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Chen Y, Liu L, Liu J, Ji T, Gao Y, Yang D, Zhao M, Zhai Y, Cao Z. Serotype distribution, antimicrobial resistance, and molecular characterization of group B Streptococcus isolates from Chinese pregnant woman. J Matern Fetal Neonatal Med 2024; 37:2295805. [PMID: 38124302 DOI: 10.1080/14767058.2023.2295805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study was aimed to investigate the serotypes, antibiotic susceptibilities, and multi-locus sequence type (MLST) profiles of group B Streptococcus (GBS) in the Beijing area. METHODS Lower vaginal and rectal swabs were obtained from pregnant women of 35-37 gestational weeks (GWs) who attended the Beijing Obstetrics and Gynecology Hospital. All GBS isolates were identified with Gram staining, catalase reaction assays, and CAMP tests, followed by antibiotic susceptibility testing, serotype identification, multilocus sequence typing and erythromycin resistance gene analysis (ermB and mefE). RESULTS From July 2020 to June 2022, 311 (5.17%) of 6012 pregnant women that were screened for GBS colonization were detected positive. Of the eight serotypes identified (III, Ia, Ib, IV, II, VIII, V, and NT), serotypes III (43.09%), Ia (34.08%) and Ib (17.04%) were the predominant species. In the antimicrobial susceptibility experiments, the resistant rates measured for erythromycin, clindamycin, levofloxacin, and tetracycline were 76.21%, 63.99%, 50.80%, and 81.03%, respectively, and 7.6% of GBS isolates showed inducible clindamycin in resistance (D-test phenotype). Meanwhile, the multilocus sequence typing analysis showed that sequence type 19 (ST19) (30.34%) and ST10 (18.62%) were the dominant sequence types. Among the 237 erythromycin-resistant isolates, 176 harbored ermB (128, 54.00%) or mefE (48, 20.30%) gene alone. CONCLUSION The infection rates, serotypes or MSLT distribution, and antimicrobial resistance of GBS in Beijing area were investigated, which may be applied in analyses of the epidemiological characteristics of GBS. This contributes to the basic knowledge required for successful GBS vaccine development suited for disease prevention and treatment in China, as well as the implementation of effective clinical antimicrobials.
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Affiliation(s)
- Yifei Chen
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lin Liu
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jing Liu
- Laboratory Department of Tsinghua University Hospital, Beijing, China
| | - Tongzhen Ji
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yang Gao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Dongmei Yang
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Mohan Zhao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yanhong Zhai
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zheng Cao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
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Oliveira LMA, Simões LC, Crestani C, Costa NS, Pantoja JCF, Rabello RF, Fracalanzza SEL, Teixeira LM, Khan UB, Jamrozy D, Bentley S, Pinto TCA, Zadoks RN. Group B Streptococcus Sequence Type 103 as Human and Bovine Pathogen, Brazil. Emerg Infect Dis 2024; 30:1697-1701. [PMID: 39043455 PMCID: PMC11286041 DOI: 10.3201/eid3008.231575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Abstract
Group B Streptococcus sequence type 103 is known primarily as a bovine mastitis pathogen. In Brazil, it has circulated in cattle and humans since the 1990s. It lacks scpB and, in humans, was found only among carriage isolates. Bovine-human interspecies transmission may have contributed to its evolution and spread.
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Crestani C, Forde TL, Bell J, Lycett SJ, Oliveira LMA, Pinto TCA, Cobo-Ángel CG, Ceballos-Márquez A, Phuoc NN, Sirimanapong W, Chen SL, Jamrozy D, Bentley SD, Fontaine M, Zadoks RN. Genomic and functional determinants of host spectrum in Group B Streptococcus. PLoS Pathog 2024; 20:e1012400. [PMID: 39133742 PMCID: PMC11341095 DOI: 10.1371/journal.ppat.1012400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/22/2024] [Accepted: 07/08/2024] [Indexed: 08/24/2024] Open
Abstract
Group B Streptococcus (GBS) is a major human and animal pathogen that threatens public health and food security. Spill-over and spill-back between host species is possible due to adaptation and amplification of GBS in new niches but the evolutionary and functional mechanisms underpinning those phenomena are poorly known. Based on analysis of 1,254 curated genomes from all major GBS host species and six continents, we found that the global GBS population comprises host-generalist, host-adapted and host-restricted sublineages, which are found across host groups, preferentially within one host group, or exclusively within one host group, respectively, and show distinct levels of recombination. Strikingly, the association of GBS genomes with the three major host groups (humans, cattle, fish) is driven by a single accessory gene cluster per host, regardless of sublineage or the breadth of host spectrum. Moreover, those gene clusters are shared with other streptococcal species occupying the same niche and are functionally relevant for host tropism. Our findings demonstrate (1) the heterogeneity of genome plasticity within a bacterial species of public health importance, enabling the identification of high-risk clones; (2) the contribution of inter-species gene transmission to the evolution of GBS; and (3) the importance of considering the role of animal hosts, and the accessory gene pool associated with their microbiota, in the evolution of multi-host bacterial pathogens. Collectively, these phenomena may explain the adaptation and clonal expansion of GBS in animal reservoirs and the risk of spill-over and spill-back between animals and humans.
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Affiliation(s)
- Chiara Crestani
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Taya L. Forde
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - John Bell
- Moredun Research Institute, Penicuik, Scotland, United Kingdom
| | - Samantha J. Lycett
- The Roslin Institute, University of Edinburgh, Midlothian, Scotland, United Kingdom
| | - Laura M. A. Oliveira
- Instituto de Microbiologia Paulo de Goes, Federal University of Rio de Janeiro, Rio de Janeiro, State of Rio de Janeiro, Brazil
| | - Tatiana C. A. Pinto
- Instituto de Microbiologia Paulo de Goes, Federal University of Rio de Janeiro, Rio de Janeiro, State of Rio de Janeiro, Brazil
| | | | | | - Nguyen N. Phuoc
- Faculty of Fisheries, University of Agriculture and Forestry, Hue University, Hue, Vietnam
| | - Wanna Sirimanapong
- Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Swaine L. Chen
- Infectious Diseases Translational Research Programme, Department of Medicine, Division of Infectious Diseases, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Laboratory of Bacterial Genomics, Genome Institute of Singapore, Singapore
| | - Dorota Jamrozy
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, England, United Kingdom
| | - Stephen D. Bentley
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, England, United Kingdom
| | | | - Ruth N. Zadoks
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
- Moredun Research Institute, Penicuik, Scotland, United Kingdom
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, NSW, Australia
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Pena JMS, Lannes-Costa PS, Nagao PE. Vaccines for Streptococcus agalactiae: current status and future perspectives. Front Immunol 2024; 15:1430901. [PMID: 38947337 PMCID: PMC11211565 DOI: 10.3389/fimmu.2024.1430901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/06/2024] [Indexed: 07/02/2024] Open
Abstract
A maternal vaccine to protect newborns against invasive Streptococcus agalactiae infection is a developing medical need. The vaccine should be offered during the third trimester of pregnancy and induce strong immune responses and placental transfer of protective antibodies. Polysaccharide vaccines against S. agalactiae conjugated to protein carriers are in advanced stages of development. Additionally, protein-based vaccines are also in development, showing great promise as they can provide protection regardless of serotype. Furthermore, safety concerns regarding a new vaccine are the main barriers identified. Here, we present vaccines in development and identified safety, cost, and efficacy concerns, especially in high-need, low-income countries.
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Affiliation(s)
- João Matheus Sobral Pena
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
| | - Pamella Silva Lannes-Costa
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
| | - Prescilla Emy Nagao
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University - UERJ, Rio de Janeiro, Brazil
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De Gaetano GV, Lentini G, Coppolino F, Famà A, Pietrocola G, Beninati C. Engagement of α 3β 1 and α 2β 1 integrins by hypervirulent Streptococcus agalactiae in invasion of polarized enterocytes. Front Microbiol 2024; 15:1367898. [PMID: 38511003 PMCID: PMC10951081 DOI: 10.3389/fmicb.2024.1367898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
The gut represents an important site of colonization of the commensal bacterium Streptococcus agalactiae (group B Streptococcus or GBS), which can also behave as a deadly pathogen in neonates and adults. Invasion of the intestinal epithelial barrier is likely a crucial step in the pathogenesis of neonatal infections caused by GBS belonging to clonal complex 17 (CC17). We have previously shown that the prototypical CC17 BM110 strain invades polarized enterocyte-like cells through their lateral surfaces using an endocytic pathway. By analyzing the cellular distribution of putative GBS receptors in human enterocyte-like Caco-2 cells, we find here that the alpha 3 (α3) and alpha 2 (α2) integrin subunits are selectively expressed on lateral enterocyte surfaces at equatorial and parabasal levels along the vertical axis of polarized cells, in an area corresponding to GBS entry sites. The α3β1 and α2β1 integrins were not readily accessible in fully differentiated Caco-2 monolayers but could be exposed to specific antibodies after weakening of intercellular junctions in calcium-free media. Under these conditions, anti-α3β1 and anti-α2β1 antibodies significantly reduced GBS adhesion to and invasion of enterocytes. After endocytosis, α3β1 and α2β1 integrins localized to areas of actin remodeling around GBS containing vacuoles. Taken together, these data indicate that GBS can invade enterocytes by binding to α3β1 and α2β1 integrins on the lateral membrane of polarized enterocytes, resulting in cytoskeletal remodeling and bacterial internalization. Blocking integrins might represent a viable strategy to prevent GBS invasion of gut epithelial tissues.
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Affiliation(s)
| | - Germana Lentini
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Francesco Coppolino
- Department of Biomedical, Dental and Imaging Sciences, University of Messina, Messina, Italy
| | - Agata Famà
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Giampiero Pietrocola
- Department of Molecular Medicine, Biochemistry Section, University of Pavia, Pavia, Italy
| | - Concetta Beninati
- Department of Human Pathology, University of Messina, Messina, Italy
- Scylla Biotech Srl, Messina, Italy
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6
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Vaz MJ, Dongas S, Ratner AJ. Capsule production promotes Group B Streptococcus intestinal colonization. Microbiol Spectr 2023; 11:e0234923. [PMID: 37732775 PMCID: PMC10655599 DOI: 10.1128/spectrum.02349-23] [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: 06/08/2023] [Accepted: 07/25/2023] [Indexed: 09/22/2023] Open
Abstract
Late-onset disease is the most common clinical presentation of Group B Streptococcus (GBS) infection during infancy, and gastrointestinal (GI) colonization is an important precursor. Previously, we described a murine model of postnatal GBS GI colonization that resulted in sustained colonization and progression to invasive disease. Capsular polysaccharide is an important GBS virulence factor. Vaccines based on a subset of capsular serotypes are in clinical trials. However, little is known regarding the role of specific GBS capsular serotypes in GI colonization. We examined the role of GBS capsule in GI colonization using capsule-producing and acapsular strains derived from GBS strain A909 (serotype Ia) in a murine model. Using isogenic GBS strains differing only in capsular serotypes, we explored the role of specific serotypes in GI colonization by determining competitive indices during cocolonization. We found that GBS A909 colonizes the murine GI tract without causing invasive disease. In monocolonization experiments, there was colonization persistence with the capsule-producing strain (100%) compared to the acapsular mutant strain (13%). In cocolonization experiments, the capsule-producing strain outcompeted its isogenic acapsular mutant, with a geometric mean competitive index of 8, 95% confidence interval (CI) [1.7, 38.9] in the colon at 7 days post-colonization. A909 expressing its native serotype Ia capsule outcompeted an isogenic mutant that expresses serotype III capsule, with a geometric mean competitive index of 2.5, 95% CI [1.2, 5.1] in the colon at 7 days post-colonization. Thus, polysaccharide capsule production enhances GBS GI colonization in vivo. In an A909 genetic background, the production of a serotype Ia capsule provides a competitive advantage over an isogenic strain producing type III capsule. The murine model is a valuable tool to understand the role of GBS capsule types in GI colonization. IMPORTANCE The establishment of GBS intestinal colonization is believed to be a critical precursor to late-onset disease in neonates, which has a significant impact on neurodevelopment outcomes in this population. Our prior work described a murine model of postnatal Group B Streptococcus (GBS) acquisition and invasive disease. Using this model, we explored the importance of GBS polysaccharide capsule production on gastrointestinal colonization. We found that the expression of capsule (compared to isogenic acapsular strains) provides an advantage in intestinal colonization and, importantly, that capsule type Ia has an advantage over capsule type III in a GBS A909 strain background. We speculate that specific serotypes may differ in colonization fitness, which may play a role in serotype distribution in neonatal disease.
