1
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Molecular Epidemiology of Group B Streptococcus Colonization in Egyptian Women. Microorganisms 2022; 11:microorganisms11010038. [PMID: 36677330 PMCID: PMC9861799 DOI: 10.3390/microorganisms11010038] [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: 11/30/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Streptococcus agalactiae or Group B Streptococcus (GBS) causes severe neonatal infections with a high burden of disease, especially in Africa. Maternal vaginal colonization and perinatal transmissions represent the common mode of acquiring the infection. Development of an effective maternal vaccine against GBS relies on molecular surveillance of the maternal GBS population to better understand the global distribution of GBS clones and serotypes. (2) Methods: Here, we present genomic data from a collection of colonizing GBS strains from Ismailia, Egypt that were sequenced and characterized within the global JUNO project. (3) Results: A large proportion of serotype VI, ST14 strains was discovered, a serotype which is rarely found in strain collections from the US and Europe and typically not included in the current vaccine formulations. (4) Conclusions: The molecular epidemiology of these strains clearly points to the African origin with the detection of several sequence types (STs) that have only been observed in Africa. Our data underline the importance of continuous molecular surveillance of the GBS population for future vaccine implementations.
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2
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Ma X, Wu M, Wang C, Li H, Fan A, Wang Y, Han C, Xue F. The pathogenesis of prevalent aerobic bacteria in aerobic vaginitis and adverse pregnancy outcomes: a narrative review. Reprod Health 2022; 19:21. [PMID: 35090514 PMCID: PMC8796570 DOI: 10.1186/s12978-021-01292-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Aerobic vaginitis is a common cause of vaginal discharge in reproductive-age women, increasing the risk of negative pregnancy outcomes such as premature delivery, abortion, premature rupture of membranes and stillbirth. However, the aetiology and pathogenesis of aerobic vaginitis causing negative pregnancy outcomes are still unclear, and there is no unified and standardized treatment method for aerobic vaginitis in the pregnancy period. Methods We conducted a literature search of published studies in the English language focusing on aerobic vaginitis and its association with adverse pregnancy outcomes utilizing PubMed and Web of Science from January 1973 through June 2021. The common pathogenic bacteria of aerobic vaginitis during pregnancy, such as group B Streptococcus, Escherichia coli, Staphylococcus aureus, Enterococcus faecalis and Klebsiella pneumoniae, as well as the related adverse pregnancy outcomes and existing treatments were reviewed. Results A total of 4534 articles were identified, and 97 studies that had inclusion criteria were subjected to careful review. The pathogenic bacteria of aerobic vaginitis can produce different toxins or affect the local immunity of patients and then lead to the occurrence of infection. Fresh wet mount microscopy is the preferred diagnostic method for aerobic vaginitis. Clindamycin is a common antibiotic used for aerobic vaginitis in pregnant women. The use of products combining probiotics has achieved excellent treatment success. Conclusions Future research in this field can provide insights regarding the mechanism of aerobic vaginitis-induced adverse pregnancy outcomes in humans and ways to prevent their occurrence. Aerobic vaginitis is an infection of the vagina that increases the risk of negative pregnancy outcomes. The aetiology and pathogenesis of aerobic vaginitis causing negative pregnancy outcomes are still unclear. This paper reviews the common pathogenic bacteria of aerobic vaginitis during pregnancy, and the related adverse pregnancy outcomes. We also review the existing treatment. Currently, it is believed that the microflora in aerobic vaginitis is composed of commensal aerobic microorganisms of intestinal origin, and the most frequently encountered bacteria are group B Streptococcus, Escherichia coli, Staphylococcus aureus, Enterococcus faecalis and Klebsiella pneumoniae. The pathogenic bacteria of aerobic vaginitis can produce different toxins or affect the local immunity of patients and then lead to the occurrence of infection. Fresh wet mount microscopy is the preferred diagnostic method for aerobic vaginitis. Clindamycin is a common antibiotic used for aerobic vaginitis in pregnant women. The use of products combining probiotics has achieved excellent treatment success. This study provides a reference for future research and early diagnosis and treatment during pregnancy. Future research in this field can provide insights regarding the mechanisms of aerobic vaginitis-induced adverse pregnancy outcomes in humans and ways to prevent their occurrence.
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Affiliation(s)
- Xiaotong Ma
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Ming Wu
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Chen Wang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Huiyang Li
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Aiping Fan
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Yingmei Wang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Cha Han
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China. .,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China.
| | - Fengxia Xue
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China. .,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China.
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3
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Shabayek S, Ferrieri P, Spellerberg B. Group B Streptococcal Colonization in African Countries: Prevalence, Capsular Serotypes, and Molecular Sequence Types. Pathogens 2021; 10:pathogens10121606. [PMID: 34959562 PMCID: PMC8706430 DOI: 10.3390/pathogens10121606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022] Open
Abstract
Streptococcus agalactiae or group B streptococcus (GBS) is a commensal of the gastrointestinal and genitourinary tracts of healthy women and an important cause of neonatal invasive infections worldwide. Transmission of bacteria to the newborn occurs at birth and can be prevented by intrapartum antibiotic prophylaxis. However, this not available in resource limited settings in Africa, which carries a particular high burden of disease. Serotype based vaccines are in development and present a suitable alternative to prevent neonatal infections. To be able to assess vaccine efficacy, knowledge and surveillance of GBS epidemiological data are required. This review summarizes investigations about the serotype distribution and the multi-locus sequence types (MLST) found in different African countries. While most serotypes and MLST data are comparable to findings from other continents, some specific differences exist. Serotype V is predominant among colonizing maternal strains in many different African countries. Serotypes that are rarely detected in western industrialized nations, such as serotypes VI, VII and IX, are prevalent in studies from Ghana and Egypt. Moreover, some specific MLST sequence types that seem to be more or less unique to Africa have been detected. However, overall, the data confirm that a hexavalent vaccine can provide broad coverage for the African continent and that a protein vaccine could represent a promising alternative.
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Affiliation(s)
- Sarah Shabayek
- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt;
| | - Patricia Ferrieri
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Barbara Spellerberg
- Institute of Medical Microbiology and Hygiene, University Hospital Ulm, 89081 Ulm, Germany
- Correspondence:
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4
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Osei Sekyere J, Mensah E. Molecular epidemiology and mechanisms of antibiotic resistance in Enterococcus spp., Staphylococcus spp., and Streptococcus spp. in Africa: a systematic review from a One Health perspective. Ann N Y Acad Sci 2020; 1465:29-58. [PMID: 31647583 DOI: 10.1111/nyas.14254] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/04/2019] [Accepted: 09/17/2019] [Indexed: 12/19/2022]
Abstract
A systematic review of antibiotic-resistant Gram-positive bacteria in Africa from a One Health perspective is lacking. Here, we report result from a search for English-language articles on the resistance mechanisms and clonality of Gram-positive bacteria in Africa between 2007 and 2019 reported in PubMed, Web of Science, ScienceDirect, and African Journals OnLine; 172 studies from 22 different African countries were identified. Resistance genes, such as mecA, erm(B), erm(C), tet(M), tet(K), tet(L), vanB, vanA, vanC, and tet(O), were found to be common. Staphylococcus spp., Enterococcus spp., and Streptococcus spp. were the main species reported by the studies, with clones such as Staphylococcus aureus ST5 (n = 218 isolates), ST8 (n = 127 isolates), ST80 (n = 133 isolates), and ST88 (n = 117 isolates), and mobile genetic elements such as IS16 (n = 28 isolates), IS256 (n = 96), Tn916 (n = 107 isolates), and SCCmec (n = 4437 isolates) identified. SCCmec IV (n = 747 isolates) was predominant, followed by SCCmec III (n = 305 isolates), SCCmec II (n = 163 isolates), SCCmec V (n = 135 isolates), and SCCmec I (n = 79 isolates). Resistance to penicillin (n = 5926 isolates), tetracycline (n = 5300 isolates), erythromycin (n = 5151 isolates), rifampicin (n = 3823 isolates), gentamycin (n = 3494 isolates), sulfamethoxazole/trimethoprim (n = 3089 isolates), and ciprofloxacin (n = 2746 isolates) was common in most reports from 22 countries. Clonal dissemination of resistance across countries and between humans, animals, and the environment was observed. Resistance rates ranged from 1.4% to 100% for 15 of the studies; 10 were One Health-related studies. Strict infection control measures, antimicrobial stewardship, and periodic One Health epidemiological surveillance studies are needed to monitor and contain the threat of increasing antibiotic resistance in Africa.
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Affiliation(s)
- John Osei Sekyere
- Department of Medical Microbiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Eric Mensah
- Kumasi Centre for Collaborative Research in Tropical Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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5
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Richards VP, Velsko IM, Alam MT, Zadoks RN, Manning SD, Pavinski Bitar PD, Hassler HB, Crestani C, Springer GH, Probert BM, Town CD, Stanhope MJ. Population Gene Introgression and High Genome Plasticity for the Zoonotic Pathogen Streptococcus agalactiae. Mol Biol Evol 2019; 36:2572-2590. [PMID: 31350563 PMCID: PMC6805230 DOI: 10.1093/molbev/msz169] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/04/2019] [Accepted: 07/18/2019] [Indexed: 01/06/2023] Open
Abstract
The influence that bacterial adaptation (or niche partitioning) within species has on gene spillover and transmission among bacterial populations occupying different niches is not well understood. Streptococcus agalactiae is an important bacterial pathogen that has a taxonomically diverse host range making it an excellent model system to study these processes. Here, we analyze a global set of 901 genome sequences from nine diverse host species to advance our understanding of these processes. Bayesian clustering analysis delineated 12 major populations that closely aligned with niches. Comparative genomics revealed extensive gene gain/loss among populations and a large pan genome of 9,527 genes, which remained open and was strongly partitioned among niches. As a result, the biochemical characteristics of 11 populations were highly distinctive (significantly enriched). Positive selection was detected and biochemical characteristics of the dispensable genes under selection were enriched in ten populations. Despite the strong gene partitioning, phylogenomics detected gene spillover. In particular, tetracycline resistance (which likely evolved in the human-associated population) from humans to bovine, canines, seals, and fish, demonstrating how a gene selected in one host can ultimately be transmitted into another, and biased transmission from humans to bovines was confirmed with a Bayesian migration analysis. Our findings show high bacterial genome plasticity acting in balance with selection pressure from distinct functional requirements of niches that is associated with an extensive and highly partitioned dispensable genome, likely facilitating continued and expansive adaptation.
