-disk diffusion test on Mueller-Hinton agar plates supplemented with 5% defibrinated sheep blood, according to the guidelines of the Clinical and Laboratory Standards Institute. Serotypes III (1218, 34.9%) and V (1069, 30.6%) were the prevalent colonizers, followed by not typable (570, 16.3%) and serotypes Ia (548, 15.7%), Ib (47, 1.3%), II (40, 1.1%), and IV (2, 0.1%). All 3494 clinical isolates were susceptible to cefditoren and vancomycin. Resistance to penicillin, ampicillin, levofloxacin, clindamycin, and erythromycin was observed in 6 (0.2%), 5 (0.1%), 161 (4.6%), 1090 (31.2%), and 1402 (40.1%) of the strains, respectively. Most of erythromycin-resistant GBS (1090/1402) showed the cMLSB phenotype, 276 the M phenotype, and 36 the iMLSB phenotype. Our findings revealed a higher prevalence of serotype III and a relevant resistance rate, among GBS strains, to the most frequently used antibiotics in antenatal screening.
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Affiliation(s)
- Carlo Genovese
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Catania, 95123, Italy.,Nacture S.r.l, Spin-off University of Catania, Catania, 95123, Italy
| | - Floriana D'Angeli
- Department of Biomedical and Biotechnological Sciences, Section of Biochemistry, University of Catania, Catania, 95123, Italy. .,Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166, Rome, Italy.
| | - Valentina Di Salvatore
- Department of Biomedical and Biotechnological Sciences, Laboratory of Translational Oncology and Functional Genomics, Section of General and Clinical Pathology and Oncology, University of Catania, Catania, 95123, Italy
| | - Gianna Tempera
- Nacture S.r.l, Spin-off University of Catania, Catania, 95123, Italy
| | - Daria Nicolosi
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Catania, 95123, Italy.,Nacture S.r.l, Spin-off University of Catania, Catania, 95123, Italy
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Multidrug-Resistant Streptococcus agalactiae Strains Found in Human and Fish with High Penicillin and Cefotaxime Non-Susceptibilities. Microorganisms 2020; 8:microorganisms8071055. [PMID: 32708529 PMCID: PMC7409034 DOI: 10.3390/microorganisms8071055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/02/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022] Open
Abstract
Penicillin non-susceptible Streptococcus agalactiae (PEN-NS GBS) has been increasingly reported, with multidrug-resistant (MDR) GBS documented in Japan. Here we identified two PEN-NS GBS strains during our surveillance studies: one from a patient's wound and the other from a tilapia. The patient's GBS (H21) and fish GBS (F49) were serotyped and tested for antibiotic susceptibility. Whole-genome sequencing was performed to find the sequence type, antimicrobial resistance genes, and mutations in penicillin-binding proteins (PBPs) and fluoroquinolone (FQ) resistance genes. H21 and F49 belonged to ST651, serotype Ib, and ST7, serotype Ia, respectively. H21 showed PEN and cefotaxime minimum inhibitory concentrations (MICs) of 2.0 mg/L. F49 showed PEN MIC 0.5 mg/L. H21 was MDR with ermB, lnuB, tetS, ant6-Ia, sat4a, and aph3-III antimicrobial resistance genes observed. Alignment of PBPs showed the combination of PBP1B (A95D) and 2B mutations (V80A, S147A, S160A) in H21 and a novel mutation in F49 at N192S in PBP2B. Alignment of FQ-resistant determinants revealed mutation sites on gyrA, gyrB, and parC and E in H21. To our knowledge, this is the first report of GBS isolates with such high penicillin and cefotaxime MICs. This raises the concern of emergence of MDR and PEN-NS GBS in and beyond healthcare facilities.
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Hayes K, O'Halloran F, Cotter L. A review of antibiotic resistance in Group B Streptococcus: the story so far. Crit Rev Microbiol 2020; 46:253-269. [PMID: 32363979 DOI: 10.1080/1040841x.2020.1758626] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Group B Streptococcus (GBS) is the leading cause of neonatal disease worldwide, and invasive disease in adults is becoming more prevalent. Currently, some countries adopt an intrapartum antibiotic prophylaxis regime to help prevent the transmission of GBS from mother to neonate during delivery. This precaution has reduced the incidence of GBS-associated early-onset disease; however, rates of late-onset disease and stillbirths associated with GBS infections remain unchanged. GBS is still recognized as being universally susceptible to beta-lactam antibiotics; however, there have been reports of reduced susceptibility to beta-lactams, including penicillin, in some countries. Resistance to second-line antibiotics, such as erythromycin and clindamycin, remains high amongst GBS, with several countries noting increased resistance rates in recent years. Moreover, resistance to other antibiotic classes, such as fluoroquinolones and aminoglycosides, also continues to rise. In instances where patients are allergic to penicillin and second-line antibiotics are ineffective, vancomycin is administered. While vancomycin, a last resort antibiotic, still remains largely effective, there have been two documented cases of vancomycin resistance in GBS. This review provides a comprehensive analysis of the prevalence of antibiotic resistance in GBS and outlines the specific resistance mechanisms identified in GBS isolates to date.
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Gao K, Guan X, Zeng L, Qian J, Zhu S, Deng Q, Zhong H, Pang S, Gao F, Wang J, Long Y, Chang CY, Liu H. An increasing trend of neonatal invasive multidrug-resistant group B streptococcus infections in southern China, 2011-2017. Infect Drug Resist 2018; 11:2561-2569. [PMID: 30573985 PMCID: PMC6292236 DOI: 10.2147/idr.s178717] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background A multidrug-resistant (MDR) RR2 gene cluster was identified by whole-genome sequencing in several highly virulent (ST-17) Group B streptococcus (GBS) isolates, which caused neonatal invasive infections in southern China in 2016. Tracing the transmission and distribution of MDR isolates in this area is important for the effective management of future infections. The aim of this study was to obtain longitudinal data of MDR isolates to monitor epidemiological trends of general common isolates in southern China, and provide evidence for future characterization of antimicrobial resistance mechanisms. Methods Clinical information and antimicrobial susceptibility of GBS isolates were acquired from electronic information management system databases of the hospital under study between January 2011 and December 2017. To confirm the presence of intact RR2, the tetO, ant6, lnuB, and ant9 genes located upstream, midstream, and downstream of RR2 were detected by PCR and DNA sequencing. Results A total of 149 cases of neonatal invasive GBS infection were identified during the period 2011–2017. Among them, 119 cases (79.9%) were caused by MDR isolates, with a general increasing trend over the past 7 years. Further characterization of 11 isolates showed that six isolates causing late-onset disease (LOD) carry the tetO, ant6, and lnuB genes, which are located on RR2. Moreover, lnuB and ant9 consistently co-occurred in GBS isolates, which suggests their close proximity to one another in the RR2 gene cluster. Conclusion The MDR GBS is responsible for a large number of neonatal invasive infections and occurs with increasing frequency over time. Particularly, the MDR GBS isolates that cause LOD are more likely to carry the RR2 gene cluster, compared with those that cause early-onset disease. The rise in number of MDR GBS isolates emphasizes the pressing need for continuous surveillance to monitor their antibiotic susceptibility and epidemiology.
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Affiliation(s)
- Kankan Gao
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Xiaoshan Guan
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Lanlan Zeng
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Jiabi Qian
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Sufei Zhu
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Qiulian Deng
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Huamin Zhong
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Shuying Pang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Fei Gao
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Jielin Wang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Yan Long
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
| | - Chien-Yi Chang
- School of Chemistry and Biosciences, University of Bradford, Bradford, BD7 1DP, UK,
| | - Haiying Liu
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China,
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