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Affiliation(s)
- Michelle J. Vaz
- Department of Pediatrics, NYU School of Medicine, New York, New York, USA
| | - Sophia Dongas
- Department of Pediatrics, NYU School of Medicine, New York, New York, USA
| | - Adam J. Ratner
- Department of Pediatrics, NYU School of Medicine, New York, New York, USA
- Department of Microbiology, NYU School of Medicine, New York, New York, USA
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7
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Kayansamruaj P, Dinh-Hung N, Srisapoome P, Na-Nakorn U, Chatchaiphan S. Genomics-driven prophylactic measures to increase streptococcosis resistance in tilapia. JOURNAL OF FISH DISEASES 2023; 46:597-610. [PMID: 36708284 DOI: 10.1111/jfd.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 05/07/2023]
Abstract
Streptococcosis caused by Streptococcus agalactiae and S. iniae is a significant problem that affects the success of tilapia aquaculture industries worldwide. In this critical review, we summarize the applicable practical strategies which may effectively enhance the world tilapia aquaculture development. Recently, the effect of vaccination and selective breeding programmes has been recognized as valuable tools to control the target disease and other consequent negative impacts caused by chemical and drug application. Advances in sequencing and molecular technologies are vital helpful factors with which to develop robust vaccines and increase the selective breeding programme's precision against streptococcosis. The genomic selection for streptococcosis-resistant tilapia strains and crucial genomic application for genomics' contribution to the development of novel Streptococcus vaccine, comparative genomics approach identifying vaccine candidates by reverse vaccinology, and next-generation vaccine design were described. Information from our review is encouraging for practical implementation of the development of vaccination and genomic selection in tilapia for streptococcosis resistance, which may be vital factors to sustain the world tilapia aquaculture industry effectively.
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Affiliation(s)
- Pattanapon Kayansamruaj
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
- Center of Excellence in Aquatic Animal Health Management, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
| | - Nguyen Dinh-Hung
- Center of Excellence in Fish Infectious Diseases (CE FID), Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Prapansak Srisapoome
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
- Center of Excellence in Aquatic Animal Health Management, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
| | - Uthairat Na-Nakorn
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
- Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - Satid Chatchaiphan
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
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Paul P, Gonçalves BP, Le Doare K, Lawn JE. 20 million pregnant women with group B streptococcus carriage: consequences, challenges, and opportunities for prevention. Curr Opin Pediatr 2023; 35:223-230. [PMID: 36749143 PMCID: PMC9994794 DOI: 10.1097/mop.0000000000001223] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Intrapartum antibiotic prophylaxis (IAP) is currently the only recommended preventive approach against clinical consequences of maternal Group B Streptococcus (GBS) colonization. In this review, we discuss new findings of total perinatal GBS burden and relative effectiveness of differing targeting of IAP, notably microbiology-based and risk factor-based screening, including potential limitations. Finally, we provide updates on maternal GBS vaccines and their potential cost-effectiveness in disease reduction. RECENT FINDINGS Updated estimates of the burden of GBS related to pregnancy outcomes show (1) early-onset GBS disease incidence and deaths are high in some low- and middle-income countries where IAP has not been implemented and (2) late-onset GBS disease, preterm birth, and stillbirth, which are not preventable by IAP, remain a public health problem in both high and low-middle income settings. Observational evidence indicates that microbiology-based screening may be more effective than risk factor-based screening, but even in high-income countries, compliance is imperfect. To address the need for alternative prevention strategies, several maternal vaccine candidates are in clinical development, and modelling suggests these could be cost-effective in most scenarios. SUMMARY Recent progress in GBS vaccine research holds promise of reducing the large and preventable burden of mortality and disability caused by GBS disease, especially in higher-burden settings where clinical and laboratory services may be limited. Importantly vaccines also hold potential to prevent GBS stillbirths and GBS-associated preterm births.
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Affiliation(s)
- Proma Paul
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine
| | - Bronner P. Gonçalves
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine
| | - Kirsty Le Doare
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, UK
- Makerere University Johns Hopkins University, Kampala, Uganda
| | - Joy E. Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine
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Moore RE, Spicer SK, Talbert JA, Manning SD, Townsend SD, Gaddy JA. Anti-biofilm Activity of Human Milk Oligosaccharides in Clinical Strains of Streptococcus agalactiae with Diverse Capsular and Sequence Types. Chembiochem 2023; 24:e202200643. [PMID: 36622717 PMCID: PMC10262446 DOI: 10.1002/cbic.202200643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/10/2023]
Abstract
Group B Streptococcus (GBS) is an encapsulated Gram-positive bacterial pathogen that causes severe perinatal infections. Human milk oligosaccharides (HMOs) are short-chain sugars that have recently been shown to possess antimicrobial and anti-biofilm activity against a variety of bacterial pathogens, including GBS. We have expanded these studies to demonstrate that HMOs can inhibit and dismantle biofilm in both invasive and colonizing strains of GBS. A cohort of 30 diverse strains of GBS were analyzed for susceptibility to HMO-dependent biofilm inhibition or destruction. HMOs were significantly effective at inhibiting biofilm in capsular-type- and sequence-type-specific fashion, with significant efficacy in CpsIb, CpsII, CpsIII, CpsV, and CpsVI strains as well as ST-1, ST-12, ST-19, and ST-23 strains. Interestingly, CpsIa as well as ST-7 and ST-17 were not susceptible to the anti-biofilm activity of HMOs, underscoring the strain-specific effects of these important antimicrobial molecules against the perinatal pathogen Streptococcus agalactiae.
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Affiliation(s)
- Rebecca E. Moore
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
- Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, Tennessee, U.S.A
| | - Sabrina K. Spicer
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee, U.S.A
| | - Julie A. Talbert
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee, U.S.A
| | - Shannon D. Manning
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, Michigan, U.S.A
| | - Steven D. Townsend
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee, U.S.A
| | - Jennifer A. Gaddy
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
- Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, Tennessee, U.S.A
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A
- Center for Medicine Health and Society, Vanderbilt University, Nashville, Tennessee, U.S.A
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Recombination Drives Evolution of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 KL47 to KL64 in China. Microbiol Spectr 2023; 11:e0110722. [PMID: 36622219 PMCID: PMC9927301 DOI: 10.1128/spectrum.01107-22] [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] [Indexed: 01/10/2023] Open
Abstract
Carbapenem-resistant Enterobacteriaceae, especially carbapenemase-producing Klebsiella pneumoniae, is an urgent problem in health care facilities worldwide. K. pneumoniae isolates classified as sequence type 11 (ST11) are largely responsible for the spread of carbapenem-resistant K. pneumoniae (CRKP) in China. Our previous phylogenetic reconstruction suggested that CRKP ST11 capsular locus 64 (KL64) was derived from an ST11-KL47 ancestor through recombination. However, the molecular origin of KL64 remains largely unknown, and our understanding of the recombination is incomplete. Here, we screened a global sample of 22,600 K. pneumoniae genomes and searched for KL64-harboring STs, which were found to be ST1764, ST3685, ST1764-1LV, ST30, ST505, ST147, and ST11, wherein ST1764, ST3685, ST1764-1LV, and ST30 belonged to a clonal complex, CC1764. We compared the genetic structures of representative strains from ST11-KL47, ST11-KL64, CC1764-KL64, ST505-KL64, and ST147-KL64 and further performed phylogenetic analysis and single-nucleotide polymorphism analysis among 248 isolates from all these STs. The results suggested a recombination event has occurred in a homologous ~154-kb region covering KL and the lipopolysaccharide biosynthesis locus (OL) between a recipient ST11-KL47-OL101 and a donor CC1764 (except ST30), giving rise to ST11-KL64-O2v1 strains (recombination I). Furthermore, we also found an infrequent ST11-KL64-O2v1 subclone which was not produced by recombination I but was hybridized from ST11-KL47-OL101 and ST147-KL64-O2v1 strains through recombination of a homologous ~485-kb region covering KL and OL (recombination II). Our findings provide important insights into the role of recombination in the evolution of clinical strains and the diversity of capsule and lipopolysaccharide of widely distributed KPC-associated ST11 K. pneumoniae in China. IMPORTANCE Chromosomal recombination events are considered to contribute to the genetic diversification and ultimate success of many bacterial pathogens. A previous study unravelled the molecular evolution history of ST258 strains, which have been largely responsible for the spread of KPC in the United States. Here, we used comparative genomic analyses to discover two recombination events in ST11 CRKP strains, which is a predominant KPC-associated CRKP clone in China. Two new ST11-CRKP subclones with altered capsule and lipopolysaccharide, which are two primary determinants of antigenicity and antigenic diversity among K. pneumoniae, were produced through these two recombination events, respectively. Horizontal transfer of the KL and OL appears to be a crucial element driving the molecular evolution of K. pneumoniae strains. These findings not only extend our understanding of the molecular evolutionary history of ST11 but also are an important step toward the development of preventive, diagnostic, and therapeutic strategies for CRKP.
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11
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Delara M, Vadlamudi NK, Sadarangani M. Strategies to Prevent Early and Late-Onset Group B Streptococcal Infection via Interventions in Pregnancy. Pathogens 2023; 12:pathogens12020229. [PMID: 36839501 PMCID: PMC9959229 DOI: 10.3390/pathogens12020229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
Group B Streptococcus is a Gram-positive bacterium that typically colonizes 10-30% of pregnant women, causing chorioamnionitis, preterm birth, and stillbirth, as well as neonatal sepsis and meningitis with early-onset disease (EOD) or late-onset disease (LOD) due to ascending infection or transmission during delivery. While there are some differences between EOD and LOD in terms of route of transmission, risk factors, and serotypes, the only preventive approach currently is maternal intrapartum antibiotic prophylaxis (IAP) which will not be able to fully address the burden of the disease since this has no impact on LOD. Probiotics and immunization in pregnancy may be more effective than IAP for both EOD and LOD. There is mixed evidence of probiotic effects on the prevention of GBS colonization, and the data from completed and ongoing clinical trials investigating different GBS vaccines are promising. Current vaccine candidates target bacterial proteins or the polysaccharide capsule and include trivalent, tetravalent, and hexavalent protein-polysaccharide conjugate vaccines. Some challenges in developing novel GBS vaccines include the lack of a correlate of protection, the potential for serotype switching, a need to understand interactions with other vaccines, and optimal timing of administration in pregnancy to maximize protection for both term and preterm infants.
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Affiliation(s)
- Mahin Delara
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 0B3, Canada
- Correspondence: (M.D.); (M.S.)
| | - Nirma Khatri Vadlamudi
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 0B3, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 0B3, Canada
- Correspondence: (M.D.); (M.S.)
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12
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Simultaneous carriage of multiple serotypes of Group B Streptococcus: Systematic review and meta-analysis. Vaccine 2023; 41:15-22. [PMID: 36435703 DOI: 10.1016/j.vaccine.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Epidemiological studies evaluating the distribution of Group B Streptococcus (GBS) serotypes are crucial for serotype-specific vaccine development and post-licensure surveillance. However, there is a paucity of data about the prevalence of simultaneous carriage of multiple serotypes. METHODS We conducted a systematic review of three databases (Medline, Embase, PubMed) to identify studies reporting GBS serotype co-carriage at the same anatomical site (multiple serotypes in one sample) or different anatomical sites (paired samples from one individual with different serotypes). We conducted a random-effects meta-analysis to evaluate the prevalence of co-carriage. RESULTS 18 articles met the inclusion criteria, representing at least 12,968 samples from 14 countries. In a random-effects meta-analysis, we identified that 10 % (95 % CI: 4-19) of the positive samples taken from one anatomical site have more than one serotype, and 11 % (95 % CI: 5-20) of positive participants with samples taken from two anatomical sites carried different serotypes. When reported, the number of serotypes simultaneously carried ranged from 1 to 4. The serotypes most often associated with co-carriage are III (20.3 %), V (20.3 %) and Ia (19.5 %). CONCLUSION This systematic review demonstrates that co-carriage is a minor but definite phenomenon, but the data are too limited to give a precise picture of the current epidemiology. Co-colonisation detection needs to be taken into consideration in the design and methods of future GBS carriage surveillance studies to estimate and evaluate the potential for serotype replacement once vaccines are introduced.
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13
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Epidemiology and bacterial characteristics of invasive group B streptococcus disease: a population-based study in Japan in 2010-2020. Epidemiol Infect 2022; 150:e184. [PMID: 36408537 PMCID: PMC9987023 DOI: 10.1017/s0950268822001534] [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: 12/14/2022] Open
Abstract
This is the first report on a population-based prospective study of invasive group B streptococcus (GBS) disease among children aged <15 years conducted over a period of 11 years in Japan. This study investigated the incidence and clinical manifestations of invasive GBS disease in children in Chiba Prefecture, Japan, and analysed the serotypes and drug susceptibility of GBS strains isolated during the study period. Overall, 127 episodes of invasive GBS disease were reported in 123 patients. Of these, 124 were observed in 120 patients aged <1 year, and the remaining three episodes were reported in a 9-year-old child and two 14-year-old children with underlying disease. For patients aged <1 year, the incidence rate per 1000 live births was 0.24 (0.15-0.36). The incidences of early-onset disease and late-onset disease were 0.04 (0.0-0.09) and 0.17 (0.08-0.25), respectively. The rate of meningitis was 45.2%, and the incidence of GBS meningitis was higher than that of other invasive diseases among children in Japan. Of the 109 patients for whom prognosis was available, 7 (6.4%) died and 21 (19.3%) had sequelae. In total, 68 strains were analysed. The most common were serotype III strains (n = 42, 61.8%), especially serotype III/ST17 strains (n = 22, 32.4%). This study showed that the incidence of invasive GBS disease among Japanese children was constant during the study period. Because of the high incidence of meningitis and disease burden, new preventive strategies, such as GBS vaccine, are essential.