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Affiliation(s)
- Vincent P Richards
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
- Department of Biological Sciences, College of Science, Clemson University, Clemson, SC
| | - Irina M Velsko
- Department of Biological Sciences, College of Science, Clemson University, Clemson, SC
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, Jena, Germany
| | - Md Tauqeer Alam
- Department of Biological Sciences, College of Science, Clemson University, Clemson, SC
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL
| | - Ruth N Zadoks
- Pentlands Science Park, Moredun Research Institute, Penicuik, United Kingdom
- Institute for Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Shannon D Manning
- Department of Microbiology and Molecular Genetics, Michigan State University, E. Lansing, MI
| | - Paulina D Pavinski Bitar
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Hayley B Hassler
- Department of Biological Sciences, College of Science, Clemson University, Clemson, SC
| | - Chiara Crestani
- Pentlands Science Park, Moredun Research Institute, Penicuik, United Kingdom
| | - Garrett H Springer
- Department of Biological Sciences, College of Science, Clemson University, Clemson, SC
| | - Brett M Probert
- Department of Biological Sciences, College of Science, Clemson University, Clemson, SC
| | | | - Michael J Stanhope
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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6
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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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7
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Cobo-Angel CG, Jaramillo-Jaramillo AS, Palacio-Aguilera M, Jurado-Vargas L, Calvo-Villegas EA, Ospina-Loaiza DA, Rodriguez-Lecompte JC, Sanchez J, Zadoks R, Ceballos-Marquez A. Potential group B Streptococcus interspecies transmission between cattle and people in Colombian dairy farms. Sci Rep 2019. [PMID: 31575879 DOI: 10.1038/s41598–019–50225–w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Group B Streptococcus (GBS), is a leading cause of neonatal death and an emerging pathogen in adults. Additionally, GBS is a bovine pathogen causing intramammary infections. The likelihood of GBS interspecies transmission is largely unknown. We explored the potential transmission of GBS between cattle and people on dairy farms in Colombia and compared the antimicrobial resistance (AMR) profiles of isolates from both host species. Across 33 farms, throat swabs and rectal swabs were collected from 191 people, and rectal swabs and composite milk samples from 2092 cattle, yielding 60 human isolates and 301 bovine isolates. The majority (64%) of isolates belonged to shared sequence types (ST). Sequence type (ST) 1 was the most common strain in both host species, suggesting that interspecies transmission may be possible. Two members of the bovine-specific clonal complex 61/67 were detected in human samples (ST718 and ST1175), providing evidence for the lack of genuine species barriers. Apparent prevalence of penicillin resistance was surprisingly high in human and bovine isolates. Further investigation of this phenomenon is needed and could lead to modification of standard testing and treatment recommendations in human and veterinary medicine.
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Affiliation(s)
- Claudia G Cobo-Angel
- Research Group in Milk Quality and Veterinary Epidemiology, Faculty of Agricultural Sciences, Universidad de Caldas, Manizales, Colombia
| | - Ana S Jaramillo-Jaramillo
- Research Group in Milk Quality and Veterinary Epidemiology, Faculty of Agricultural Sciences, Universidad de Caldas, Manizales, Colombia
| | | | | | | | - Diego A Ospina-Loaiza
- Research Group in Milk Quality and Veterinary Epidemiology, Faculty of Agricultural Sciences, Universidad de Caldas, Manizales, Colombia
| | - Juan C Rodriguez-Lecompte
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Javier Sanchez
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Ruth Zadoks
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
| | - Alejandro Ceballos-Marquez
- Research Group in Milk Quality and Veterinary Epidemiology, Faculty of Agricultural Sciences, Universidad de Caldas, Manizales, Colombia.
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8
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Potential group B Streptococcus interspecies transmission between cattle and people in Colombian dairy farms. Sci Rep 2019; 9:14025. [PMID: 31575879 PMCID: PMC6773701 DOI: 10.1038/s41598-019-50225-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 08/27/2019] [Indexed: 01/10/2023] Open
Abstract
Group B Streptococcus (GBS), is a leading cause of neonatal death and an emerging pathogen in adults. Additionally, GBS is a bovine pathogen causing intramammary infections. The likelihood of GBS interspecies transmission is largely unknown. We explored the potential transmission of GBS between cattle and people on dairy farms in Colombia and compared the antimicrobial resistance (AMR) profiles of isolates from both host species. Across 33 farms, throat swabs and rectal swabs were collected from 191 people, and rectal swabs and composite milk samples from 2092 cattle, yielding 60 human isolates and 301 bovine isolates. The majority (64%) of isolates belonged to shared sequence types (ST). Sequence type (ST) 1 was the most common strain in both host species, suggesting that interspecies transmission may be possible. Two members of the bovine-specific clonal complex 61/67 were detected in human samples (ST718 and ST1175), providing evidence for the lack of genuine species barriers. Apparent prevalence of penicillin resistance was surprisingly high in human and bovine isolates. Further investigation of this phenomenon is needed and could lead to modification of standard testing and treatment recommendations in human and veterinary medicine.
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9
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Boonyayatra S, Wongsathein D, Tharavichitkul P. Genetic Relatedness Among Streptococcus agalactiae Isolated from Cattle, Fish, and Humans. Foodborne Pathog Dis 2019; 17:137-143. [PMID: 31549865 DOI: 10.1089/fpd.2019.2687] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Streptococcus agalactiae is well recognized to cause a variety of infections in many animal species and humans. We aimed to investigate genetic relatedness of S. agalactiae strains isolated from humans and animal origins, including cattle and fish, using capsular gene typing, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing techniques. Our results revealed that S. agalactiae strains with capsular type Ia and ST103 were observed from all bovine isolates (17/17) and one human isolate (1/5). S. agalactiae strains with capsular type III and ST283 were detected among isolates from fish (5/5) and from humans (2/5). Two PFGE clusters containing isolates from mixed origins were demonstrated: one cluster of five fish and one human isolate, and another cluster of one bovine and one human isolate. In conclusion, the close genetic relationship among S. agalactiae strains isolated from humans and animal origins was evident.
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Affiliation(s)
- Sukolrat Boonyayatra
- Department of Food Animal Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Dilok Wongsathein
- Department of Food Animal Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prasit Tharavichitkul
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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10
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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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11
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Barkham T, Zadoks RN, Azmai MNA, Baker S, Bich VTN, Chalker V, Chau ML, Dance D, Deepak RN, van Doorn HR, Gutierrez RA, Holmes MA, Huong LNP, Koh TH, Martins E, Mehershahi K, Newton P, Ng LC, Phuoc NN, Sangwichian O, Sawatwong P, Surin U, Tan TY, Tang WY, Thuy NV, Turner P, Vongsouvath M, Zhang D, Whistler T, Chen SL. One hypervirulent clone, sequence type 283, accounts for a large proportion of invasive Streptococcus agalactiae isolated from humans and diseased tilapia in Southeast Asia. PLoS Negl Trop Dis 2019; 13:e0007421. [PMID: 31246981 PMCID: PMC6597049 DOI: 10.1371/journal.pntd.0007421] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/29/2019] [Indexed: 12/11/2022] Open
Abstract
Background In 2015, Singapore had the first and only reported foodborne outbreak of invasive disease caused by the group B Streptococcus (GBS; Streptococcus agalactiae). Disease, predominantly septic arthritis and meningitis, was associated with sequence type (ST)283, acquired from eating raw farmed freshwater fish. Although GBS sepsis is well-described in neonates and older adults with co-morbidities, this outbreak affected non-pregnant and younger adults with fewer co-morbidities, suggesting greater virulence. Before 2015 ST283 had only been reported from twenty humans in Hong Kong and two in France, and from one fish in Thailand. We hypothesised that ST283 was causing region-wide infection in Southeast Asia. Methodology/Principal findings We performed a literature review, whole genome sequencing on 145 GBS isolates collected from six Southeast Asian countries, and phylogenetic analysis on 7,468 GBS sequences including 227 variants of ST283 from humans and animals. Although almost absent outside Asia, ST283 was found in all invasive Asian collections analysed, from 1995 to 2017. It accounted for 29/38 (76%) human isolates in Lao PDR, 102/139 (73%) in Thailand, 4/13 (31%) in Vietnam, and 167/739 (23%) in Singapore. ST283 and its variants were found in 62/62 (100%) tilapia from 14 outbreak sites in Malaysia and Vietnam, in seven fish species in Singapore markets, and a diseased frog in China. Conclusions GBS ST283 is widespread in Southeast Asia, where it accounts for a large proportion of bacteraemic GBS, and causes disease and economic loss in aquaculture. If human ST283 is fishborne, as in the Singapore outbreak, then GBS sepsis in Thailand and Lao PDR is predominantly a foodborne disease. However, whether transmission is from aquaculture to humans, or vice versa, or involves an unidentified reservoir remains unknown. Creation of cross-border collaborations in human and animal health are needed to complete the epidemiological picture. An outbreak due to a bacterium called Streptococccus agalactiae in Singapore in 2015 was caused by a clone called ST283, and was associated with consumption of raw freshwater-fish. It was considered unique as it was the only reported foodborne outbreak of this bacterium. Our new data show that invasive ST283 disease is far from unique. ST283 has been causing disease in humans and farmed fish in SE Asian countries for decades. Reports of ST283 are almost absent outside Asia. We suspect that human ST283 is fishborne in other Asian countries, as it was in Singapore, but we haven’t looked at this yet. We don’t know where ST283 originally came from; it may have been transmitted from humans to fish, or come from another animal. More studies are needed to determine ST283’s geographical extent and burden of disease, as well as its origin, how it is transmitted, and what enables it to be so aggressive. We may then be able to interrupt transmission, to the benefit of fish, farmers, and the general public.
