Ultra-late-onset Meningitis Caused by Serotype IX Group B Streptococcus

Whole genome sequencing for antimicrobial resistance mechanisms, virulence factors and clonality in invasive Streptococcus agalactiae blood culture isolates recovered in Australia

Invasive Streptococcus agalactiae (Group B streptococci, GBS) infections result in a large burden of disease globally. Changes in clinical and molecular epidemiology, as well as antibiotic resistance patterns, are being described globally amongst GBS isolates. Very little is known about the characteristics of invasive GBS disease in the Australian setting. Therefore, this study aimed to define the clinical and genomic characteristics of invasive GBS isolates from the Sunshine Coast region in Australia. Thirty-two isolates were identified over a 3-year period. Known risk factors for disease were present in 71.9% and the leading site of disease was the skin and soft tissue (40.6%). Sequence types (ST) 1, 17 and 23 made up 50% with ST17 making up 56.2% of the total. Serotype Ia was the most prevalent (9/32, 28.1%). Clindamycin and erythromycin resistance was seen in 12.5% and 25%, respectively. Active surveillance and local knowledge of GBS epidemiology and antibiotic resistance has both patient and public health importance. Vaccine candidates are currently in their clinical phase of development.

Intracranial hemorrhage associated with late-onset group B streptococcus disease-a case report and a review of literature

To report a case of intracranial hemorrhage in an 86-day-old boy with late-onset group B streptococcus (GBS) disease and review the literature of GBS disease. Physical and auxiliary examinations and PubMed search with keywords of "GBS disease" and "intracranial hemorrhage". The 86-day-old boy was admitted to hospital for respiratory arrest. High tension in bregma indicated intracranial infection. Laboratory examination showed low red blood cell account, low white blood cell account and high C-reactive protein account. Also, GBS was positive in cerebrospinal fluid (CSF) and blood culture. Computed tomography (CT) indicated intracranial hemorrhage. Meropenem and other supportive treatment started immediately. Because of the patient's poor condition, the patient's parents abandoned the treatment. As for literature review, intracranial hemorrhage is rarely seen in late-onset disease (LOD). The case contributes to further exploration on the syndromes of GBS disease. Clinical workers should notice the complexity of bacterial infection. The relationship between polluted breast milk and infection remains to be explored.

Perinatal Streptococcus agalactiae Epidemiology and Surveillance Targets

Streptococcus agalactiae, or group B streptococcus (GBS), is a major neonatal pathogen. Recent data have elucidated the global prevalence of maternal and neonatal colonization, but gaps still remain in the epidemiology of this species. A number of phenotypic and genotypic classifications can be used to identify the diversity of GBS strains, and some are more discriminatory than others. This review explores the main schemes used for GBS epidemiology and further details the targets for epidemiological surveillance. Current screening practices across the world provide a unique opportunity to gain detailed information on maternal colonizing strains and neonatal disease-causing strains, which is vital for monitoring and therapeutics, if sufficient detail can be extracted. Deciphering which isolates are circulating within specific populations and recording targets within invasive strains are crucial steps in monitoring the implementation of therapeutics, such as vaccines, as well as developing novel therapies against prevalent GBS strains. Having a detailed understanding of global GBS epidemiology will prove invaluable for understanding the pathogenesis of this organism and equipping future prevention strategies for success.