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Andersen M, Smith B, Murra M, Nielsen SY, Slotved HC, Henriksen TB. Invasive group B Streptococcus strains and clinical characteristics in Danish infants from 1999 to 2009. Front Microbiol 2022; 13:1001953. [PMID: 36246253 PMCID: PMC9554412 DOI: 10.3389/fmicb.2022.1001953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundGroup B Streptococcus (GBS) infection in infants may result in both respiratory, cardiovascular, and neurological dysfunction and ultimately death of the infant. Surveillance of GBS strains in infants and their clinical characteristics guide development of effective vaccines and other potential treatments and may have implications for future prognostics and infant care. Therefore, we aimed to study GBS serotypes and clonal complexes (CC) in Danish infants with early onset infection (EOD) (0–6 days of life) and late-onset infection (LOD) (7–89 days of life) and to estimate the association between GBS strain and different clinical outcomes.MethodsWe included Danish infants less than 3 months of age with GBS isolates from blood or cerebrospinal fluid between 1999 and 2009. GBS isolates were analyzed by serotyping and multilocus sequence typing with classification of isolates into clonal complexes. Clinical characteristics were obtained by questionnaires completed by tending pediatrician including gestational age, Apgar scores, age at onset, meningitis, symptom severity, treatment duration, and mortality. Symptom severities were reported within neurological symptoms, need for respiratory or circulatory support, and treatment of disseminated intravascular coagulation.ResultsA total of 212 GBS isolates were collected with 129 from EOD and 83 from LOD. The dominating GBS strains were III/CC17 (41%), Ia/CC23 (17%), III/CC19 (15%), Ib/CC8-10 (7%), and V/CC1 (6%). Strain Ia/CC23 was mostly found in EOD, while III/CC17 was widespread in LOD, though being the most common in both EOD and LOD. Strain III/CC17 and Ia/CC23 had highest percentage of samples from cerebrospinal fluid (26%), while III/CC19 had the least (8%). Strain III/CC19 had highest mortality with about one fifth of infected infants dying (22%) followed by Ia/CC23 (16%), Ib/CC8-10 (9%), and then III/CC17 (6%). The symptom severity varied between strains, but with no strain consistently resulting in more severe symptoms.ConclusionSome potential differences in disease severity were observed between the different strains. These findings emphasize the continuous need for multimodal surveillance of infant GBS strains and their clinical characteristics to optimize development of GBS vaccines and other potential treatments.
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Affiliation(s)
- Mads Andersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- *Correspondence: Mads Andersen,
| | - Birgitte Smith
- Department of Pediatrics and Adolescent Medicine, Hvidovre Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - May Murra
- Department of Microbiology, Vejle Hospital, Vejle, Denmark
| | - Stine Yde Nielsen
- Department of Microbiology, Vejle Hospital, Vejle, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Tine Brink Henriksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
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How GBS Got Its Hump: Genomic Analysis of Group B Streptococcus from Camels Identifies Host Restriction as well as Mobile Genetic Elements Shared across Hosts and Pathogens. Pathogens 2022; 11:pathogens11091025. [PMID: 36145457 PMCID: PMC9504112 DOI: 10.3390/pathogens11091025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/23/2022] Open
Abstract
Group B Streptococcus (GBS) literature largely focuses on humans and neonatal disease, but GBS also affects numerous animals, with significant impacts on health and productivity. Spill-over events occur between humans and animals and may be followed by amplification and evolutionary adaptation in the new niche, including changes in the core or accessory genome content. Here, we describe GBS from one-humped camels (Camelus dromedarius), a relatively poorly studied GBS host of increasing importance for food security in arid regions. Genomic analysis shows that virtually all GBS from camels in East Africa belong to a monophyletic clade, sublineage (SL)609. Capsular types IV and VI, including a new variant of type IV, were over-represented compared to other host species. Two genomic islands with signatures of mobile elements contained most camel-associated genes, including genes for metal and carbohydrate utilisation. Lactose fermentation genes were associated with milk isolates, albeit at lower prevalence in camel than bovine GBS. The presence of a phage with high identity to Streptococcus pneumoniae and Streptococcus suis suggests lateral gene transfer between GBS and bacterial species that have not been described in camels. The evolution of camel GBS appears to combine host restriction with the sharing of accessory genome content across pathogen and host species.
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16
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Clinical Profile and Risk Factors of Group B Streptococcal Colonization in Mothers from the Eastern District of China. J Trop Med 2022; 2022:5236430. [PMID: 36211624 PMCID: PMC9534697 DOI: 10.1155/2022/5236430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
Objective The main aim of this study was to determine the prevalence, capsular genotyping, antimicrobial susceptibility, and associated factors of colonizing Group B Streptococcus (GBS) in pregnant women admitted to a hospital in Jinan, East China. Methods Demographic data, clinical characteristics, and vaginal and rectal swabs were obtained from a group of expecting mothers subjected to GBS screening at the late stage of pregnancy who went into labor over the period from November 2019 to October 2020. Identification of GBS and determination of antimicrobial resistance patterns were performed using a BD Phoenix-100 system. Capsular genotypes were analyzed using polymerase chain reaction and the associated factors were evaluated via logistic regression. Result A total of 2761 pregnant women were recruited for this study. The GBS colonization rate was 6.70% (185/2761). Among the 172 GBS strains examined, all were susceptible to vancomycin and linezolid. Resistance was the highest for erythromycin (80.2%), followed by clindamycin (75.0%), levofloxacin (65.1%), and tetracycline (57.6%). The most common serotype identified was Ia (61.0%), followed by III (29.7%), VI (4.6%), II (3.5%), VII (0.6%), and a nontypeable strain. Risk factors for maternal GBS colonization included maternal age (older than 30 years) (OR = 1.913 (1.662, 2.478)), gestational age at birth (average gestational age) (OR = 1.992 (1.445, 2.746)), and prelabor rupture of membrane (OR = 3.838 (1.619, 9.099)). Conclusion The prevalence of GBS was relatively low. The maternal age was a factor associated with GBS colonization. Subjects showing GBS positivity during late pregnancy were prone to prolonged rupture of the membrane (PROM) and birth at lower a gestation age than the GBS-negative group. Penicillin could still be used as the first agent of choice for intrapartum antibiotic prophylaxis (IAP).
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Wang Z, Enotarpi J, Buffi G, Pezzicoli A, Gstöttner CJ, Nicolardi S, Balducci E, Fabbrini M, Romano MR, van der Marel GA, del Bino L, Adamo R, Codée JDC. Chemical Synthesis and Immunological Evaluation of Fragments of the Multiantennary Group-Specific Polysaccharide of Group B Streptococcus. JACS AU 2022; 2:1724-1735. [PMID: 35911445 PMCID: PMC9327088 DOI: 10.1021/jacsau.2c00302] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Group B Streptococcus (GBS) is a Gram-positive bacterium and the most common cause of neonatal blood and brain infections. At least 10 different serotypes exist, that are characterized by their different capsular polysaccharides. The Group B carbohydrate (GBC) is shared by all serotypes and therefore attractive be used in a glycoconjugate vaccine. The GBC is a highly complex multiantennary structure, composed of rhamnose rich oligosaccharides interspaced with glucitol phosphates. We here report the development of a convergent approach to assemble a pentamer, octamer, and tridecamer fragment of the termini of the antennae. Phosphoramidite chemistry was used to fuse the pentamer and octamer fragments to deliver the 13-mer GBC oligosaccharide. Nuclear magnetic resonance spectroscopy of the generated fragments confirmed the structures of the naturally occurring polysaccharide. The fragments were used to generate model glycoconjugate vaccine by coupling with CRM197. Immunization of mice delivered sera that was shown to be capable of recognizing different GBS strains. The antibodies raised using the 13-mer conjugate were shown to recognize the bacteria best and the serum raised against this GBC fragment-mediated opsonophagocytic killing best, but in a capsule dependent manner. Overall, the GBC 13-mer was identified to be a highly promising antigen for incorporation into future (multicomponent) anti-GBS vaccines.
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Affiliation(s)
- Zhen Wang
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, The Netherlands
| | - Jacopo Enotarpi
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, The Netherlands
| | - Giada Buffi
- GSK
Siena Italy, Via Fiorentina
1 Siena 53100, Italy
| | | | - Christoph J. Gstöttner
- Center
for Proteomics and Metabolomics, Leiden
University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Simone Nicolardi
- Center
for Proteomics and Metabolomics, Leiden
University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | | | | | | | | | | | - Roberto Adamo
- GSK
Siena Italy, Via Fiorentina
1 Siena 53100, Italy
| | - Jeroen D. C. Codée
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, The Netherlands
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Feuerschuette OHM, Alves EV, Scheffer MC, Vilela APP, Barazzetti FH, Feuerschuette HM, Cancelier ACL, Bazzo ML. Genetic diversity and antimicrobial resistance of invasive, noninvasive and colonizing group B Streptococcus isolates in southern Brazil. Access Microbiol 2022; 4:acmi000370. [PMID: 36004365 PMCID: PMC9394672 DOI: 10.1099/acmi.0.000370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/12/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction. Group B
Streptococcus
(GBS) is a human commensal bacterium that is also associated with infection in pregnant and non-pregnant adults, neonates and elderly people.
Gap Statement. The authors hypothesize that knowledge of regional GBS genetic patterns may allow the use of prevention and treatment measures to reduce the burden of streptococcal disease.
Aim. The aim was to report the genotypic diversity and antimicrobial sensitivity profiles of invasive, noninvasive urinary and colonizing GBS strains, and evaluate the relationships between these findings.
Methodology. The study included consecutive and non-duplicated GBS isolates recovered in southern Brazil from 2015 to 2017. We performed multiple-locus variable-number tandem repeat analysis (MLVA) and PCR analyses to determine capsular serotypes and identify the presence of the resistance genes mefA/E, ermB and ermA/TR, and also antibiotic susceptibility testing.
Results. The sample consisted of 348 GBS strains, 42 MLVA types were identified, and 4 of them represented 64 % of isolates. Serotype Ia was the most prevalent (42.2 %) and was found in a higher percentage associated with colonization, followed by serotypes V (24.4 %), II (17.8 %) and III (7.8 %). Serotype V was associated with invasive isolates and serotypes II and III with noninvasive isolates, without significant differences. All isolates were susceptible to penicillin. GBS 2018/ hvgA was observed in 17 isolates, with 11 belonging to serogroup III. The Hunter–Gaston diversity index was calculated as 0.879. The genes mefA/E, erm/B and erm/A/TR were found in 45, 19 and 46 isolates.
Conclusion. This report suggests that the circulating GBS belong to a limited number of genetic lineages. The most common genotypes were Ia/MT12 and V/MT18, which are associated with high resistance to macrolides and the presence of the genes mefA/E and ermA/TR. Penicillin remains the antibiotic of choice. Implementation of continuous surveillance of GBS infections will be essential to assess GBS epidemiology and develop accurate GBS prevention, especially strategies associated with vaccination.
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Affiliation(s)
- Otto Henrique May Feuerschuette
- Universidade do Sul de Santa Catarina – UNISUL, Tubarão, Brazil
- Hospital Universitário Professor Polydoro Ernani de São Thiago, HU/UFSC, Florianópolis, Brazil
| | - Eduardo Venâncio Alves
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
| | - Mara Cristina Scheffer
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
- Hospital Universitário Professor Polydoro Ernani de São Thiago, HU/UFSC, Florianópolis, Brazil
| | - Ana Paula Pessoa Vilela
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
| | | | | | | | - Maria Luiza Bazzo
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
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Brokaw A, Nguyen S, Quach P, Orvis A, Furuta A, Johansson-Lindbom B, Fischer PB, Rajagopal L. A Recombinant Alpha-Like Protein Subunit Vaccine (GBS-NN) Provides Protection in Murine Models of Group B Streptococcus Infection. J Infect Dis 2022; 226:177-187. [PMID: 35429401 PMCID: PMC9890916 DOI: 10.1093/infdis/jiac148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Group B Streptococcus (GBS) transmission during pregnancy causes preterm labor, stillbirths, fetal injury, or neonatal infections. Rates of adult infections are also rising. The GBS-NN vaccine, engineered by fusing N-terminal domains of GBS Alpha C and Rib proteins, is safe in healthy, nonpregnant women, but further assessment is needed for use during pregnancy. Here, we tested GBS-NN vaccine efficacy using mouse models that recapitulate human GBS infection outcomes. METHODS Following administration of GBS-NN vaccine or adjuvant, antibody profiles were compared by ELISA. Vaccine efficacy was examined by comparing infection outcomes in GBS-NN vaccinated versus adjuvant controls during systemic and pregnancy-associated infections, and during intranasal infection of neonatal mice following maternal vaccination. RESULTS Vaccinated mice had higher GBS-NN-specific IgG titers versus controls. These antibodies bound alpha C and Rib on GBS clinical isolates. Fewer GBS were recovered from systemically challenged vaccinated mice versus controls. Although vaccination did not eliminate GBS during ascending infection in pregnancy, vaccinated dams experienced fewer in utero fetal deaths. Additionally, maternal vaccination prolonged neonatal survival following intranasal GBS challenge. CONCLUSIONS These findings demonstrate GBS-NN vaccine efficacy in murine systemic and perinatal GBS infections and suggest that maternal vaccination facilitates the transfer of protective antibodies to neonates.