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Affiliation(s)
- Timothy Barkham
- Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore
- * E-mail: (TB); (SLC)
| | - Ruth N. Zadoks
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Mohammad Noor Amal Azmai
- Department of Biology, Faculty of Science, and Laboratory of Marine Biotechnology, Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia
| | - Stephen Baker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Vu Thi Ngoc Bich
- Centre for Tropical Medicine, Oxford University Clinical Research Unit, Hanoi, Vietnam
| | | | - Man Ling Chau
- Environmental Health Institute, National Environment Agency, Singapore
- National Centre for Food Science, Singapore Food Agency, Singapore
| | - David Dance
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - H. Rogier van Doorn
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, United Kingdom
| | - Ramona A. Gutierrez
- Environmental Health Institute, National Environment Agency, Singapore
- National Centre for Infectious Diseases, Singapore
| | - Mark A. Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Tse Hsien Koh
- Department of Microbiology, Singapore General Hospital, Singapore
| | - Elisabete Martins
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Kurosh Mehershahi
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paul Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
| | - Nguyen Ngoc Phuoc
- Faculty of Fisheries, University of Agriculture and Forestry, Hue University, Hue City, Vietnam
| | - Ornuma Sangwichian
- Thailand Ministry of Public Health (MOPH)-US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Pongpun Sawatwong
- Thailand Ministry of Public Health (MOPH)-US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Uraiwan Surin
- Nakhon Phanom General Hospital, Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand
| | - Thean Yen Tan
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - Wen Ying Tang
- Molecular Biology Laboratory, Tan Tock Seng Hospital, Singapore
| | - Nguyen Vu Thuy
- National Hospital for Obstetrics & Gynaecology, Hanoi, Vietnam
| | - Paul Turner
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, United Kingdom
- Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Defeng Zhang
- Key Laboratory of Tropical & Subtropical Fishery Resource Application & Cultivation, Ministry of Agriculture and Rural Affairs, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People’s Republic of China
| | - Toni Whistler
- Thailand Ministry of Public Health (MOPH)-US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Swaine L. Chen
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Infectious Diseases Group, Genome Institute of Singapore, Singapore
- * E-mail: (TB); (SLC)
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12
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Tazi A, Plainvert C, Anselem O, Ballon M, Marcou V, Seco A, El Alaoui F, Joubrel C, El Helali N, Falloukh E, Frigo A, Raymond J, Trieu-Cuot P, Branger C, Le Monnier A, Azria E, Ancel PY, Jarreau PH, Mandelbrot L, Goffinet F, Poyart C. Risk Factors for Infant Colonization by Hypervirulent CC17 Group B Streptococcus: Toward the Understanding of Late-onset Disease. Clin Infect Dis 2019; 69:1740-1748. [DOI: 10.1093/cid/ciz033] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/22/2019] [Indexed: 11/12/2022] Open
Abstract
The hypervirulent group B Streptococcus clone CC17 accounts for the majority of infant late-onset disease (LOD). We provide evidence that the high incidence of CC17 in LOD is likely due to an enhanced post-delivery mother-to-infant transmission.
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Affiliation(s)
- Asmaa Tazi
- Department of Bacteriology, University Hospitals Paris Centre-Cochin, French National Center for Streptococci, Assistance Publique - Hôpitaux de Paris (AP-HP)
- Département Hospitalo-Universitaire Risks and Pregnancy
- Team Barriers and Pathogens of Cochin Institute, Institut National de la Santé et de la Recherche Médicale (INSERM) U1016 - Unité Mixte de Recherche Centre National de la Recherche Scientifique (UMR CNRS) 8104
- Paris Descartes University
| | - Céline Plainvert
- Department of Bacteriology, University Hospitals Paris Centre-Cochin, French National Center for Streptococci, Assistance Publique - Hôpitaux de Paris (AP-HP)
- Département Hospitalo-Universitaire Risks and Pregnancy
- Team Barriers and Pathogens of Cochin Institute, Institut National de la Santé et de la Recherche Médicale (INSERM) U1016 - Unité Mixte de Recherche Centre National de la Recherche Scientifique (UMR CNRS) 8104
| | - Olivia Anselem
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
- Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospitals Paris Centre Cochin Port Royal, AP-HP
| | - Morgane Ballon
- Département Hospitalo-Universitaire Risks and Pregnancy
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epidémiologie Périnatale, Obstétricale et Pédiatrique), INSERM UMR 1153
| | - Valérie Marcou
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
- Maternity Unit, Paris Saint Joseph Hospital
| | - Aurélien Seco
- Département Hospitalo-Universitaire Risks and Pregnancy
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epidémiologie Périnatale, Obstétricale et Pédiatrique), INSERM UMR 1153
| | | | - Caroline Joubrel
- Department of Bacteriology, University Hospitals Paris Centre-Cochin, French National Center for Streptococci, Assistance Publique - Hôpitaux de Paris (AP-HP)
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
| | - Najoua El Helali
- Unité de Recherche Clinique-Centre d’Investigation Clinique P1419, University Hospitals Paris Centre Cochin Port Royal, AP-HP
| | - Emile Falloukh
- Department of Neonatal Medicine, Louis Mourier Hospital, AP-HP
| | - Amandine Frigo
- Department of Bacteriology, University Hospitals Paris Centre-Cochin, French National Center for Streptococci, Assistance Publique - Hôpitaux de Paris (AP-HP)
- Département Hospitalo-Universitaire Risks and Pregnancy
| | - Josette Raymond
- Department of Bacteriology, University Hospitals Paris Centre-Cochin, French National Center for Streptococci, Assistance Publique - Hôpitaux de Paris (AP-HP)
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
| | - Patrick Trieu-Cuot
- Biology of Gram-Positive Bacterial Pathogens Unit, CNRS Equipe de Recherche Labellisée, Pasteur Institute, Paris
| | - Catherine Branger
- Department of Microbiology, Louis Mourier Hospital, AP-HP
- Infection Antimicrobials Modelling Evolution, INSERM UMR1137, France
| | | | - Elie Azria
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epidémiologie Périnatale, Obstétricale et Pédiatrique), INSERM UMR 1153
- Maternity Unit, Paris Saint Joseph Hospital
| | - Pierre-Yves Ancel
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epidémiologie Périnatale, Obstétricale et Pédiatrique), INSERM UMR 1153
- Unité de Recherche Clinique-Centre d’Investigation Clinique P1419, University Hospitals Paris Centre Cochin Port Royal, AP-HP
| | - Pierre Henri Jarreau
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
- Department of Neonatal Medicine, Cochin-Port Royal Hospital, AP-HP
| | - Laurent Mandelbrot
- Département Hospitalo-Universitaire Risks and Pregnancy
- Department of Obstetrics and Gynecology, Louis Mourier Hospital, AP-HP
- Paris Diderot University
- Infection Antimicrobials Modelling Evolution, INSERM UMR1137, France
| | - François Goffinet
- Département Hospitalo-Universitaire Risks and Pregnancy
- Paris Descartes University
- Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospitals Paris Centre Cochin Port Royal, AP-HP
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epidémiologie Périnatale, Obstétricale et Pédiatrique), INSERM UMR 1153
| | - Claire Poyart
- Department of Bacteriology, University Hospitals Paris Centre-Cochin, French National Center for Streptococci, Assistance Publique - Hôpitaux de Paris (AP-HP)
- Département Hospitalo-Universitaire Risks and Pregnancy
- Team Barriers and Pathogens of Cochin Institute, Institut National de la Santé et de la Recherche Médicale (INSERM) U1016 - Unité Mixte de Recherche Centre National de la Recherche Scientifique (UMR CNRS) 8104
- Paris Descartes University
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13
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Kayansamruaj P, Soontara C, Unajak S, Dong HT, Rodkhum C, Kondo H, Hirono I, Areechon N. Comparative genomics inferred two distinct populations of piscine pathogenic Streptococcus agalactiae, serotype Ia ST7 and serotype III ST283, in Thailand and Vietnam. Genomics 2018; 111:1657-1667. [PMID: 30453061 DOI: 10.1016/j.ygeno.2018.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/06/2018] [Accepted: 11/13/2018] [Indexed: 11/16/2022]
Abstract
The genomes of Streptococcus agalactiae (group B streptococcus; GBS) collected from diseased fish in Thailand and Vietnam over a nine-year period (2008-2016) were sequenced and compared (n = 21). Based on capsular serotype and multilocus sequence typing (MLST), GBS isolates are divided into 2 groups comprised of i) serotype Ia; sequence type (ST)7 and ii) serotype III; ST283. Population structure inferred by core genome (cg)MLST and Bayesian clustering analysis also strongly indicated distribution of two GBS populations in both Thailand and Vietnam. Deep phylogenetic analysis implied by CRISPR array's spacer diversity was able to cluster GBS isolates according to their temporal and geographic origins, though ST7 has varying CRISPR1-spacer profiles when compared to ST283 strains. Based on overall genotypic features, Thai ST283 strains were closely related to the Singaporean ST283 strain causing foodborne illness in humans in 2015, thus, signifying zoonotic potential of this GBS population in the country.
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Affiliation(s)
| | - Chayanit Soontara
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
| | - Sasimanas Unajak
- Department of Biochemistry, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Ha Thanh Dong
- Department of Science, Faculty of Science and Technology, Suan Sunandha Rajabhat University, Bangkok, Thailand
| | - Channarong Rodkhum
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand; Research Unit of Fish Infectious Diseases (RU-FIDs), Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Hidehiro Kondo
- Laboratory of Genome Science, Tokyo University of Marine Science and Technology, Tokyo, Japan
| | - Ikuo Hirono
- Laboratory of Genome Science, Tokyo University of Marine Science and Technology, Tokyo, Japan
| | - Nontawith Areechon
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, Bangkok, Thailand
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14
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The plasminogen binding protein PbsP is required for brain invasion by hypervirulent CC17 Group B streptococci. Sci Rep 2018; 8:14322. [PMID: 30254272 PMCID: PMC6156580 DOI: 10.1038/s41598-018-32774-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 08/30/2018] [Indexed: 01/09/2023] Open
Abstract
Streptococcus agalactiae (Group B Streptococcus or GBS) is a frequent cause of serious disease in newborns and adults. Epidemiological evidence indicates a strong association between GBS strains belonging to the hypervirulent CC17 clonal complex and the occurrence of meningitis in neonates. We investigate here the role of PbsP, a cell wall plasminogen binding protein, in colonization of the central nervous system by CC17 GBS. Deletion of pbsP selectively impaired the ability of the CC17 strain BM110 to colonize the mouse brain after intravenous challenge, despite its unchanged capacity to persist at high levels in the blood and to invade the kidneys. Moreover, immunization with a recombinant form of PbsP considerably reduced brain infection and lethality. In vitro, pbsP deletion markedly decreased plasmin-dependent transmigration of BM110 through brain microvascular endothelial cells. Although PbsP was modestly expressed in bacteria grown under standard laboratory conditions, pbsP expression was markedly upregulated during in vivo infection or upon contact with cultured brain endothelial cells. Collectively, our studies indicate that PbsP is a highly conserved Plg binding adhesin, which is functionally important for invasion of the central nervous system by the hypervirulent CC17 GBS. Moreover, this antigen is a promising candidate for inclusion in a universal GBS vaccine.
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15
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Liu J, Xu R, Zhong H, Zhong Y, Xie Y, Li L, Li B, Chen D, Xu Z. RETRACTED: Prevalence of GBS serotype III and identification of a ST 17-like genotype from neonates with invasive diseases in Guangzhou, China. Microb Pathog 2018; 120:213-218. [DOI: 10.1016/j.micpath.2018.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 03/27/2018] [Accepted: 05/02/2018] [Indexed: 10/25/2022]
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16
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Beauruelle C, Pastuszka A, Mereghetti L, Lanotte P. Group B Streptococcus Vaginal Carriage in Pregnant Women as Deciphered by Clustered Regularly Interspaced Short Palindromic Repeat Analysis. J Clin Microbiol 2018; 56:e01949-17. [PMID: 29618502 PMCID: PMC5971545 DOI: 10.1128/jcm.01949-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/28/2018] [Indexed: 11/20/2022] Open
Abstract
We evaluated the diversity of group B Streptococcus (GBS) vaginal carriage populations in pregnant women. For this purpose, we studied each isolate present in a primary culture of a vaginal swab using a new approach based on clustered regularly interspaced short palindromic repeats (CRISPR) locus analysis. To evaluate the CRISPR array composition rapidly, a restriction fragment length polymorphism (RFLP) analysis was performed. For each different pattern observed, the CRISPR array was sequenced and capsular typing and multilocus sequence typing (MLST) were performed. A total of 970 isolates from 10 women were analyzed by CRISPR-RFLP. Each woman carrying GBS isolates presented one to five specific "personal" patterns. Five women showed similar isolates with specific and unique restriction patterns, suggesting the carriage of a single GBS clone. Different patterns were observed among isolates from the other five women. For three of these, CRISPR locus sequencing highlighted low levels of internal modifications in the locus backbone, whereas there were high levels of modifications for the last two women, suggesting the carriage of two different clones. These two clones were closely related, having the same ancestral spacer(s), the same capsular type and, in one case, the same ST, but showed different antibiotic resistance patterns in pairs. Eight of 10 women were colonized by a single GBS clone, while two of them were colonized by two strains, leading to a risk of selection of more-virulent and/or more-resistant clones during antibiotic prophylaxis. This CRISPR analysis made it possible to separate isolates belonging to a single capsular type and sequence type, highlighting the greater discriminating power of this approach.
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Affiliation(s)
- Clemence Beauruelle
- Université François Rabelais de Tours, UMR1282 Infectiologie et Santé Publique, Tours, France
- INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly, France
- CHRU de Tours, Service de Bactériologie-Virologie, Tours, France
| | - Adeline Pastuszka
- Université François Rabelais de Tours, UMR1282 Infectiologie et Santé Publique, Tours, France
- INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly, France
- CHRU de Tours, Service de Bactériologie-Virologie, Tours, France
| | - Laurent Mereghetti
- Université François Rabelais de Tours, UMR1282 Infectiologie et Santé Publique, Tours, France
- INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly, France
- CHRU de Tours, Service de Bactériologie-Virologie, Tours, France
| | - Philippe Lanotte
- Université François Rabelais de Tours, UMR1282 Infectiologie et Santé Publique, Tours, France
- INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly, France
- CHRU de Tours, Service de Bactériologie-Virologie, Tours, France
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17
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Li L, Wang R, Huang Y, Huang T, Luo F, Huang W, Yang X, Lei A, Chen M, Gan X. High Incidence of Pathogenic Streptococcus agalactiae ST485 Strain in Pregnant/Puerperal Women and Isolation of Hyper-Virulent Human CC67 Strain. Front Microbiol 2018; 9:50. [PMID: 29467722 PMCID: PMC5808242 DOI: 10.3389/fmicb.2018.00050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 01/10/2018] [Indexed: 01/02/2023] Open
Abstract
Group B streptococcus (GBS) is the major pathogen causing diseases in neonates, pregnant/puerperal women, cows and fish. Recent studies have shown that GBS may be infectious across hosts and some fish GBS strain might originate from human. The purpose of this study is to investigate the genetic relationship of CC103 strains that recently emerged in cows and humans, and explore the pathogenicity of clinical GBS isolates from human to tilapia. Ninety-two pathogenic GBS isolates were identified from 19 patients with different diseases and their evolution and pathogenicity to tilapia were analyzed. The multilocus sequence typing revealed that clonal complex (CC) 103 strain was isolated from 21.74% (20/92) of patients and ST485 strain was from 14.13% (13/92) patients with multiple diseases including neonates. Genomic evolution analysis showed that both bovine and human CC103 strains alternately form independent evolutionary branches. Three CC67 isolates carried gbs2018-C gene and formed one evolutionary branch with ST61 and ST67 strains that specifically infect dairy cows. Studies of interspecies transmission to tilapia found that 21/92 (22.83%) isolates including all ST23 isolates were highly pathogenic to tilapia and demonstrated that streptococci could break through the blood-brain barrier into brain tissue. In conclusions, CC103 strains are highly prevalent among pathogenic GBS from humans and have evolved into the highly pathogenic ST485 strains specifically infecting humans. The CC67 strains isolated from cows are able to infect humans through evolutionary events of acquiring CC17-specific type C gbs2018 gene and others. Human-derived ST23 pathogenic GBS strains are highly pathogenic to tilapia.
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Affiliation(s)
- Liping Li
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China.,Bacteria Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Rui Wang
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China.,Institute of Animal Science and Technology, Guangxi University, Nanning, China
| | - Yan Huang
- Bacteria Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Ting Huang
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China
| | - Fuguang Luo
- Liuzhou's Aquaculture Technology Extending Station, Liuzhou, China
| | - Weiyi Huang
- Institute of Animal Science and Technology, Guangxi University, Nanning, China
| | - Xiuying Yang
- School of Public Health, National Medical College of Right Rivers, Baise, China
| | - Aiying Lei
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China
| | - Ming Chen
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China.,Bacteria Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China.,Institute of Animal Science and Technology, Guangxi University, Nanning, China
| | - Xi Gan
- Guangxi Key Laboratory for Aquatic Genetic Breeding and Healthy Aquaculture, Guangxi Institute of Fisheries, Nanning, China
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18
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Wang X, Cao X, Li S, Ou Q, Lin D, Yao Z, Chen S, Wu C, Wen G, Ye X. Phenotypic and molecular characterization of Streptococcus agalactiae colonized in Chinese pregnant women: predominance of ST19/III and ST17/III. Res Microbiol 2018; 169:101-107. [PMID: 29378338 DOI: 10.1016/j.resmic.2017.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/10/2017] [Accepted: 12/14/2017] [Indexed: 11/24/2022]
Abstract
Streptococcus agalactiae (GBS) remains a major cause of invasive infections in neonates and pregnant women. Our aim was to evaluate the phenotypic and molecular characteristics of GBS isolates in order to reveal potential relationships among molecular characteristics and differences in genotype-phenotype characteristics between ST17 and ST19. A total of 104 GBS isolates were collected from pregnant women. All isolates were tested for antibiotic susceptibility by disk diffusion method and molecular characteristics, including antibiotic-resistant genes, virulence genes, serotypes and STs. The prevalence of GBS colonization in pregnant women was 4.9%. All isolates were susceptible to penicillin, but a high prevalence of resistance was observed for tetracycline (76.9%) and erythromycin (72.1%), with the predominant resistant genes being tet(M), tet(O), erm(B) and mef (A/E). The most frequent serotypes were III, Ia and V, and the predominant STs were ST19, ST17, ST12, ST10 and ST651. A potential correlation existed between STs, serotypes and alp genes, with ST19/III/rib and ST17/III/rib as the most prevalent clones. Notably, we observed significant differences in phenotypic and genotypic characteristics between ST17 [levofloxacin-susceptible and tet(O)-positive] and ST19 [levofloxacin-resistant and tet(O)-negative]. Our findings reveal a high prevalence of ST19/III and ST17/III and significant characteristic differences between them.