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Affiliation(s)
- Alyssa Brokaw
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, Washington, USA,Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Shayla Nguyen
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Phoenicia Quach
- Present affiliation: Phoenicia Quach, Universal Cells, Seattle 98121, Washington
| | - Austyn Orvis
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Anna Furuta
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, Washington, USA,Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | | | - Lakshmi Rajagopal
- Correspondence: L. Rajagopal, PhD, Department of Pediatrics, University of Washington, Seattle Children’s Hospital Research Institute, 307 Westlake Ave N, Seattle, WA 98109 ()
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Khan UB, Jauneikaite E, Andrews R, Chalker VJ, Spiller OB. Identifying large-scale recombination and capsular switching events in Streptococcus agalactiae strains causing disease in adults in the UK between 2014 and 2015. Microb Genom 2022; 8:000783. [PMID: 35290175 PMCID: PMC9176283 DOI: 10.1099/mgen.0.000783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cases of invasive group B streptococcal infection in the adult UK population have steadily increased over recent years, with the most common serotypes being V, III and Ia, but less is known of the genetic background of these strains. We have carried out in-depth analysis of the whole-genome sequences of 193 clinically important group B Streptococcus (GBS) isolates (184 were from invasive infection, 8 were from non-invasive infection and 1 had no information on isolation site) isolated from adults and submitted to the National Reference Laboratory at the UK Health Security Agency between January 2014 and December 2015. We have determined that capsular serotypes III (26.9%), Ia (26.4%) and V (15.0%) were most commonly identified, with slight differences in gender and age distribution. Most isolates (n=182) grouped to five clonal complexes (CCs), CC1, CC8/CC10, CC17, CC19 and CC23, with common associations between specific serotypes and virulence genes. Additionally, we have identified large recombination events mediating potential capsular switching events between sequence type (ST)1 serotype V and serotypes Ib (n=2 isolates), II (n=2 isolates) and VI (n=2 isolates); between ST19 serotype III and serotype V (n=5 isolates); and between CC17 serotype III and serotype IV (n=1 isolate). The high genetic diversity of disease-causing isolates and multiple recombination events reported in this study highlight the need for routine surveillance of the circulating disease-causing GBS strains. This information is crucial to better understand the global spread of GBS serotypes and genotypes, and will form the baseline information for any future GBS vaccine research in the UK and worldwide.
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Affiliation(s)
- Uzma Basit Khan
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
- Present address: Parasites and Microbes, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton CB10 1SA, UK
| | - Elita Jauneikaite
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
- *Correspondence: Elita Jauneikaite,
| | - Robert Andrews
- Systems Immunity University Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Victoria J. Chalker
- National Infection Service, United Kingdom Health Security Agency, Colindale, London, UK
| | - Owen B. Spiller
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
- National Infection Service, United Kingdom Health Security Agency, Colindale, London, UK
- *Correspondence: Owen B. Spiller,
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21
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Francis JD, Guevara MA, Lu J, Madhi SA, Kwatra G, Aronoff DM, Manning SD, Gaddy JA. The antimicrobial activity of zinc against group B Streptococcus is strain-dependent across diverse sequence types, capsular serotypes, and invasive versus colonizing isolates. BMC Microbiol 2022; 22:23. [PMID: 35026981 PMCID: PMC8756620 DOI: 10.1186/s12866-021-02428-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Streptococcus agalactiae or Group B Streptococcus (GBS) is an encapsulated gram-positive bacterial pathobiont that commonly colonizes the lower gastrointestinal tract and reproductive tract of human hosts. This bacterium can infect the gravid reproductive tract and cause invasive infections of pregnant patients and neonates. Upon colonizing the reproductive tract, the bacterial cell is presented with numerous nutritional challenges imposed by the host. One strategy employed by the host innate immune system is intoxication of bacterial invaders with certain transition metals such as zinc. METHODOLOGY Previous work has demonstrated that GBS must employ elegant strategies to circumnavigate zinc stress in order to survive in the vertebrate host. We assessed 30 strains of GBS from diverse isolation sources, capsular serotypes, and sequence types for susceptibility or resistance to zinc intoxication. RESULTS Invasive strains, such as those isolated from early onset disease manifestations of GBS infection were significantly less susceptible to zinc toxicity than colonizing strains isolated from rectovaginal swabs of pregnant patients. Additionally, capsular type III (cpsIII) strains and the ST-17 and ST-19 strains exhibited the greatest resilience to zinc stress, whereas ST-1 and ST-12 strains as well as those possessing capsular type Ib (cpsIb) were more sensitive to zinc intoxication. Thus, this study demonstrates that the transition metal zinc possesses antimicrobial properties against a wide range of GBS strains, with isolation source, capsular serotype, and sequence type contributing to susceptibility or resistance to zinc stress.
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Affiliation(s)
- Jamisha D Francis
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Miriam A Guevara
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Jacky Lu
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gaurav Kwatra
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - David M Aronoff
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, A2200 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232, U.S.A
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center Nashville, Nashville, TN, 37232, USA
| | - Shannon D Manning
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, 48824, USA
| | - Jennifer A Gaddy
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA.
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, A2200 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232, U.S.A..
- Department of Veterans Affairs, Tennessee Valley Healthcare Systems, Nashville, TN, 37212, USA.
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22
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Fister P, Peček J, Jeverica S, Primec ZR, Paro-Panjan D. Neonatal Group B Streptococcal Meningitis: Predictors for Poor Neurologic Outcome at 18 Months. J Child Neurol 2022; 37:64-72. [PMID: 34816748 DOI: 10.1177/08830738211053128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To find early predictors for poor neurodevelopmental outcome after neonatal group B streptococcal meningitis. METHODS We retrospectively analyzed clinical characteristics of 23 patients with neonatal group B streptococcal meningitis and their neurodevelopmental outcome at 18 months. Available group B Streptococcus strains were serotyped and their genomes characterized. RESULTS We found several differences between patients with early- (n = 5) and late-onset (n = 18) disease. Nine children had neurologic abnormalities at 18 months and 4 had epilepsy, all of them after late-onset disease. Most important risk factors for poor outcome were impaired consciousness at admission, hemodynamic instability, seizures, or abnormal electroencephalogram during the acute illness and abnormal neurologic and ophthalmologic examination at the end of treatment, whereas abnormalities in laboratory and imaging studies were not predictive. Hypervirulent serotype III, multilocus sequence type 17 group B Streptococcus was the predominant pathogen. CONCLUSIONS Neurodevelopmental impairment after neonatal group B streptococcal meningitis is likelier in those with clinical and neurophysiological features indicating worse disease severity.
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Affiliation(s)
- Petja Fister
- Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.,37664Faculty of Medicine, University of Ljubljana, Slovenia
| | - Jerneja Peček
- Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.,37664Faculty of Medicine, University of Ljubljana, Slovenia
| | - Samo Jeverica
- 68924National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - Zvonka Rener Primec
- 37664Faculty of Medicine, University of Ljubljana, Slovenia.,Department of Neurology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Darja Paro-Panjan
- Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.,37664Faculty of Medicine, University of Ljubljana, Slovenia
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23
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Abstract
Group B Streptococcus (GBS) is a leading cause of invasive neonatal disease. Epidemiological surveillance of GBS is important to determine cumulative incidence, antimicrobial resistance rates, and maternal and neonatal disease prevention. In this study, we present an update on GBS epidemiology in Alberta, Canada, from 2014 to 2020. Over the 7-year period, 1,556 GBS isolates were submitted to the Alberta Public Health Laboratory for capsular polysaccharide (CPS) typing and antimicrobial susceptibility testing. We analyzed the distribution of CPS types in Alberta and found CPS types III (23.6%), Ia (16.0%), Ib (14.8%), II (13.3%), V (12.7%), IV (12.5%), and VI (2.38%) to be the most prevalent. Less than 1% each of CPS types VII, VIII, and IX were identified. In agreement with historical data, the presence of CPS type IV continued to rise across Alberta, particularly in cases of adult infection, where a 2-fold increase was observed. Cumulative incidences of GBS cases per 100,000 population and late-onset disease per 1,000 live births increased from 4.43 to 5.36 and 0.38 to 0.41, respectively, from 2014 to 2020. However, the incidence of early-onset disease decreased during the 7-year period from 0.2 to 0.07, suggestive of successful intrapartum chemoprophylaxis treatment programs. All GBS isolates were susceptible to penicillin and vancomycin. However, nonsusceptibility to erythromycin increased significantly, from 36.85% to 50.8%, from 2014 to 2020. Similarly, nonsusceptibility to clindamycin also increased significantly, from 21.0% to 45.8%. In comparison to historical data, the overall rates of GBS infection and antimicrobial resistance have increased and the predominant CPS types have changed. IMPORTANCE 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.
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MESH Headings
- Adolescent
- Adult
- Alberta/epidemiology
- Anti-Bacterial Agents/therapeutic use
- Bacterial Typing Techniques
- Blood Culture
- Canada/epidemiology
- Child
- Child, Preschool
- Clindamycin/therapeutic use
- Drug Resistance, Multiple, Bacterial/genetics
- Erythromycin/therapeutic use
- Female
- Humans
- Infant
- Infant, Newborn
- Infant, Newborn, Diseases/drug therapy
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/microbiology
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Polysaccharides, Bacterial/analysis
- Streptococcal Infections/drug therapy
- Streptococcal Infections/epidemiology
- Streptococcus agalactiae/classification
- Streptococcus agalactiae/drug effects
- Streptococcus agalactiae/isolation & purification
- Young Adult
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Affiliation(s)
- Angela Ma
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Albertagrid.17089.37, Edmonton, Canada
| | - L Alexa Thompson
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Albertagrid.17089.37, Edmonton, Canada
| | - Thomas Corsiatto
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Albertagrid.17089.37, Edmonton, Canada
| | - Donna Hurteau
- Alberta Precision Laboratories-Provincial Laboratory for Public Health, Edmonton, Canada
| | - Gregory J Tyrrell
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Albertagrid.17089.37, Edmonton, Canada
- Alberta Precision Laboratories-Provincial Laboratory for Public Health, Edmonton, Canada
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24
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Epidemiological Characterization of Group B Streptococcus Infections in Alberta, Canada: An Update from 2014 to 2020. Microbiol Spectr 2021; 9:e0128321. [PMID: 34762517 PMCID: PMC8585492 DOI: 10.1128/spectrum.01283-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Group B Streptococcus (GBS) is a leading cause of invasive neonatal disease. Epidemiological surveillance of GBS is important to determine cumulative incidence, antimicrobial resistance rates, and maternal and neonatal disease prevention. In this study, we present an update on GBS epidemiology in Alberta, Canada, from 2014 to 2020. Over the 7-year period, 1,556 GBS isolates were submitted to the Alberta Public Health Laboratory for capsular polysaccharide (CPS) typing and antimicrobial susceptibility testing. We analyzed the distribution of CPS types in Alberta and found CPS types III (23.6%), Ia (16.0%), Ib (14.8%), II (13.3%), V (12.7%), IV (12.5%), and VI (2.38%) to be the most prevalent. Less than 1% each of CPS types VII, VIII, and IX were identified. In agreement with historical data, the presence of CPS type IV continued to rise across Alberta, particularly in cases of adult infection, where a 2-fold increase was observed. Cumulative incidences of GBS cases per 100,000 population and late-onset disease per 1,000 live births increased from 4.43 to 5.36 and 0.38 to 0.41, respectively, from 2014 to 2020. However, the incidence of early-onset disease decreased during the 7-year period from 0.2 to 0.07, suggestive of successful intrapartum chemoprophylaxis treatment programs. All GBS isolates were susceptible to penicillin and vancomycin. However, nonsusceptibility to erythromycin increased significantly, from 36.85% to 50.8%, from 2014 to 2020. Similarly, nonsusceptibility to clindamycin also increased significantly, from 21.0% to 45.8%. In comparison to historical data, the overall rates of GBS infection and antimicrobial resistance have increased and the predominant CPS types have changed. IMPORTANCE 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.
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25
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Dammann AN, Chamby AB, Gonzalez FJ, Sharp ME, Flores K, Shahi I, Dongas S, Hooven TA, Ratner AJ. Group B Streptococcus capsular serotype alters vaginal colonization fitness. J Infect Dis 2021; 225:1896-1904. [PMID: 34788438 DOI: 10.1093/infdis/jiab559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Group B Streptococcus (GBS) remains a leading cause of infant morbidity and mortality. A candidate vaccine targets six GBS serotypes, offering a potential alternative to intrapartum antibiotic prophylaxis to reduce disease burden. However, our understanding of the contributions of specific capsule types to GBS colonization and disease remains limited. METHODS Using allelic exchange, we generated isogenic GBS strains differing only in the serotype-determining region in two genetic backgrounds, including the hypervirulent clonal complex (CC) 17. Using a murine model of vaginal co-colonization, we evaluated the roles of the presence of capsule and of expression of specific capsular types in GBS vaginal colonization fitness independent of other genetic factors. RESULTS Encapsulated wild-type strains COH1 (CC17, serotype III) and A909 (non-CC17, serotype Ia), outcompeted isogenic acapsular mutants in murine vaginal co-colonization. COH1 wild-type outcompeted A909. Notably, expression of type Ia capsule conferred an advantage over type III capsule in both genetic backgrounds. CONCLUSIONS Specific capsule types may provide an advantage in GBS vaginal colonization in vivo. However, success of certain GBS lineages, including CC17, likely involves both capsule and non-capsule genetic elements. Capsule switching in GBS, a potential outcome of conjugate vaccine programs, may alter colonization fitness or pathogenesis.