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Affiliation(s)
- Xiaolin Wang
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xuelian Cao
- Women Health Care, Maternal and Child Healthcare Hospital of Longhua District, Shenzhen, China
| | - Shunming Li
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qianting Ou
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Dongxin Lin
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhenjiang Yao
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Sidong Chen
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chuan'an Wu
- Women Health Care, Maternal and Child Healthcare Hospital of Longhua District, Shenzhen, China
| | - Guoming Wen
- Women Health Care, Maternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
| | - Xiaohua Ye
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
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Kolter J, Henneke P. Codevelopment of Microbiota and Innate Immunity and the Risk for Group B Streptococcal Disease. Front Immunol 2017; 8:1497. [PMID: 29209311 PMCID: PMC5701622 DOI: 10.3389/fimmu.2017.01497] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/24/2017] [Indexed: 12/14/2022] Open
Abstract
The pathogenesis of neonatal late-onset sepsis (LOD), which manifests between the third day and the third month of life, remains poorly understood. Group B Streptococcus (GBS) is the most important cause of LOD in infants without underlying diseases or prematurity and the third most frequent cause of meningitis in the Western world. On the other hand, GBS is a common intestinal colonizer in infants. Accordingly, despite its adaption to the human lower gastrointestinal tract, GBS has retained its potential virulence and its transition from a commensal to a dangerous pathogen is unpredictable in the individual. Several cellular innate immune mechanisms, in particular Toll-like receptors, the inflammasome and the cGAS pathway, are engaged by GBS effectors like nucleic acids. These are likely to impact on the GBS-specific host resistance. Given the long evolution of streptococci as a normal constituent of the human microbiota, the emergence of GBS as the dominant neonatal sepsis cause just about 50 years ago is remarkable. It appears that intensive usage of tetracycline starting in the 1940s has been a selection advantage for the currently dominant GBS clones with superior adhesive and invasive properties. The historical replacement of Group A by Group B streptococci as a leading neonatal pathogen and the higher frequency of other β-hemolytic streptococci in areas with low GBS prevalence suggests the existence of a confined streptococcal niche, where locally competing streptococcal species are subject to environmental and immunological selection pressure. Thus, it seems pivotal to resolve neonatal innate immunity at mucous surfaces and its impact on microbiome composition and quality, i.e., genetic heterogeneity and metabolism, at the microanatomical level. Then, designer pro- and prebiotics, such as attenuated strains of GBS, and oligonucleotide priming of mucosal immunity may unfold their potential and facilitate adaptation of potentially hazardous streptococci as part of a beneficial local microbiome, which is stabilized by mucocutaneous innate immunity.
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Affiliation(s)
- Julia Kolter
- Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Philipp Henneke
- Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Pediatrics and Adolescent Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Intrinsic Maturational Neonatal Immune Deficiencies and Susceptibility to Group B Streptococcus Infection. Clin Microbiol Rev 2017; 30:973-989. [PMID: 28814408 DOI: 10.1128/cmr.00019-17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although a normal member of the gastrointestinal and vaginal microbiota, group B Streptococcus (GBS) can also occasionally be the cause of highly invasive neonatal disease and is an emerging pathogen in both elderly and immunocompromised adults. Neonatal GBS infections are typically transmitted from mother to baby either in utero or during passage through the birth canal and can lead to pneumonia, sepsis, and meningitis within the first few months of life. Compared to the adult immune system, the neonatal immune system has a number of deficiencies, making neonates more susceptible to infection. Recognition of GBS by the host immune system triggers an inflammatory response to clear the pathogen. However, GBS has developed several mechanisms to evade the host immune response. A comprehensive understanding of this interplay between GBS and the host immune system will aid in the development of new preventative measures and therapeutics.
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Russell NJ, Seale AC, O’Driscoll M, O’Sullivan C, Bianchi-Jassir F, Gonzalez-Guarin J, Lawn JE, Baker CJ, Bartlett L, Cutland C, Gravett MG, Heath PT, Le Doare K, Madhi SA, Rubens CE, Schrag S, Sobanjo-ter Meulen A, Vekemans J, Saha SK, Ip M. Maternal Colonization With Group B Streptococcus and Serotype Distribution Worldwide: Systematic Review and Meta-analyses. Clin Infect Dis 2017; 65:S100-S111. [PMID: 29117327 PMCID: PMC5848259 DOI: 10.1093/cid/cix658] [Citation(s) in RCA: 296] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Maternal rectovaginal colonization with group B Streptococcus (GBS) is the most common pathway for GBS disease in mother, fetus, and newborn. This article, the second in a series estimating the burden of GBS, aims to determine the prevalence and serotype distribution of GBS colonizing pregnant women worldwide. METHODS We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus), organized Chinese language searches, and sought unpublished data from investigator groups. We applied broad inclusion criteria to maximize data inputs, particularly from low- and middle-income contexts, and then applied new meta-analyses to adjust for studies with less-sensitive sampling and laboratory techniques. We undertook meta-analyses to derive pooled estimates of maternal GBS colonization prevalence at national and regional levels. RESULTS The dataset regarding colonization included 390 articles, 85 countries, and a total of 299924 pregnant women. Our adjusted estimate for maternal GBS colonization worldwide was 18% (95% confidence interval [CI], 17%-19%), with regional variation (11%-35%), and lower prevalence in Southern Asia (12.5% [95% CI, 10%-15%]) and Eastern Asia (11% [95% CI, 10%-12%]). Bacterial serotypes I-V account for 98% of identified colonizing GBS isolates worldwide. Serotype III, associated with invasive disease, accounts for 25% (95% CI, 23%-28%), but is less frequent in some South American and Asian countries. Serotypes VI-IX are more common in Asia. CONCLUSIONS GBS colonizes pregnant women worldwide, but prevalence and serotype distribution vary, even after adjusting for laboratory methods. Lower GBS maternal colonization prevalence, with less serotype III, may help to explain lower GBS disease incidence in regions such as Asia. High prevalence worldwide, and more serotype data, are relevant to prevention efforts.
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Affiliation(s)
- Neal J Russell
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, United Kingdom;
- King’s College London, United Kingdom
| | - Anna C Seale
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, United Kingdom;
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Megan O’Driscoll
- Centre for International Child Health, Imperial College London, United Kingdom;
| | - Catherine O’Sullivan
- Paediatric Infectious Diseases Research Group, St George’s, University of London, United Kingdom
| | - Fiorella Bianchi-Jassir
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, United Kingdom;
| | | | - Joy E Lawn
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, United Kingdom;
| | - Carol J Baker
- Departments of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas;
| | - Linda Bartlett
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Clare Cutland
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand,Johannesburg, South Africa
| | - Michael G Gravett
- Global Alliance to Prevent Prematurity and Stillbirth
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
| | - Paul T Heath
- Paediatric Infectious Diseases Research Group, St George’s, University of London, United Kingdom
| | - Kirsty Le Doare
- Centre for International Child Health, Imperial College London, United Kingdom;
- Paediatric Infectious Diseases Research Group, St George’s, University of London, United Kingdom
| | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand,Johannesburg, South Africa
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Craig E Rubens
- Global Alliance to Prevent Prematurity and Stillbirth
- Department of Global Health, University of Washington, Seattle;
| | - Stephanie Schrag
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong
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Choi MJ, Noh JY, Cheong HJ, Kim WJ, Lin SM, Zhi Y, Lim JH, Lim S, Seo HS, Song JY. Development of a multiplexed opsonophagocytic killing assay (MOPA) for group B Streptococcus. Hum Vaccin Immunother 2017; 14:67-73. [PMID: 28933634 DOI: 10.1080/21645515.2017.1377379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Group B Streptococcus (GBS) is a leading cause of sepsis in infants as well as chorioamnionitis in pregnant women. Opsonophagocytic killing assays (OPAs) are an essential technique in vaccine studies of encapsulated bacteria for estimating serotype-specific functional antibody levels in vitro. Here, we developed a three-fold multiplexed OPA (MOPA) to enable practical, large-scale assessment of GBS vaccine immunogenicity, including against serotypes Ia, III, and V. First, three target bacteria strains resistant to streptomycin, spectinomycin, or kanamycin were generated by natural selection through exposure to increasing antibiotic concentrations. Since a high level of nonspecific killing (NSK) of serotype V was observed in a 12.5% baby rabbit complement (BRC) solution, the BRC concentration was optimized. The final GBS-MOPA BRC concentration was 9%, which resulted in less than 20% NSK. The specificity was measured by preabsorbing serum with inactivated GBS. The opsonic index (OI) of preabsorbed serum with the homologous serotype GBS was significantly reduced in all three serotypes tested. The accuracy of the MOPA was compared with that of a single OPA (SOPA) with 35 serum samples. The OIs of the MOPA correlated well with those of the SOPA, and the r2 values were higher than 0.950 for all three serotypes. The precision of the MOPA assay was assessed in five independent experiments with five serum samples. The inter-assay precision of the GBS-MOPA was 12.5% of the average coefficient of variation. This is the first report to develop and standardize a GBS-MOPA, which will be useful for GBS vaccine development and evaluation.
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Affiliation(s)
- Min Joo Choi
- a Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Ji Yun Noh
- a Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Hee Jin Cheong
- a Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Woo Joo Kim
- a Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Shun-Mei Lin
- b Biotechnology Division, Korea Atomic Energy Research Institute , Jeongeup , Republic of Korea
| | - Yong Zhi
- b Biotechnology Division, Korea Atomic Energy Research Institute , Jeongeup , Republic of Korea
| | - Jae Hyang Lim
- c Department of Microbiology and Tissue Injury Defense Research Center , Ewha Womans University School of Medicine , Seoul , Republic of Korea
| | - Sangyong Lim
- b Biotechnology Division, Korea Atomic Energy Research Institute , Jeongeup , Republic of Korea
| | - Ho Seong Seo
- b Biotechnology Division, Korea Atomic Energy Research Institute , Jeongeup , Republic of Korea
| | - Joon Young Song
- a Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
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Large-scale genomic analyses reveal the population structure and evolutionary trends of Streptococcus agalactiae strains in Brazilian fish farms. Sci Rep 2017; 7:13538. [PMID: 29051505 PMCID: PMC5648781 DOI: 10.1038/s41598-017-13228-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/20/2017] [Indexed: 12/19/2022] Open
Abstract
Streptococcus agalactiae is a major pathogen and a hindrance on tilapia farming worldwide. The aims of this work were to analyze the genomic evolution of Brazilian strains of S. agalactiae and to establish spatial and temporal relations between strains isolated from different outbreaks of streptococcosis. A total of 39 strains were obtained from outbreaks and their whole genomes were sequenced and annotated for comparative analysis of multilocus sequence typing, genomic similarity and whole genome multilocus sequence typing (wgMLST). The Brazilian strains presented two sequence types, including a newly described ST, and a non-typeable lineage. The use of wgMLST could differentiate each strain in a single clone and was used to establish temporal and geographical correlations among strains. Bayesian phylogenomic analysis suggests that the studied Brazilian population was co-introduced in the country with their host, approximately 60 years ago. Brazilian strains of S. agalactiae were shown to be heterogeneous in their genome sequences and were distributed in different regions of the country according to their genotype, which allowed the use of wgMLST analysis to track each outbreak event individually.
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Parallel Evolution of Group B Streptococcus Hypervirulent Clonal Complex 17 Unveils New Pathoadaptive Mutations. mSystems 2017; 2:mSystems00074-17. [PMID: 28904998 PMCID: PMC5585690 DOI: 10.1128/msystems.00074-17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/10/2017] [Indexed: 12/21/2022] Open
Abstract
The incidence of group B Streptococcus (GBS) neonatal disease continues to be a significant cause of concern worldwide. Strains belonging to clonal complex 17 (CC17) are the most frequently responsible for GBS infections in neonates, especially among late-onset disease cases. Therefore, we undertook the largest genomic study of GBS CC17 strains to date to decipher the genetic bases of their remarkable colonization and infection ability. We show that crucial functions involved in different steps of the colonization or infection process of GBS are distinctly mutated during the adaptation of CC17 to the human host. In particular, our results implicate the CovRS two-component regulator of virulence in the differentiation between carriage- and disease-associated isolates. Not only does this work raise important implications for the ongoing development of a vaccine against GBS but might also drive the discovery of key functions for GBS adaptation and pathogenesis that have been overlooked until now. Group B Streptococcus (GBS) is a commensal of the gastrointestinal and genitourinary tracts, while a prevailing cause of neonatal disease worldwide. Of the various clonal complexes (CCs), CC17 is overrepresented in GBS-infected newborns for reasons that are still largely unknown. Here, we report a comprehensive genomic analysis of 626 CC17 isolates collected worldwide, identifying the genetic traits behind their successful adaptation to humans and the underlying differences between carriage and clinical strains. Comparative analysis with 923 GBS genomes belonging to CC1, CC19, and CC23 revealed that the evolution of CC17 is distinct from that of other human-adapted lineages and recurrently targets functions related to nucleotide and amino acid metabolism, cell adhesion, regulation, and immune evasion. We show that the most distinctive features of disease-specific CC17 isolates were frequent mutations in the virulence-associated CovS and Stk1 kinases, underscoring the crucial role of the entire CovRS regulatory pathway in modulating the pathogenicity of GBS. Importantly, parallel and convergent evolution of major components of the bacterial cell envelope, such as the capsule biosynthesis operon, the pilus, and Rib, reflects adaptation to host immune pressures and should be taken into account in the ongoing development of a GBS vaccine. The presence of recurrent targets of evolution not previously implicated in virulence also opens the way for uncovering new functions involved in host colonization and GBS pathogenesis. IMPORTANCE The incidence of group B Streptococcus (GBS) neonatal disease continues to be a significant cause of concern worldwide. Strains belonging to clonal complex 17 (CC17) are the most frequently responsible for GBS infections in neonates, especially among late-onset disease cases. Therefore, we undertook the largest genomic study of GBS CC17 strains to date to decipher the genetic bases of their remarkable colonization and infection ability. We show that crucial functions involved in different steps of the colonization or infection process of GBS are distinctly mutated during the adaptation of CC17 to the human host. In particular, our results implicate the CovRS two-component regulator of virulence in the differentiation between carriage- and disease-associated isolates. Not only does this work raise important implications for the ongoing development of a vaccine against GBS but might also drive the discovery of key functions for GBS adaptation and pathogenesis that have been overlooked until now. Author Video: An author video summary of this article is available.
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25
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Elikwu CJ, Oduyebo O, Ogunsola FT, Anorlu RI, Okoromah CN, König B. High group B streptococcus carriage rates in pregnant women in a tertiary institution in Nigeria. Pan Afr Med J 2016; 25:249. [PMID: 28293365 PMCID: PMC5337299 DOI: 10.11604/pamj.2016.25.249.9433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 10/31/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION In contrast to industrialized countries, until recently Group B Streptococcus (GBS) was infrequently reported in the developing world. This study was aimed at investigating the prevalence of GBS maternal colonization and to analyze the serotype distribution among the isolates. METHODS Vagino-rectal swabs collected from pregnant women were cultured for GBS using conventional media. Swabs were also taken from the mouths, ears and umbilical stumps of the neonates born to colonized mothers. Multiplex PCR and a conventional PCR to discern the gbs2018-ST-17 gene (specific for sequence type(ST)-17 clone) was performed to characterize the Group B streptococcus isolates. RESULTS A total of 300 pregnant women and 53 neonates were studied by culture but only 175 mothers by PCR. GBS was identified in four (6.8%) of 59 (19.7%) neonates of colonized mothers. Out of 175 mothers investigated by PCR, 112 (64%) were colonized. Serotype Ia (23.9%) was the most common among vagino-rectal isolates. Serotype II (71.4%) predominates among colonizing strain in newborns. A significant association between frequency of intercourse of > 2 per week and GBS carriage was found (t-test= 2.2; P value < 0.05). CONCLUSION GBS carriage is high with low transmission. Strains that have been associated with GBS neonatal disease were reported, though in very low rates. Though none of the babies studied had invasive GBS disease, a more expansive study in the future will be required to establish if invasive GBS neonatal disease is uncommon in Nigeria.
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MESH Headings
- Adolescent
- Adult
- Carrier State/epidemiology
- Female
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/microbiology
- Infectious Disease Transmission, Vertical
- Middle Aged
- Multiplex Polymerase Chain Reaction
- Nigeria/epidemiology
- Polymerase Chain Reaction
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/microbiology
- Prevalence
- Serotyping
- Streptococcal Infections/diagnosis
- Streptococcal Infections/epidemiology
- Streptococcal Infections/microbiology
- Streptococcus agalactiae/isolation & purification
- Young Adult
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Affiliation(s)
- Charles John Elikwu
- Department of Medical Microbiology & Parasitology, Ben Carson School of Medicine, Babcock University/Babcock University Teaching Hospitals, Ilisan-Remo, Ogun State, Nigeria; Department of Medical Microbiology & Parasitology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Oyinlola Oduyebo
- Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Folasade Tolulope Ogunsola
- Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Rose Ihuoma Anorlu
- Department of Obstetrics & Gynaecology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Christy Nene Okoromah
- Department of Paediatrics and Child Health, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Brigitte König
- Institut für Medizinische Mikrobiologie und Infektionsepidemiologie, Universitätsklinikum Leipzig, Germany
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Changing Epidemiology of Group B Streptococcus Susceptibility to Fluoroquinolones and Aminoglycosides in France. Antimicrob Agents Chemother 2016; 60:7424-7430. [PMID: 27736761 DOI: 10.1128/aac.01374-16] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/29/2016] [Indexed: 12/27/2022] Open
Abstract
Group B Streptococcus (GBS) is the leading cause of neonatal invasive infections and an emerging pathogen in the elderly. Our objectives were to describe the evolution of GBS resistance to antibiotics in France and to investigate the emergence of fluoroquinolone (FQ)-resistant isolates. A total of 8,757 unrelated GBS isolates were collected and tested for antibiotic susceptibility from 2007 to 2014 according to EUCAST recommendations. All isolates were susceptible to penicillin G, amoxicillin, and vancomycin. Resistance to macrolides decreased from 47.0% to 30.0%, whereas high-level resistance to aminoglycosides, especially amikacin, increased from 6.4% to 8.8% and 24 isolates (0.3%) were highly resistant to gentamicin. FQ resistance gradually increased from 0.2% in 2007 (n = 1) to 1.5% in 2014 (n = 18, P < 0.01). Capsular polysaccharide (CPS) genotyping, multilocus sequence typing, and sequencing of the quinolone resistance-determining region (QRDR) showed that GBS isolates of sequence type 19 (ST-19) CPS type V were largely overrepresented in FQ-resistant isolates (n = 30, 45.5%). All 30 strains displayed the same QRDR mutations and were often associated with cross-resistance to macrolides (93.3%) and gentamicin (30%). In conclusion, we report the rise of FQ- and aminoglycoside-resistant GBS in France over an 8-year study period, an evolution likely linked to the clonal expansion of ST-19 CPS V-resistant isolates. This study emphasizes the need for a continuous surveillance of GBS epidemiology and antibiotic susceptibility.
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Korir ML, Laut C, Rogers LM, Plemmons JA, Aronoff DM, Manning SD. Differing mechanisms of surviving phagosomal stress among group B Streptococcus strains of varying genotypes. Virulence 2016; 8:924-937. [PMID: 27791478 DOI: 10.1080/21505594.2016.1252016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Group B Streptococcus (GBS), a leading cause of neonatal sepsis and meningitis, asymptomatically colonizes up to 30% of women and can persistently colonize even after antibiotic treatment. Previous studies have shown that GBS resides inside macrophages, but the mechanism by which it survives remains unknown. Here, we examined the ability of 4 GBS strains to survive inside macrophages and then focused on 2 strains belonging to sequence type (ST)-17 and ST-12, to examine persistence in the presence of antibiotics. A multiple stress medium was also developed using several stressors found in the phagosome to assess the ability of 30 GBS strains to withstand phagosomal stress. The ST-17 strain was more readily phagocytosed and survived intracellularly longer than the ST-12 strain, but the ST-12 strain was tolerant to ampicillin unlike the ST-17 strain. Exposure to sub-inhibitory concentrations of ampicillin and erythromycin increased the level of phagocytosis of the ST-17 strain, but had no effect on the ST-12 strain. In addition, blocking acidification of the phagosome decreased the survival of the ST-17 strain indicating a pH-dependent survival mechanism for the ST-17 strain. Congruent with the macrophage experiments, the ST-17 strain had a higher survival rate in the multiple stress medium than the ST-12 strain, and overall, serotype III isolates survived significantly better than other serotypes. These results indicate that diverse GBS strains may use differing mechanisms to persist and that serotype III strains are better able to survive specific stressors inside the phagosome relative to other serotypes.