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Affiliation(s)
- Allison N Dammann
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Anna B Chamby
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Francisco J Gonzalez
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Molly E Sharp
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Karina Flores
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ifrah Shahi
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sophia Dongas
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Thomas A Hooven
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Richard King Mellon Institute for Pediatric Research, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Adam J Ratner
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.,Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
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26
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Lu J, Guevara MA, Francis JD, Spicer SK, Moore RE, Chambers SA, Craft KM, Manning SD, Townsend SD, Gaddy JA. Analysis of Susceptibility to the Antimicrobial and Anti-Biofilm Activity of Human Milk Lactoferrin in Clinical Strains of Streptococcus agalactiae With Diverse Capsular and Sequence Types. Front Cell Infect Microbiol 2021; 11:740872. [PMID: 34616691 PMCID: PMC8488155 DOI: 10.3389/fcimb.2021.740872] [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: 07/13/2021] [Accepted: 09/01/2021] [Indexed: 01/31/2023] Open
Abstract
Group B Streptococcus (GBS) is one of the leading infection-related causes of adverse maternal and neonatal outcomes. This includes chorioamnionitis, which leads to preterm ruptures of membranes and can ultimately result in preterm or stillbirth. Infection can also lead to maternal and neonatal sepsis that may contribute to mortality. Currently, treatment for GBS infection include a bolus of intrapartum antibiotic prophylaxis to mothers testing positive for GBS colonization during late pregnancy. Lactoferrin is an antimicrobial peptide expressed in human breast milk, mucosal epithelia, and secondary granules of neutrophils. We previously demonstrated that lactoferrin possesses antimicrobial and antibiofilm properties against several strains of GBS. This is largely due to the ability of lactoferrin to bind and sequester iron. We expanded upon that study by assessing the effects of purified human breast milk lactoferrin against a panel of phenotypically and genetically diverse isolates of GBS. Of the 25 GBS isolates screened, lactoferrin reduced bacterial growth in 14 and biofilm formation in 21 strains. Stratifying the data, we observed that colonizing strains were more susceptible to the growth inhibition activity of lactoferrin than invasive isolates at lactoferrin concentrations between 250-750 µg/mL. Treatment with 750 µg/mL of lactoferrin resulted in differences in bacterial growth and biofilm formation between discrete sequence types. Differences in bacterial growth were also observed between capsular serotypes 1a and III. Maternally isolated strains were more susceptible to lactoferrin with respect to bacterial growth, but not biofilm formation, compared to neonatal sepsis isolates. Finally, high biofilm forming GBS strains were more impacted by lactoferrin across all isolates tested. Taken together, this study demonstrates that lactoferrin possesses antimicrobial and antibiofilm properties against a wide range of GBS isolates, with maternally isolated colonizing strains being the most susceptible.
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Affiliation(s)
- Jacky Lu
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Miriam A Guevara
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Jamisha D Francis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Sabrina K Spicer
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
| | - Rebecca E Moore
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
| | - Schuyler A Chambers
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
| | - Kelly M Craft
- Department of Chemistry, Harvard University, Cambridge, MA, United States
| | - Shannon D Manning
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States
| | - Steven D Townsend
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
| | - Jennifer A Gaddy
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, United States.,Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.,Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, TN, United States
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27
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Brokaw A, Furuta A, Dacanay M, Rajagopal L, Adams Waldorf KM. Bacterial and Host Determinants of Group B Streptococcal Vaginal Colonization and Ascending Infection in Pregnancy. Front Cell Infect Microbiol 2021; 11:720789. [PMID: 34540718 PMCID: PMC8446444 DOI: 10.3389/fcimb.2021.720789] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/09/2021] [Indexed: 12/17/2022] Open
Abstract
Group B streptococcus (GBS) is a gram-positive bacteria that asymptomatically colonizes the vaginal tract. However, during pregnancy maternal GBS colonization greatly predisposes the mother and baby to a wide range of adverse outcomes, including preterm birth (PTB), stillbirth, and neonatal infection. Although many mechanisms involved in GBS pathogenesis are partially elucidated, there is currently no approved GBS vaccine. The development of a safe and effective vaccine that can be administered during or prior to pregnancy remains a principal objective in the field, because current antibiotic-based therapeutic strategies do not eliminate all cases of invasive GBS infections. Herein, we review our understanding of GBS disease pathogenesis at the maternal-fetal interface with a focus on the bacterial virulence factors and host defenses that modulate the outcome of infection. We follow GBS along its path from an asymptomatic colonizer of the vagina to an invasive pathogen at the maternal-fetal interface, noting factors critical for vaginal colonization, ascending infection, and vertical transmission to the fetus. Finally, at each stage of infection we emphasize important host-pathogen interactions, which, if targeted therapeutically, may help to reduce the global burden of GBS.
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Affiliation(s)
- Alyssa Brokaw
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Anna Furuta
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Matthew Dacanay
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States
| | - Lakshmi Rajagopal
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States.,Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Kristina M Adams Waldorf
- Department of Global Health, University of Washington, Seattle, WA, United States.,Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States.,Department of Obstetrics and Gynecology, University of Washington and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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28
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Zhu Y, Dong W, Ma J, Zhang Y, Zhong X, Pan Z, Liu G, Wu Z, Yao H. Comparative genetic analyses provide clues about capsule switching in Streptococcus suis 2 strains with different virulence levels and genetic backgrounds. Microbiol Res 2021; 250:126814. [PMID: 34256310 DOI: 10.1016/j.micres.2021.126814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/22/2021] [Accepted: 07/04/2021] [Indexed: 12/19/2022]
Abstract
Streptococcus suis (S. suis) is a major bacterial pathogen in the swine industry and an emerging zoonotic agent. S. suis produces an important extracellular component, capsular polysaccharide (CPS), based on which dozens of serotypes have been identified. Through virulence genotyping, we revealed the relatedness between subpopulations of S. suis serotype 2 (SS2), S. suis serotype 3 (SS3) and S. suis serotype 7 (SS7) strains despite their serotype differences. Multilocus sequence typing (MLST) was used to characterize the whole S. suis population and revealed capsule switching between S. suis strains. Importantly, capsule switching occurred in the SS2, SS3 and SS7 strains belonging to CC28 and CC29, which are phylogenetically distinct from the main CC1 SS2 lineage. To further explore capsule switching in S. suis, comparative genomic analyses were performed using available complete S. suis genomes. Phylogenetic analyses suggested that the SS2 strains could be divided into two clades (1 and 2), and those classified into clade 2 colocalized with SS3 and SS7 strains, in accordance with the above virulence genotyping and MLST analyses. Clade 2 SS2 strains presented high genetic similarity to SS3 and SS7 and shared common competence and defensive elements with them but were significantly different from Clade 1 SS2 strains. Notably, although the cps loci shared by Clade 1 and 2 SS2 strains were almost identical, a specific region of the cps locus of strain NSUI002 (Clade 2 SS2) could be found in the SS3 cps locus but not in the Clade 1 SS2 strain. These data indicated that the SS2 strains in CC28 and CC29 might have acquired the cps locus through capsule switching, which could explain the distinct genetic lineages within the SS2 population.
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Affiliation(s)
- Yinchu Zhu
- Institute of Animal Husbandry and Veterinary Sciences, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China; College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China
| | - Wenyang Dong
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China; Beijing Advanced Innovation Center for Genomics (ICG) & Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, 100871, China
| | - Jiale Ma
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China
| | - Yue Zhang
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China; College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China
| | - Xiaojun Zhong
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China
| | - Zihao Pan
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China
| | - Guangjin Liu
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China
| | - Zongfu Wu
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China
| | - Huochun Yao
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China; Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, 210095, China; OIE Reference Lab for Swine Streptococcosis, Nanjing, 210095, China.
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29
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Silvestre I, Nunes A, Borges V, Isidro J, Silva C, Vieira L, Gomes JP, Borrego MJ. Genomic insights on DNase production in Streptococcus agalactiae ST17 and ST19 strains. INFECTION GENETICS AND EVOLUTION 2021; 93:104969. [PMID: 34147652 DOI: 10.1016/j.meegid.2021.104969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
Streptococcus agalactiae evasion from the human defense mechanisms has been linked to the production of DNases. These were proposed to contribute to the hypervirulence of S. agalactiae ST17/capsular-type III strains, mostly associated with neonatal meningitis. We performed a comparative genomic analysis between ST17 and ST19 human strains with different cell tropism and distinct DNase production phenotypes. All S. agalactiae ST17 strains, with the exception of 2211-04, were found to display DNase activity, while the opposite scenario was observed for ST19, where 1203-05 was the only DNase(+) strain. The analysis of the genetic variability of the seven genes putatively encoding secreted DNases in S. agalactiae revealed an exclusive amino acid change in the predicted signal peptide of GBS0661 (NucA) of the ST17 DNase(-), and an exclusive amino acid change alteration in GBS0609 of the ST19 DNase(+) strain. Further core-genome analysis identified some specificities (SNVs or indels) differentiating the DNase(-) ST17 2211-04 and the DNase(+) ST19 1203-05 from the remaining strains of each ST. The pan-genomic analysis evidenced an intact phage without homology in S. agalactiae and a transposon homologous to TnGBS2.3 in ST17 DNase(-) 2211-04; the transposon was also found in one ST17 DNase(+) strain, yet with a different site of insertion. A group of nine accessory genes were identified among all ST17 DNase(+) strains, including the Eco47II family restriction endonuclease and the C-5 cytosine-specific DNA methylase. None of these loci was found in any DNase(-) strain, which may suggest that these proteins might contribute to the lack of DNase activity. In summary, we provide novel insights on the genetic diversity between DNase(+) and DNase(-) strains, and identified genetic traits, namely specific mutations affecting predicted DNases (NucA and GBS0609) and differences in the accessory genome, that need further investigation as they may justify distinct DNase-related virulence phenotypes in S. agalactiae.
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Affiliation(s)
- Inês Silvestre
- Department of Life Sciences, UCIBIO, Nova School of Science and Technology, 2829-516 Caparica, Portugal; National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - Alexandra Nunes
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; CBIOS - Research Center for Biosciences & Health Technologies, Lusófona University of Humanities and Technologies, Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Vítor Borges
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - Joana Isidro
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - Catarina Silva
- Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; Centre for Toxicogenomics and Human Health (ToxOmics), Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056 Lisbon, Portugal
| | - Luís Vieira
- Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; Centre for Toxicogenomics and Human Health (ToxOmics), Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056 Lisbon, Portugal
| | - João Paulo Gomes
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal.
| | - Maria José Borrego
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisbon, Portugal.
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30
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Humphries RM. Group B Streptococcus Dynamics in the United States. Clin Infect Dis 2021; 72:1014-1015. [PMID: 32060524 DOI: 10.1093/cid/ciaa155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/13/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Romney M Humphries
- Accelerate Diagnostics, Tucson, Arizona, USA.,Department of Pathology, University of Arizona, Tucson, Arizona, USA
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31
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Meehan M, Eogan M, McCallion N, Cunney R, Bray JE, Jolley KA, Unitt A, Maiden MCJ, Harrison OB, Drew RJ. Genomic epidemiology of group B streptococci spanning 10 years in an Irish maternity hospital, 2008-2017. J Infect 2021; 83:37-45. [PMID: 33862060 DOI: 10.1016/j.jinf.2021.04.003] [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: 02/07/2021] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The genomic epidemiology of group b streptococcal (GBS) isolates from the Rotunda maternity hospital, Dublin, 2008-2017, was investigated. METHODS Whole genome sequences of isolates (invasive, n = 114; non-invasive, n = 76) from infants and women were analysed using the PubMLST database (https://pubmlst.org/sagalactiae/). RESULTS Serotypes III (36%), Ia (18%), V (17%), II (11%) and Ib, (9%) and sequence types (ST) 17 (23%), ST-23 (14%), ST-1 (12%) and ST-19 (7%) were most common. Core genome MLST (cgMLST) differentiated isolates of the same ST, grouped STs into five lineages congruent with known clonal complexes and identified known mother-baby pairs and suspected linked infant cases. Clonal complex (CC) 17 accounted for 40% and 22% of infant and maternal invasive cases, respectively and 21% of non-invasive isolates. CC23 and CC19 were associated with maternal disease (30%) and carriage (24%), respectively. Erythromycin (26%) and clindamycin (18%) resistance increased over the study period and was associated with presence of the erm(B) gene (55%), CC1 (33%) and CC19 (24%). A multi-resistant integrative conjugative element incorporated in the PI-1 locus was detected in CC17, an ST-12 and ST-23 isolate confirming the global dissemination of this element. All isolates possessed one or more pilus islands. Genes encoding other potential protective proteins including Sip, C5a peptidase and Srr1 were present in 100%, 99.5% and 65.8% of isolates, respectively. The srr2 gene was unique to CC17. CONCLUSIONS The PubMLST.org website provides a valuable framework for genomic GBS surveillance to inform on local and global GBS epidemiology, preventive and control measures.