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Affiliation(s)
- Michelle L Korir
- a Department of Microbiology and Molecular Genetics , Michigan State University , East Lansing , MI , USA
| | - Clare Laut
- a Department of Microbiology and Molecular Genetics , Michigan State University , East Lansing , MI , USA
| | - Lisa M Rogers
- b Department of Medicine , Vanderbilt University , Nashville , TN , USA
| | - Jessica A Plemmons
- a Department of Microbiology and Molecular Genetics , Michigan State University , East Lansing , MI , USA
| | - David M Aronoff
- b Department of Medicine , Vanderbilt University , Nashville , TN , USA
| | - Shannon D Manning
- a Department of Microbiology and Molecular Genetics , Michigan State University , East Lansing , MI , USA
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28
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Emaneini M, Jabalameli F, Mirsalehian A, Ghasemi A, Beigverdi R. Characterization of virulence factors, antimicrobial resistance pattern and clonal complexes of group B streptococci isolated from neonates. Microb Pathog 2016; 99:119-122. [PMID: 27554272 DOI: 10.1016/j.micpath.2016.08.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/16/2016] [Accepted: 08/18/2016] [Indexed: 11/27/2022]
Abstract
Between January and December 2013, swab samples were taken for the throat and external ear canals of 1037 newborns for screening of Group B Streptococcus (GBS or S. agalactiae). Isolates were analyzed form Multilocus sequence typing (MLST), capsular type, virulence genes and antibiotic susceptibility. The MLST analysis of 19 GBS isolates showed 8 sequence types (STs). Overall the most common STs were ST19 and ST28. Other STs were ST1, ST4, ST8, ST12, ST335 and ST734 (a new ST). The most common clonal complexes (CCs) were CC19 (68.4%) and CC10 (21%). The scpB, hlyB and bca virulence genes were detected in all STS, while the bac gene was predominant in ST12 with capsular type (CT) Ib. The IS1548 and the rib genes were particularly prevalent in CTIII and were detected in isolates belong to ST19, ST335 and ST734 and were grouped in CC19. All isolates were susceptible to penicillin, vancomycin, linezolid and quinupristin-dalfopristin. Resistance to tetracycline was observed in all 19 (100%) strains and was correlated with presence of the tetM gene except for one isolate with ST12. All the ST8 and ST12 isolates were resistant to macrolide carrying two resistance genes; the ermTR and the ermB, respectively. The results of this study showed that the CC19 was a major clone in the neonatal intensive care unit (NICU) of Imam Khomeini hospital which can cause severe infections in susceptible neonates (particularly in premature infants). As a result, an intensive infection control policy is needed to prevent the spread of this clone.
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Affiliation(s)
- Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Mirsalehian
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ghasemi
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Reza Beigverdi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Epidemiology of Invasive Group B Streptococcal Disease in Alberta, Canada, from 2003 to 2013. J Clin Microbiol 2016; 54:1774-1781. [PMID: 27098960 DOI: 10.1128/jcm.00355-16] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/12/2016] [Indexed: 11/20/2022] Open
Abstract
Group B streptococci (GBS) cause severe invasive disease in both neonates and adults. Understanding the epidemiology of GBS provides information that can include determining disease prevalence rates in defined populations and geographic regions, documenting the success of GBS screening programs, and understanding antimicrobial susceptibility patterns. In Alberta, only neonatal invasive GBS (iGBS) disease is notifiable to health authorities. We performed a surveillance study of iGBS in Alberta, Canada, from 2003 to 2013. Over the 11-year period, the disease incidence rate increased from a low of 3.92 cases/100,000 population to a high of 5.99 cases/100,000 population. The capsular polysaccharide serotypes (CPSs) found were CPS III (20.3%), CPS V (19.1%), CPS Ia (18.9%), CPS Ib (12.7%), CPS II (11.1%), CPS IV (6.3%), and nontypeable GBS (9.4%). Rates of early-onset disease (0 to 7 days) increased from 0.15 cases/1,000 live births (in 2003) to 0.34 cases/1,000 live births (in 2013). Rates of late-onset disease (>7 to 90 days) also rose, from 0.15 cases/1,000 live births (in 2003) to 0.39 cases/1,000 live births (in 2013). Alberta also experienced an increase in CPS IV isolates, from 2 cases (in 2003) to 24 cases (in 2013), of which the majority were hvgA negative (93.4%) [corrected]. The predominant sequence type (ST) in 2013 was ST459. Erythromycin resistance rose from 23.6% to 43.9% (in 2013). Clindamycin resistance also increased, from 12.2% to 32.5%. In summary, Alberta, Canada, has experienced an increase in GBS disease; the increase includes both neonatal and adult disease. CPS IV cases also notably increased during the surveillance period, as did resistance to erythromycin and clindamycin.
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Clonal Complex 17 Group B Streptococcus strains causing invasive disease in neonates and adults originate from the same genetic pool. Sci Rep 2016; 6:20047. [PMID: 26843175 PMCID: PMC4740736 DOI: 10.1038/srep20047] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/23/2015] [Indexed: 11/20/2022] Open
Abstract
A significant proportion of group B Streptococcus (GBS) neonatal disease, particularly late-onset disease, is associated with strains of serotype III, clonal complex (CC) 17. CC17 strains also cause invasive infections in adults. Little is known about the phylogenetic relationships of isolates recovered from neonatal and adult CC17 invasive infections. We performed whole-genome-based phylogenetic analysis of 93 temporally and geographically matched CC17 strains isolated from both neonatal and adult invasive infections in the metropolitan region of Toronto/Peel, Canada. We also mined the whole-genome data to reveal mobile genetic elements carrying antimicrobial resistance genes. We discovered that CC17 GBS strains causing neonatal and adult invasive disease are interspersed and cluster tightly in a phylogenetic tree, signifying that they are derived from the same genetic pool. We identified limited variation due to recombination in the core CC17 genome. We describe that loss of Pilus Island 1 and acquisition of different mobile genetic elements carrying determinants of antimicrobial resistance contribute to CC17 genetic diversity. Acquisition of some of these mobile genetic elements appears to correlate with clonal expansion of the strains that possess them. Our results provide a genome-wide portrait of the population structure and evolution of a major disease-causing clone of an opportunistic pathogen.
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Bergal A, Loucif L, Benouareth DE, Bentorki AA, Abat C, Rolain JM. Molecular epidemiology and distribution of serotypes, genotypes, and antibiotic resistance genes of Streptococcus agalactiae clinical isolates from Guelma, Algeria and Marseille, France. Eur J Clin Microbiol Infect Dis 2015; 34:2339-48. [PMID: 26415872 DOI: 10.1007/s10096-015-2487-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 09/03/2015] [Indexed: 02/05/2023]
Abstract
This study describes, for the first time, the genetic and phenotypic diversity among 93 Streptococcus agalactiae (group B Streptococcus, GBS) isolates collected from Guelma, Algeria and Marseille, France. All strains were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The molecular support of antibiotic resistance and serotyping were investigated by polymerase chain reaction (PCR). The phylogenetic lineage of each GBS isolate was determined by multilocus sequence typing (MLST) and grouped into clonal complexes (CCs) using eBURST. The isolates represented 37 sequence types (STs), 16 of which were novel, grouped into five CCs, and belonging to seven serotypes. Serotype V was the most prevalent serotype in our collection (44.1%). GBS isolates of each serotype were distributed among multiple CCs, including cps III/CC19, cps V/CC1, cps Ia/CC23, cps II/CC10, and cps III/CC17. All isolates presented susceptibility to penicillin, whereas resistance to erythromycin was detected in 40% and tetracycline in 82.2% of isolates. Of the 37 erythromycin-resistant isolates, 75.7% showed the macrolide-lincosamide-streptogramin B (MLSB)-resistant phenotype and 24.3% exhibited the macrolide (M)-resistant phenotype. Constitutive MLSB resistance (46%) mediated by the ermB gene was significantly associated with the Guelma isolates, whereas the M resistance phenotype (24.3%) mediated by the mefA/E gene dominated among the Marseille isolates and belonged to ST-23. Tetracycline resistance was predominantly due to tetM, which was detected alone (95.1%) or associated with tetO (3.7%). These results provide epidemiological data in these regions that establish a basis for monitoring increased resistance to erythromycin and also provide insight into correlations among clones, serotypes, and resistance genes.
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Affiliation(s)
- A Bergal
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France.,Département d'Écologie et Génie de l'Environnement, Faculté des Sciences de la Nature et de la Vie et Sciences de la Terre et de l'Univers, Université 8 Mai 1945, Guelma, Algeria
| | - L Loucif
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France.,Laboratoire de Biotechnologie des Molécules Bioactives et de la Physiopathologie Cellulaire (LBMBPC), Université El Hadj Lakhdar, Batna, Algeria
| | - D E Benouareth
- Département d'Écologie et Génie de l'Environnement, Faculté des Sciences de la Nature et de la Vie et Sciences de la Terre et de l'Univers, Université 8 Mai 1945, Guelma, Algeria
| | - A A Bentorki
- Laboratoire de Microbiologie, CHU Dorban, Annaba, Algeria
| | - C Abat
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France
| | - J-M Rolain
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France.