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Affiliation(s)
- Mary Meehan
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland.
| | - Maeve Eogan
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - Naomi McCallion
- Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Robert Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James E Bray
- Department of Zoology, University of Oxford, Peter Medawar Building, Oxford OX1 3SY, UK
| | - Keith A Jolley
- Department of Zoology, University of Oxford, Peter Medawar Building, Oxford OX1 3SY, UK
| | - Anastasia Unitt
- Department of Zoology, University of Oxford, Peter Medawar Building, Oxford OX1 3SY, UK
| | - Martin C J Maiden
- Department of Zoology, University of Oxford, Peter Medawar Building, Oxford OX1 3SY, UK
| | - Odile B Harrison
- Department of Zoology, University of Oxford, Peter Medawar Building, Oxford OX1 3SY, UK
| | - Richard J Drew
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Clinical Innovation Unit, Rotunda Hospital, Dublin, Ireland; Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
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Trends in molecular characteristics and antimicrobial resistance of group B streptococci: a multicenter study in Serbia, 2015-2020. Sci Rep 2021; 11:540. [PMID: 33436658 PMCID: PMC7804007 DOI: 10.1038/s41598-020-79354-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/07/2020] [Indexed: 01/29/2023] Open
Abstract
Group 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.
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Ager EPC, Steele ED, Nielsen LE, Nestander MA, Mende K, Spencer SE. Hypervirulent Streptococcus agalactiae septicemia in twin ex-premature infants transmitted by breast milk: report of source detection and isolate characterization using commonly available molecular diagnostic methods. Ann Clin Microbiol Antimicrob 2020; 19:55. [PMID: 33243275 PMCID: PMC7691097 DOI: 10.1186/s12941-020-00396-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/07/2020] [Indexed: 01/01/2023] Open
Abstract
Background Group B Streptococcus (GBS) infections caused by Streptococcus agalactiae is a leading cause of meningitis and sepsis in neonates, with early-onset GBS symptoms emerging during the first week of life and late-onset occurring thereafter. Perinatal transmission of GBS to the neonate through the birth canal is the main factor associated with early-onset neonate infections, while less is understood about the source of late-onset infections. Methods In this report we describe a case of twin ex-premature infants who presented one month after birth with GBS septicemia. The mother had been appropriately screened at gestational age 35–37 weeks and laboratory methods failed to detect GBS colonization by culture or clinical molecular methods. In attempts to identify and isolate the source of GBS infection, additional surveillance swabs were collected from the mother at the time of neonate admission. Culture and a commercially available, FDA-cleared molecular PCR assay were performed. Results No GBS was detected from swabs collected from the perianal, thigh/groin or axillary areas. However, expressed breast milk and swabs from the breastmilk pump were positive by both methods. Since simultaneous culture and molecular methods which used breastmilk as a source were performed, investigators ascertained the limit of detection for GBS in breastmilk. The limit of detection was determined to be tenfold lower than that of LIM-broth enriched cultures—the FDA-approved source. Subsequent whole genome sequencing (WGS) analysis of isolates recovered from breastmilk and blood cultures from the infants demonstrated all strains were related and characterized as ST-452. Both infants responded very well to treatment and continued to have no related events or concerns at the two-year follow up appointment. Conclusions Strain type 452 (capsular type IV) has recently emerged as a hypervirulent strain and has previously been documented as causing GBS infections in elderly populations. Antibiotic therapy resolved both mother and infant infections. Subsequent testing for the presence of GBS in breastmilk samples also showed an absence of bacteria. This is the first report of infant twins late-onset GBS infections caused by the hypervirulent S. agalactiae ST-452 with breastmilk as the source.
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Affiliation(s)
- Edward P C Ager
- Department of Clinical Investigations, Brooke Army Medical Center, San Antonio, TX, USA.
| | - Eric D Steele
- Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX, USA
| | - Lindsey E Nielsen
- Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX, USA
| | - Matthew A Nestander
- Department of Pediatric Infectious Disease, Brooke Army Medical Center, San Antonio, TX, USA
| | - Katrin Mende
- Infectious Disease Clinical Research Program, Preventive Medicine and Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, USA.,Infectious Disease Service, Brooke Army Medical Center, San Antonio, TX, USA
| | - Steven E Spencer
- Department of Pediatric Infectious Disease, Brooke Army Medical Center, San Antonio, TX, USA
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Ali MM, Woldeamanuel Y, Asrat D, Fenta DA, Beall B, Schrag S, McGee L. Features of Streptococcus agalactiae strains recovered from pregnant women and newborns attending different hospitals in Ethiopia. BMC Infect Dis 2020; 20:848. [PMID: 33198686 PMCID: PMC7668015 DOI: 10.1186/s12879-020-05581-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022] Open
Abstract
Background Streptococcus agalactiae (Group B Streptococcus, GBS) serotypes, sequence types, and antimicrobial resistance profile vary across different geographic locations affecting disease patterns in newborns. These differences are important considerations for vaccine development efforts and data from large countries in Africa is limited. The aim of this study was to determine serotypes and genotypes of GBS isolates from pregnant women and their newborns in Ethiopia. Methods A hospital based cross-sectional study was conducted at three hospitals in Ethiopia from June 2014 to September 2015. Out of 225 GBS isolates, 121 GBS were recovered, confirmed and characterized at CDC’s Streptococcus Laboratory using conventional microbiology methods and whole genome sequencing. Results Of the 121 isolates, 87 were from rectovaginal samples of pregnant women, 32 from different body parts of their newborns and 2 from blood of newborns with suspected sepsis. There were 25 mother-infant pairs and 24 pairs had concordant strains. The most prevalent serotypes among mothers and/or their babies were II, Ia and V (41.5, 20.6, 19.5 and 40.6%, 25 and 15.6%, respectively). Multilocus sequence typing (MLST) on 83 isolates showed ST10 (24; 28.9%) and ST2 (12; 14.5%) as most predominant sequence types. All GBS strains were susceptible to penicillin, cefotaxime and vancomycin, which correlated to the presence of wildtype PBP2x types and the lack of known vancomycin-resistance genes. Tetracycline resistance was high (73; 88%, associated primarily with tetM, but also tetO and tetL). Five isolates (6%) were resistant to erythromycin and clindamycin and 3 isolates were fluoroquinolone-resistant, containing associated mutations in gyrA and parC genes. All isolates were positive for one of four homologous Alpha/Rib family determinants and 1–2 of the three main pilus types. Conclusions Predominant serotypes were II, Ia, and V. A limited number of clonal types were identified with two STs accounting for about half of the isolates. All strains collected in this study were susceptible to beta-lactam antibiotics and vancomycin. Typical of most GBS, these isolates were positive for single alpha-like family protein, serine-rich repeat gene, as well as 1–2 pilus determinants. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05581-8.
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Affiliation(s)
- Musa Mohammed Ali
- Hawassa University College of Medicine and Health Sciences, School of Medical laboratory Science, Hawassa, Ethiopia.
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University College of Health Science, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University College of Health Science, Addis Ababa, Ethiopia
| | - Demissie Assegu Fenta
- Hawassa University College of Medicine and Health Sciences, School of Medical laboratory Science, Hawassa, Ethiopia
| | - Bernard Beall
- Respiratory Diseases Branch, Centers of Disease Control and Prevention (CDC), Atlanta, USA
| | - Stephanie Schrag
- Respiratory Diseases Branch, Centers of Disease Control and Prevention (CDC), Atlanta, USA
| | - Lesley McGee
- Respiratory Diseases Branch, Centers of Disease Control and Prevention (CDC), Atlanta, USA
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Phylogeny, recombination, and invasiveness of group B Streptococcus revealed by genomic comparisons of its global strains. Eur J Clin Microbiol Infect Dis 2020; 40:581-590. [PMID: 33067737 PMCID: PMC7567417 DOI: 10.1007/s10096-020-04067-4] [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: 04/14/2020] [Accepted: 10/09/2020] [Indexed: 11/26/2022]
Abstract
Capsular polysaccharide (CPS) genes and pilus islands encode important virulence factors for group B Streptococcus (GBS) genomes. This study aims to detect phylogenetic inconsistency in CPS genes and pilus islands in GBSs and to explore its relationship with invasiveness. A total of 1016 GBS genomes were downloaded from the NCBI public database. The multi-locus sequence typing (MLST) and Bayesian analysis of Population Structure (BAPS) analyses were both conducted for phylogeny construction. Serotyping and pilus typing were determined in silico using the genomic sequences. The CPS and pilus typing results were generally consistent with MLST and BAPS clustering. GBS isolates of serotype II and of the PI-1 + PI-2b and PI-2a types were more prone to phylogenetic inconsistency than the others. Isolates of serotype Ib and of PI-1 + PI-2a were more likely to appear as colonizing strains, whereas PI-2b was more likely to appear in invasive strains. For serotype V, phylogenetic inconsistency occurred more commonly in colonizing isolates, while for serotype III, the opposite occurred. The present study profiles for the first time the phylogenetic inconsistency of CPS genes and pilus islands in global GBS isolates, which is helpful for infection control and the development of new vaccines for the prevention of GBS occurrence.
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Systematic review of Group B Streptococcal capsular types, sequence types and surface proteins as potential vaccine candidates. Vaccine 2020; 38:6682-6694. [PMID: 32888741 PMCID: PMC7526974 DOI: 10.1016/j.vaccine.2020.08.052] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 01/31/2023]
Abstract
Most comprehensive review of Group B Streptococcal serotypes through 2018. First systematic review of Group B Streptococcal strain type and protein data. Theoretically candidate vaccines may protect against 93-99% disease-causing strains. More studies on GBS strains in low- and middle-income countries are needed.
Background 21 million pregnant women worldwide (18%) are estimated to carry Group B Streptococcus (GBS), which is a risk for invasive disease in newborns, pregnant women, and stillbirths. Adults ≥ 60 years or with underlying health conditions are also vulnerable to invasive GBS disease. We undertook systematic reviews on GBS organism characteristics including: capsular polysaccharide (serotype), sequence type (multi-locus sequence types (MLST)), and virulence proteins. We synthesised data by at-risk populations, to inform vaccine development. Methods We conducted systematic reviews and meta-analyses to estimate proportions of GBS serotypes for at risk populations: maternal colonisation, invasive disease in pregnant women, stillbirths, infants 0–90 days age, and older adults (≥60 years). We considered regional variation and time trends (2001–2018). For these at-risk population groups, we summarised reported MLST and surface proteins. Results Based on 198 studies (29247isolates), 93–99% of GBS isolates were serotypes Ia, Ib, II, III, IV and V. Regional variation is likely, but data gaps are apparent, even for maternal colonisation which has most data. Serotype III dominates for infant invasive disease (60%) and GBS-associated stillbirths (41%). ST17 accounted for a high proportion of infant invasive disease (41%; 95%CI: 35–47) and was found almost exclusively in serotype III strains, less present in maternal colonisation (9%; 95%CI:6–13),(4%; 95%CI:0–11) infant colonisation, and adult invasive disease (4%, 95%CI:2–6). Percentages of strains with at least one of alp 1, alp2/3, alpha C or Rib surface protein targets were 87% of maternal colonisation, 97% infant colonisation, 93% infant disease and 99% adult invasive disease. At least one of three pilus islands proteins were reported in all strains. Discussion A hexavalent vaccine (serotypes Ia, Ib, II, III, IV and V) might provide comprehensive cover for all at-risk populations. Surveillance of circulating, disease-causing target proteins is useful to inform vaccines not targeting capsular polysaccharide. Addressing data gaps especially by world region and some at-risk populations (notably stillbirths) is fundamental to evidence-based decision-making during vaccine design.
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Crestani C, Forde TL, Zadoks RN. Development and Application of a Prophage Integrase Typing Scheme for Group B Streptococcus. Front Microbiol 2020; 11:1993. [PMID: 32983017 PMCID: PMC7487436 DOI: 10.3389/fmicb.2020.01993] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/28/2020] [Indexed: 01/18/2023] Open
Abstract
Group B Streptococcus (GBS) is a gram-positive pathogen mainly affecting humans, cattle, and fishes. Mobile genetic elements play an important role in the evolution of GBS, its adaptation to host species and niches, and its pathogenicity. In particular, lysogenic prophages have been associated with a high virulence of certain strains and with their ability to cause invasive infections in humans. It is therefore important to be able to accurately detect and classify prophages in GBS genomes. Several bioinformatic tools for the identification of prophages in bacterial genomes are available on-line. However, genome searches for most of these programs are affected by the composition of their reference database. Lack of databases specific to GBS results in failure to recognize all prophages in the species. Additionally, performance of these programs is affected by genome fragmentation in the case of draft genomes, leading to underestimation of the number of phages. They also prove impractical when dealing with large genome datasets and they do not offer a quick way of classifying bacteriophages. We developed a GBS-specific method to screen genome assemblies for the presence of prophages and to classify them based on a reproducible typing scheme. This was achieved through an extensive search of a vast number of high-quality GBS sequences (n = 572) originating from different host species and countries in order to build a database of phage integrase types, on which the scheme is based. The proposed typing scheme comprises 12 integration sites and sixteen prophage integrase types, including multiple subtypes per integration site and integrase genes that were not site-specific. Two putative phage-inducible chromosomal islands (PICI) and their insertion sites were also identified during the course of these analyses. Phages were common and diverse in all major clonal complexes associated with human disease and detected in isolates from every animal species and continent included in the study. This database will facilitate further work on the prevalence and role of prophages in GBS evolution, and identifies the roles of PICIs in GBS and of prophage in hypervirulent ST283 as areas for further research.
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Affiliation(s)
- Chiara Crestani
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Taya L Forde
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Ruth N Zadoks
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom.,Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
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Carreras-Abad C, Ramkhelawon L, Heath PT, Le Doare K. A Vaccine Against Group B Streptococcus: Recent Advances. Infect Drug Resist 2020; 13:1263-1272. [PMID: 32425562 PMCID: PMC7196769 DOI: 10.2147/idr.s203454] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/10/2020] [Indexed: 01/12/2023] Open
Abstract
Group B streptococcus (GBS) causes a high burden of neonatal and infant disease globally. Implementing a vaccine for pregnant women is a promising strategy to prevent neonatal and infant GBS disease and has been identified as a priority by the World Health Organisation (WHO). GBS serotype-specific polysaccharide – protein conjugate vaccines are at advanced stages of development, but a large number of participants would be required to undertake Phase III clinical efficacy trials. Efforts are therefore currently focused on establishing serocorrelates of protection in natural immunity studies as an alternative pathway for licensure of a GBS vaccine, followed by Phase IV studies to evaluate safety and effectiveness. Protein vaccines are in earlier stages of development but are highly promising as they might confer protection irrespective of serotype. Further epidemiological, immunological and health economic studies are required to enable the vaccine to reach its target population as soon as possible.
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Affiliation(s)
- Clara Carreras-Abad
- Paediatric Infectious Diseases Research Group and Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, London, UK.,Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laxmee Ramkhelawon
- Paediatric Infectious Diseases Research Group and Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Paul T Heath
- Paediatric Infectious Diseases Research Group and Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Kirsty Le Doare
- Paediatric Infectious Diseases Research Group and Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, London, UK.,Pathogen Immunity Group, Public Health England, Porton Down,UK.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
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Diaz-Dinamarca DA, Hernandez C, Escobar DF, Soto DA, Muñoz GA, Badilla JF, Manzo RA, Carrión F, Kalergis AM, Vasquez AE. Mucosal Vaccination with Lactococcus lactis-Secreting Surface Immunological Protein Induces Humoral and Cellular Immune Protection against Group B Streptococcus in a Murine Model. Vaccines (Basel) 2020; 8:vaccines8020146. [PMID: 32224855 PMCID: PMC7349291 DOI: 10.3390/vaccines8020146] [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: 02/18/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 12/22/2022] Open
Abstract
Group B Streptococcus (GBS) is the primary etiological agent of sepsis and meningitis in newborns and is associated with premature birth and stillbirth. The development of a licensed vaccine is one of the pending challenges for the World Health Organization. Previously, we showed that oral immunization with surface immune protein (SIP) decreases vaginal colonization of GBS and generates functional opsonizing antibodies, which was determined by opsonophagocytic assays (OPA) in vitro. We also showed that the protein has an adjuvant vaccine profile. Therefore, an oral vaccine based on SIP may be an attractive alternative to employ in the development of new vaccines against GBS. Lactococcus lactis is a highlighted oral vaccine probiotic inducer of the mucosal immune response. This bacterium could serve as an antigen-delivering vehicle for the development of an edible vaccine and has been used in clinical trials. In this study, we showed that an oral vaccine with a recombinant L. lactis strain secreting SIP from GBS (rL. lactis-SIP) can induce protective humoral and cellular immunity in an experimental model of GBS vaginal colonization in C57BL/6 mice. Mice immunized with rL. lactis-SIP were protected against clinical symptoms and bacterial colonization after GBS vaginal colonization. Our rL. lactis-SIP vaccine also induces an increase of immunoglobulin G (IgG) and immunoglobulin A (IgA) specifically against SIP. The adoptive transfer of serum from vaccinated mice to naïve mice generated protection against GBS vaginal colonization. Moreover, the rL.lactis-SIP strain induces the activation of SIP-specific T cells, which could decrease GBS vaginal colonization and generate protective antibodies when transferred to other mice. Our experimental observations strongly support the notion that rL. lactis-SIP induces protective humoral and cellular immunity and could be considered as a novel alternative in the development of vaccines for GBS.
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Affiliation(s)
- Diego A. Diaz-Dinamarca
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
| | - Carlos Hernandez
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8380453, Chile;
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas y Farmaceuticas, Universidad de Chile, Independencia, Santiago 8380492, Chile
| | - Daniel F. Escobar
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
| | - Daniel A. Soto
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
| | - Guillermo A. Muñoz
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8380453, Chile;
| | - Jesús F. Badilla
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8380453, Chile;
- Escuela de Biotecnología, Facultad de Ciencias, Universidad Santo Tomas, Santiago 8320000, Chile
| | - Ricardo A. Manzo
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
| | - Flavio Carrión
- Programa de Inmunología Traslacional, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago 7610315, Chile;
| | - Alexis M. Kalergis
- Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8380453, Chile;
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Abel E. Vasquez
- Sección de Biotecnología, Instituto de Salud Pública de Chile, Santiago 780050, Chile; (D.A.D.-D.); (C.H.); (D.F.E.); (D.A.S.); (G.A.M.); (J.F.B.); (R.A.M.)
- Escuela de Biotecnología, Facultad de Ciencias, Universidad Santo Tomas, Santiago 8320000, Chile
- Facultad de Medicina y Ciencia, Universidad San Sebastián, Providencia, Santiago 8320000, Chile
- Correspondence: ; Tel.: +562-2575-5513
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Shipitsyna E, Shalepo K, Zatsiorskaya S, Krysanova A, Razinkova M, Grigoriev A, Savicheva A. Significant shifts in the distribution of vaccine capsular polysaccharide types and rates of antimicrobial resistance of perinatal group B streptococci within the last decade in St. Petersburg, Russia. Eur J Clin Microbiol Infect Dis 2020; 39:1487-1493. [DOI: 10.1007/s10096-020-03864-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/09/2020] [Indexed: 01/31/2023]
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Gizachew M, Tiruneh M, Moges F, Adefris M, Tigabu Z, Tessema B. Molecular characterization of Streptococcus agalactiae isolated from pregnant women and newborns at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. BMC Infect Dis 2020; 20:35. [PMID: 31931732 PMCID: PMC6958622 DOI: 10.1186/s12879-020-4776-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 01/08/2020] [Indexed: 01/22/2023] Open
Abstract
Background Streptococcus agalctiae (Group B Streptococcus, GBS) is a perinatal pathogen and a leading cause of neonatal infections worldwide. Serotype, sequence type, clonality, antibiotic resistance genes and surface protein profiles of GBS are scarce in Ethiopia, a reason that this study was planned to investigate. . Methods Sixteen colonizing GBS isolates obtained from recto-vaginal swabs of pregnant women and body surfaces of newborns were further analyzed. Minimum inhibitory concentration (MIC) test, and whole genome sequence (WGS) methods were done for antibiotic susceptibility test, and molecular characterization of the isolates. Results All the GBS isolates analyzed were belonged to four capsular serotypes: II, 11/16(68.8%), V, 3/16(18.8%), Ia and VI each with 1/16(6.3%) and five sequence type (ST-2, ST-10, ST-14, ST-569 and ST-933). Sequence type-10 was the most predominant ST followed by ST-569. The five STs were grouped into the four clonal complexes (CC - 1, CC-10, CC-19, and CC-23). Different surface proteins and pili families such as ALP1, ALPHA, ALP23, PI-1 / PI-2A1, PI-1 / PI-2B, and Srr1 were detected from WGS data. All isolates were found to be susceptible to the tested antibiotics except for tetracycline in MIC and WGS test methods used. Tetracycline resistant determinant genes such as TETM and TETL / TETM combination were identified. Conclusion Further studies on serotype and molecular epidemiology will provide a comprehensive data of the GBS capsular serotype and clones available in Ethiopia.
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Affiliation(s)
- Mucheye Gizachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
| | - Moges Tiruneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Mulat Adefris
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Zemene Tigabu
- Department of Pediatrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Belay Tessema
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
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42
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Kobayashi M, Schrag SJ, Alderson MR, Madhi SA, Baker CJ, Sobanjo-Ter Meulen A, Kaslow DC, Smith PG, Moorthy VS, Vekemans J. WHO consultation on group B Streptococcus vaccine development: Report from a meeting held on 27-28 April 2016. Vaccine 2019; 37:7307-7314. [PMID: 28017431 PMCID: PMC6892266 DOI: 10.1016/j.vaccine.2016.12.029] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
Globally, group B Streptococcus (GBS) remains a leading cause of sepsis and meningitis in infants in the first 90days of life. Intrapartum antibiotic prophylaxis (IAP) for women at increased risk of transmitting GBS to their newborns has been effective in reducing part, but not all, of the GBS disease burden in many high income countries (HICs). In low- and middle-income countries (LMICs), IAP use is low. Immunization of pregnant women with a GBS vaccine represents an alternative strategy to protecting newborns and young infants, through transplacental antibody transfer and potentially by reducing new vaginal colonization. This vaccination strategy was first suggested in the 1970s and several potential GBS vaccines have completed phase I/II clinical trials. During the 2015 WHO Product Development for Vaccines Advisory Committee meeting, GBS was identified as a high priority for the development of a vaccine for maternal immunization because of the major public health burden posed by GBS in LMICs, and the high technical feasibility for successful development. Following this meeting, the first WHO technical consultation on GBS vaccines was held on the 27th and 28th of April 2016, to consider development pathways for such vaccines, focused on their potential role in reducing newborn and young infant deaths and possibly stillbirths in LMICs. Discussion topics included: (1) pathophysiology of disease; (2) current gaps in the knowledge of global disease burden and serotype distribution; (3) vaccine candidates under development; (4) design considerations for phase III trials; and (5) pathways to licensure, policy recommendations and use. Efforts to address gaps identified in each of these areas are needed to establish the public health need for, the development and deployment of, efficacious GBS vaccines. In particular, more work is required to understand the global disease burden of GBS-associated stillbirths, and to develop quality-assured standardized antibody assays to identify correlates of protection.
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Affiliation(s)
- Miwako Kobayashi
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Stephanie J Schrag
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| | - Mark R Alderson
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - Shabir A Madhi
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, and Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Carol J Baker
- Department of Pediatrics, Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | | | - David C Kaslow
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - Peter G Smith
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Vasee S Moorthy
- Initiative for Vaccine Research, World Health Organization, CH-1211 Geneva 27, Switzerland
| | - Johan Vekemans
- Initiative for Vaccine Research, World Health Organization, CH-1211 Geneva 27, Switzerland.
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Kardos S, Tóthpál A, Laub K, Kristóf K, Ostorházi E, Rozgonyi F, Dobay O. High prevalence of group B streptococcus ST17 hypervirulent clone among non-pregnant patients from a Hungarian venereology clinic. BMC Infect Dis 2019; 19:1009. [PMID: 31779587 PMCID: PMC6883650 DOI: 10.1186/s12879-019-4626-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 11/11/2019] [Indexed: 11/08/2022] Open
Abstract
Background Although Streptococcus agalactiae is the leading causative agent of neonatal sepsis and meningitis, recently it is increasingly isolated from non-pregnant adults. The relation between its presence in the genitourinary tract and manifested clinical symptoms of STD patients remains an open question. In this study, a complex epidemiological investigation of GBS isolates from a venerology clinic was performed. Methods Ninety-six GBS isolates were serotyped and their genetic relatedness determined by PFGE. MLST was also performed for a subset of 20 isolates. The antibiotic susceptibility was tested with agar dilution. Surface proteins and the ST-17 hypervirulent clone was detected by PCR. Results The serotype prevalence was the following: V (29.2%), III (27.1%), Ia (22.9%), IV (10.4%), II (5.2%) and Ib (4.2%). A strong association was demonstrated between surface protein genes and serotypes. All isolates were fully susceptible to penicillin, but erythromycin and clindamycin resistance was high (41.7 and 35.4%, respectively), and 8 phenotypically macrolide sensitive isolates carried the ermB gene. 21.9% of all strains belonged to the hypervirulent ST17 clone, most being of serotype III and all were rib +. We found a few serotype IV isolates belonging to several STs and one serotype V/ST110 strain, containing a 44-bp deletion in the atr allele. Conclusions The presence of silent ermB genes is of worry, as their expression upon macrolide exposure could lead to unforeseen therapeutic failure, while clindamycin is used for intrapartum antibiotic prophylaxis, in case of penicillin allergy. The other alarming result is the high prevalence of ST17 among these strains from STD patients, who could be sources of further infections. This is the first report from Hungary providing both serotyping and genotyping data of GBS isolates. These results could be helpful for vaccine production as the major vaccine candidates are capsular antigens or surface proteins.
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Affiliation(s)
- Szilvia Kardos
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary
| | - Adrienn Tóthpál
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary
| | - Krisztina Laub
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary
| | - Katalin Kristóf
- Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Ostorházi
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary.,Department of Dermatology, Dermatooncology and Venerology, Semmelweis University, Budapest, Hungary
| | - Ferenc Rozgonyi
- Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary.,Department of Dermatology, Dermatooncology and Venerology, Semmelweis University, Budapest, Hungary
| | - Orsolya Dobay
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary.
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Ratner AJ. Enhanced Postnatal Acquisition of Hypervirulent Group B Streptococcus. Clin Infect Dis 2019; 69:1749-1751. [PMID: 30945730 PMCID: PMC6821193 DOI: 10.1093/cid/ciz035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/10/2019] [Indexed: 12/28/2022] Open
Affiliation(s)
- Adam J Ratner
- Departments of Pediatrics and Microbiology, New York University School of Medicine, New York
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45
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Furfaro LL, Chang BJ, Kahler CM, Payne MS. Genomic characterisation of perinatal Western Australian Streptococcus agalactiae isolates. PLoS One 2019; 14:e0223256. [PMID: 31577825 PMCID: PMC6774530 DOI: 10.1371/journal.pone.0223256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022] Open
Abstract
As a leading cause of neonatal sepsis, Streptococcus agalactiae, commonly known as Group B Streptococcus, is a major neonatal pathogen. Current global screening practices employ risk- or culture-based protocols for detection of these organisms. In Western Australia (WA), universal culture-based screening is provided, with subsequent intrapartum antibiotic prophylaxis for all S. agalactiae-positive women during labour. Widespread antibiotic exposure is not ideal and this is one of the factors driving development of vaccines against S. agalactiae. Vaccine candidates have focused on the capsule, surface proteins and pilus types, however, capsule serotypes are known to vary geographically. The aim of this study was to use genome sequencing to gain an understanding of the circulating genotypes in WA, and to assess variations in the associated gene pools. We sequenced 141 antenatal carriage (vaginal/rectal) isolates and 10 neonatal invasive disease isolates from WA. Based on the global PubMLST database, the 151 strains were characterised into 30 sequence types, with clustering of these mainly into clonal complexes 1, 12, 17, 19 and 23. Of the genes encoding eleven surface proteins that were analysed, the most prevalent were fbp, lmb and scpB which were present in ≥ 98% of isolates. A cluster of non-haemolytic isolates, one of which was a neonatal invasive disease isolate, appeared to lack the entire cyl locus. Admixture analysis of population structure revealed evidence of genetic transfer among the WA isolates across structural groups. When compared against the PubMLST S. agalactiae data, WA isolates showed high levels of strain diversity with minimal apparent clustering. This is the first whole genome sequence study of WA S. agalactiae isolates and also represents the first addition of Australian isolate data to PubMLST. This report provides insight into the distribution and diversity of vaccine targets of S. agalactiae within Western Australia, indicating that the most appropriate capsular vaccine for this population would be the proposed pentavalent (Cps Ia, Ib, II, III and V) preparation, whilst vaccines targeting surface proteins should ideally utilise Fbp, Lmb and/or ScpB.
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Affiliation(s)
- Lucy L. Furfaro
- The School of Medicine, Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
| | - Barbara J. Chang
- The School of Biomedical Sciences, The Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, Perth, Western Australia, Australia
| | - Charlene M. Kahler
- The School of Biomedical Sciences, The Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew S. Payne
- The School of Medicine, Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
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46
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Lopes E, Fernandes T, Machado MP, Carriço JA, Melo-Cristino J, Ramirez M, Martins ER. Increasing macrolide resistance among Streptococcus agalactiae causing invasive disease in non-pregnant adults was driven by a single capsular-transformed lineage, Portugal, 2009 to 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 29845930 PMCID: PMC6152215 DOI: 10.2807/1560-7917.es.2018.23.21.1700473] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We characterised Lancefield group B streptococcal (GBS) isolates causing invasive disease among non-pregnant adults in Portugal between 2009 and 2015. All isolates (n = 555) were serotyped, assigned to clonal complexes (CCs) by multilocus sequence typing and characterised by surface protein and pilus island gene profiling. Antimicrobial susceptibility was tested by disk diffusion and resistance genotypes identified by PCR. Overall, serotype Ia was most frequent in the population (31%), followed by serotypes Ib (24%) and V (18%). Serotype Ib increased significantly throughout the study period (p < 0.001) to become the most frequent serotype after 2013. More than 40% of isolates clustered in the CC1/alp3/PI-1+PI-2a genetic lineage, including most isolates of serotypes Ib (n = 110) and V (n = 65). Erythromycin and clindamycin resistance rates were 35% and 34%, respectively, both increasing from 2009 to 2015 (p < 0.010) and associated with CC1 and serotype Ib (p < 0.001). The Ib/CC1 lineage probably resulted from acquisition of the type Ib capsular operon in a single recombination event by a representative of the V/CC1 macrolide-resistant lineage. Expansion of the new serotype Ib/CC1 lineage resulted in increased macrolide resistance in GBS, causing invasive disease among adults in Portugal. The presence of this clone elsewhere may predict more widespread increase in resistance.
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Affiliation(s)
- Elísia Lopes
- These authors contributed equally to this work.,Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Tânia Fernandes
- These authors contributed equally to this work.,Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Miguel P Machado
- Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - João André Carriço
- Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - José Melo-Cristino
- Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Mário Ramirez
- Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Elisabete R Martins
- Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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- The members of group are listed at the end of the article
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47
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Lee CC, Hsu JF, Prasad Janapatla R, Chen CL, Zhou YL, Lien R, Chiu CH. Clinical and Microbiological Characteristics of Group B Streptococcus from Pregnant Women and Diseased Infants in Intrapartum Antibiotic Prophylaxis Era in Taiwan. Sci Rep 2019; 9:13525. [PMID: 31537886 PMCID: PMC6753095 DOI: 10.1038/s41598-019-49977-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/15/2019] [Indexed: 01/09/2023] Open
Abstract
Group B Streptococcus (GBS) is one of the most important pathogens for neonates. This study included 69 invasive GBS diseases in neonates, including 7 early-onset disease (EOD), 55 late-onset disease, and 7 very-late-onset disease from 2013 to 2017. A significant reduction of EOD after the deployment of intrapartum antibiotic prophylaxis (IAP) in 2012 was observed. A previously-recognized hypervirulent clone GBS III ST17, accounting for 68% of the overall infections and 71% of the meningitis, was identified among the 69 cases. A novel GBS Ia ST890 emerged, becoming the fourth most common clone. Overall 96% of the invasive GBS infections were caused by serotypes Ia, Ib, and III. We collected 300 GBS isolates from vagina of the healthy pregnant women in 2014 and 2017. The serotype distribution of the maternal colonization isolates was VI (35%), III (21%), V (15%), Ib (13%) and Ia (11%) in 2014, and VI (32%), III (22%), V (16%), Ia (16%), and Ib (8%) in 2017. The most common sequence types were ST1 (32%), ST12 (22%), and ST23 (15%). Serotype diversity of maternal colonization strains did not change between 2014 and 2017. The study provides useful information in surveillance of GBS disease in the era of IAP.
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Affiliation(s)
- Chien-Chung Lee
- Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jen-Fu Hsu
- Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | | | - Chyi-Liang Chen
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ying-Li Zhou
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Reyin Lien
- Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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48
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Li J, Ji W, Gao K, Zhou H, Zhang L, Mu X, Yuan C, Guan X, Deng Q, Zhang L, Zhong H, Gao X, Gao F, Long Y, Chang CY, McIver DJ, Liu H. Molecular characteristics of group B Streptococcus isolates from infants in southern mainland China. BMC Infect Dis 2019; 19:812. [PMID: 31533652 PMCID: PMC6751900 DOI: 10.1186/s12879-019-4434-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/30/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Invasive group B Streptococcus (GBS) disease in Chinese infants has gradually gained attention in recent years, but the molecular epidemiology of the pathogen is still not well known. METHODS This multicenter study retrospectively investigated distribution of capsular serotypes, sequence types (STs), and hypervirulent GBS adhesin gene (hvgA) in clinical GBS isolates that caused invasive disease in infants aged < 3 months of age in southern mainland China between January 2013 and June 2016. Genes for antibiotic resistance to tetracycline, erythromycin, and clindamycin were also examined. RESULTS From a total of 93 GBS isolates taken from 34 early-onset disease (EOD, 0-6 days after birth) and 59 late-onset disease (LOD, 7-89 days after birth) cases, four serotypes were identified: serotypes III (79.6%), Ib (12.9%), Ia (4.3%), and V (3.2%). Serotype III accounted for 73.5% of EOD and 83.1% of LOD and was responsible for 75.5% of cases involving meningitis. Fifteen STs were found, with the majority being ST17 (61.3%), ST12 (7.5%), ST19 (7.5%), and others (23.7%). 96.8% of STs belonged to only five clonal complexes (CCs): CC17 (64.5%), CC10 (12.9%), CC19 (9.7%), CC23 (6.5%), and CC1 (3.2%). The hvgA gene was detected in 66.7% of GBS isolates and 95% of CC17 isolates, all of which were serotype III except one serotype Ib/CC17 isolate. A large proportion of GBS isolates were found to be resistant to tetracycline (93.5%), clindamycin (65.5%), and erythromycin (60.2%). Genes of tetO (74.7%) and tetM (46.0%) were found in tetracycline resistant isolates, linB (24.6%) in clindamycin resistant isolates, and ermB (87.5%) and mefA (3.6%) in erythromycin resistant isolates. CONCLUSION Our results reveal higher prevalence of serotype III, ST17, CC17, hvgA expressing, and antibiotic resistant GBS isolates than previously reported in southern mainland China. This study provides guidance for appropriate measures of prevention and control to be taken in the future.
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Affiliation(s)
- Juan Li
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
- Clinical Laboratory, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095 Guangdong China
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi China
| | - Kankan Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Haijian Zhou
- National Institute for Communicable Disease Control and Prevention, and State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, 102206 China
| | - Lihua Zhang
- Clinical Laboratory, Dongguan Tungwah Hospital, Sun Yat-Sen Universtiy, Dongguan, 523110 Guangdong China
| | - Xiaoping Mu
- Clinical Laboratory, Guangdong Women and Children’s Hospital, Guangzhou, 511400 Guangdong China
| | - Chunlei Yuan
- Clinical Laboratory, ZhongshanBoai Hospital, Zhongshan, 528403 Guangdong China
| | - Xiaoshan Guan
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Qiulian Deng
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Lian Zhang
- Department of Neonatalogy, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong China
| | - Huamin Zhong
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Xiurong Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Fei Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Yan Long
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Chien-Yi Chang
- School of Chemistry and Biosceinces, University of Bradford, Bradford, UK
| | | | - Haiying Liu
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
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49
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Chen SL. Genomic Insights Into the Distribution and Evolution of Group B Streptococcus. Front Microbiol 2019; 10:1447. [PMID: 31316488 PMCID: PMC6611187 DOI: 10.3389/fmicb.2019.01447] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/11/2019] [Indexed: 01/31/2023] Open
Abstract
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a bacteria with truly protean biology. It infects a variety of hosts, among which the most commonly studied are humans, cattle, and fish. GBS holds a singular position in the history of bacterial genomics, as it was the substrate used to describe one of the first major conceptual advances of comparative genomics, the idea of the pan-genome. In this review, I describe a brief history of GBS and the major contributions of genomics to understanding its genome plasticity and evolution as well as its molecular epidemiology, focusing on the three hosts mentioned above. I also discuss one of the major recent paradigm shifts in our understanding of GBS evolution and disease burden: foodborne GBS can cause invasive infections in humans.
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Affiliation(s)
- Swaine L Chen
- Division of Infectious Diseases, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Infectious Diseases Group, Genome Institute of Singapore, Singapore, Singapore
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50
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Hsu JF, Chen CL, Lee CC, Lien R, Chu SM, Fu RH, Chiang MC, Yang CY, Lai MY, Wu IH, Yen YS, Chiu CH. Characterization of group B Streptococcus colonization in full-term and Late-Preterm neonates in Taiwan. Pediatr Neonatol 2019; 60:311-317. [PMID: 30145107 DOI: 10.1016/j.pedneo.2018.07.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 06/26/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Group B streptococcus (GBS) infections can be life-threatening in newborns. This study aimed to analyze GBS carriage status and genotypic diversity in healthy neonates after implementation of intrapartum antibiotic prophylaxis (IAP) in Taiwan. METHODS Newborns carrying GBS were identified from a screen of 500 newborns and followed up until their cultures turned negative. Their mothers' GBS screening data were reviewed. Molecular methods, including capsular serotyping, multilocus sequence typing and pulsed-field gel electrophoresis (PFGE), were used to analyze GBS isolates. RESULTS GBS colonization was detected at either the nose or anus in 11 of 500 healthy neonates (2.2%). In this group of 11 neonates, 4 had GBS serotypes II and III for 4-6 months, 1 had serotype V for 2 months, 6 had serotypes Ia, II, V, and VI for less than 1 month, and 1 had 2 different serotypes (serotypes V and II) at different times. The most prevalent serotype was II (33.3%), followed by Ia (25.0%), III (16.7%), V (16.7%), and VI (8.3%). The main sequence type was ST1 (50.0%), followed by ST19 (16.7%), ST23 (8.3%), ST24 (8.3%), ST103 (8.3%), and ST 231 (8.3%). All isolates were grouped into 5 PFGE clusters F, G, J, X, and Y, and all were susceptible to β-lactam antimicrobial agents. CONCLUSIONS GBS was carried in 2.2% (11/500) healthy newborns and persisted for 6 months in 3 neonates. This study makes clearer our understanding of GBS colonization, serotype distribution, and genotype distribution in healthy neonates.
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Affiliation(s)
- Jen-Fu Hsu
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chyi-Liang Chen
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Chung Lee
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Reyin Lien
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shih-Ming Chu
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ren-Huei Fu
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Chou Chiang
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chang-Yo Yang
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Mei-Yin Lai
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - I-Hsyuan Wu
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Shan Yen
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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