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Chang B, Wada A, Hosoya M, Oishi T, Ishiwada N, Oda M, Sato T, Terauchi Y, Okada K, Nishi J, Akeda H, Kamiya H, Ohnishi M, Ihara T. Characteristics of group B Streptococcus isolated from infants with invasive infections: a population-based study in Japan. Jpn J Infect Dis 2015; 67:356-60. [PMID: 25241685 DOI: 10.7883/yoken.67.356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Group B Streptococcus (GBS) is one of the leading causes of neonatal bacterial infections. Population-based surveillance of GBS-related invasive diseases among newborns and infants from 10 prefectures in Japan was performed between 2007 and 2012. The characteristics of cases and isolated GBS are described in this study. The incidence rate of GBS-related invasive diseases was 0.13 per 1,000 live births. Analysis of GBS samples obtained from 60 invasive cases showed that the most frequent serotypes were III (48.3%), Ia (30.0%), and Ib (10.0%). All isolates were susceptible to penicillin G, ampicillin, cefotaxime, imipenem, and panipenem. However, 14, 2, and 7 isolates were resistant to erythromycin, clindamycin, and both erythromycin and clindamycin, respectively. Multilocus sequence typing revealed that GBS sequence type (ST) 23, ST17, and ST335 caused higher incidences of meningitis. These data show that serotypes III, Ia, and Ib together caused more than 80% of invasive infections in Japanese infants, and that GBS strains are still susceptible to β-lactam antibiotics.
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Affiliation(s)
- Bin Chang
- Department of Bacteriology I, National Institute of Infectious Diseases
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Wang YH, Lu CC, Chiu CH, Wang MH, Yang TH, Chu C. Genetically diverse serotypes III and VI substitute major clonal disseminated serotypes Ib and V as prevalent serotypes of Streptococcus agalactiae from 2007 to 2012. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 49:672-678. [PMID: 26316010 DOI: 10.1016/j.jmii.2015.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 05/14/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Streptococcus agalactiae [group B Streptococcus (GBS)] has become more prevalent in nonpregnant women, the elderly, and people who are immunocompromised. We investigated the serotype and genomic changes of GBS human isolates from different hospitals from 2007 to 2012. METHODS The serotype and genotype of 658 GBS human isolates were determined with multiplex polymerase chain reaction and pulsed field gel electrophoresis analysis. Multilocus sequence typing analysis determined the sequence type (ST) of the major clones of serotypes Ib, V, and VI. RESULTS Most of the isolates were collected from urine samples (60.5%) with a reduction in the rate from 74.6% in 2007 to 34.5% in 2012 and from infected patients older than 30 years (72.6%). The female/male ratio differed depending on the source: 3.52 in the urine group, 0.48 in the wound group, and 0.43 in pus. Serotypes Ib (16.5%), III (16.9%), V (27.2%), and VI (17.6%) were the most predominant among the nine serotypes identified and were separated into two prevalence patterns: a decrease in serotypes Ib and V and an increase in serotypes III and VI from 2007 to 2012. The prevalence change was associated with the urine group. Additionally, serotype VI become more prevalent in blood samples in four hospitals. The pulsed field gel electrophoresis analysis demonstrated three genetic patterns: limited pulsotypes and a major clonal dissemination for serotypes Ib and V, diverse pulsotypes for serotypes III, and diverse pulsotypes with a major clonal dissemination for serotype VI. Multilocus sequence typing analysis of the major clones identified ST12 for serotype Ib and ST1 for serotypes V and VI. CONCLUSION Rapid genomic variations with different evolutionary patterns have led to the establishment of serotypes III and VI as the predominant GBS serotypes.
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Affiliation(s)
- Ying-Hsiang Wang
- Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Chih-Cheng Lu
- Department of Microbiology, Immunology, and Biopharmaceuticals, National Chiayi University, Chiayi, Taiwan, ROC
| | - Cherng-Hsun Chiu
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC; Division of Pediatric Infectious Diseases, Chang Gung Children's Hospital, Taoyuan, Taiwan, ROC
| | - Mei-Hei Wang
- Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Tsung-Han Yang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Chishih Chu
- Department of Microbiology, Immunology, and Biopharmaceuticals, National Chiayi University, Chiayi, Taiwan, ROC.
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Lier C, Baticle E, Horvath P, Haguenoer E, Valentin AS, Glaser P, Mereghetti L, Lanotte P. Analysis of the type II-A CRISPR-Cas system of Streptococcus agalactiae reveals distinctive features according to genetic lineages. Front Genet 2015; 6:214. [PMID: 26124774 PMCID: PMC4466440 DOI: 10.3389/fgene.2015.00214] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/01/2015] [Indexed: 12/12/2022] Open
Abstract
CRISPR-Cas systems (clustered regularly interspaced short palindromic repeats/CRISPR-associated proteins) are found in 90% of archaea and about 40% of bacteria. In this original system, CRISPR arrays comprise short, almost unique sequences called spacers that are interspersed with conserved palindromic repeats. These systems play a role in adaptive immunity and participate to fight non-self DNA such as integrative and conjugative elements, plasmids, and phages. In Streptococcus agalactiae, a bacterium implicated in colonization and infections in humans since the 1960s, two CRISPR-Cas systems have been described. A type II-A system, characterized by proteins Cas9, Cas1, Cas2, and Csn2, is ubiquitous, and a type I–C system, with the Cas8c signature protein, is present in about 20% of the isolates. Unlike type I–C, which appears to be non-functional, type II-A appears fully functional. Here we studied type II-A CRISPR-cas loci from 126 human isolates of S. agalactiae belonging to different clonal complexes that represent the diversity of the species and that have been implicated in colonization or infection. The CRISPR-cas locus was analyzed both at spacer and repeat levels. Major distinctive features were identified according to the phylogenetic lineages previously defined by multilocus sequence typing, especially for the sequence type (ST) 17, which is considered hypervirulent. Among other idiosyncrasies, ST-17 shows a significantly lower number of spacers in comparison with other lineages. This characteristic could reflect the peculiar virulence or colonization specificities of this lineage.
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Affiliation(s)
- Clément Lier
- UMR1282 Infectiologie et Santé Publique, Bactéries et Risque Materno-Foetal, Université de Tours, Tours France ; INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly France ; Service de Bactériologie-Virologie, Hôpital Bretonneau - Centre Hospitalier Régional et Universitaire de Tours, Tours France
| | - Elodie Baticle
- Service de Bactériologie-Virologie, Hôpital Bretonneau - Centre Hospitalier Régional et Universitaire de Tours, Tours France
| | | | - Eve Haguenoer
- UMR1282 Infectiologie et Santé Publique, Bactéries et Risque Materno-Foetal, Université de Tours, Tours France ; INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly France
| | - Anne-Sophie Valentin
- UMR1282 Infectiologie et Santé Publique, Bactéries et Risque Materno-Foetal, Université de Tours, Tours France ; INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly France ; Service de Bactériologie-Virologie, Hôpital Bretonneau - Centre Hospitalier Régional et Universitaire de Tours, Tours France
| | - Philippe Glaser
- Unité de Biologie des Bactéries Pathogènes à Gram Positif, Institut Pasteur, Paris France ; CNRS UMR 3525, Paris France
| | - Laurent Mereghetti
- UMR1282 Infectiologie et Santé Publique, Bactéries et Risque Materno-Foetal, Université de Tours, Tours France ; INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly France ; Service de Bactériologie-Virologie, Hôpital Bretonneau - Centre Hospitalier Régional et Universitaire de Tours, Tours France
| | - Philippe Lanotte
- UMR1282 Infectiologie et Santé Publique, Bactéries et Risque Materno-Foetal, Université de Tours, Tours France ; INRA, UMR1282 Infectiologie et Santé Publique, Nouzilly France ; Service de Bactériologie-Virologie, Hôpital Bretonneau - Centre Hospitalier Régional et Universitaire de Tours, Tours France
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Group B streptococcus neonatal invasive infections, France 2007-2012. Clin Microbiol Infect 2015; 21:910-6. [PMID: 26055414 DOI: 10.1016/j.cmi.2015.05.039] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 05/21/2015] [Accepted: 05/26/2015] [Indexed: 11/22/2022]
Abstract
Streptococcus agalactiae (group B streptococcus (GBS)) is the leading cause of invasive infections among newborns in industrialized countries, with two described syndromes: early-onset disease (EOD) and late-onset disease (LOD). Since the introduction in many countries of intrapartum antibioprophylaxis (IAP), the incidence of EOD has dramatically decreased, whereas that of LOD remains unchanged. We describe the clinical and bacteriological characteristics of 438 GBS neonatal invasive infections notified to the French National Reference Centre for Streptococci in France from 2007 to 2012. Clinical data were retrieved from hospitalization reports or questionnaires. Capsular type, assignment to the hypervirulent clonal complex (CC)17 and antibiotic susceptibility profiles were determined. One hundred and seventy-four (39.7%) and 264 (60.3%) isolates were responsible for EOD, including death in utero, and LOD, respectively. EOD was associated with bacteraemia (n = 103, 61%) and LOD with meningitis (n = 145, 55%). EOD was mainly due to capsular polysaccharide (CPS) III isolates (n = 99, 57%) and CPS Ia isolates (n = 40, 23%), and CPS III isolates were responsible for 80% (n = 211) of LOD cases. CC17 accounted for 80% (n = 121) of CPS III isolates responsible for meningitis (n = 151; total cases of meningitis, 188). Bad outcome risk factors were low gestational age and low birthweight. LOD represents almost 60% of cases of neonatal GBS disease in France and other countries in which IAP has been implemented. This observation reinforces the need to develop new prevention strategies targeting CC17, which is predominant in GBS neonatal infections.
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Sequence type 1 group B Streptococcus, an emerging cause of invasive disease in adults, evolves by small genetic changes. Proc Natl Acad Sci U S A 2015; 112:6431-6. [PMID: 25941374 DOI: 10.1073/pnas.1504725112] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The molecular mechanisms underlying pathogen emergence in humans is a critical but poorly understood area of microbiologic investigation. Serotype V group B Streptococcus (GBS) was first isolated from humans in 1975, and rates of invasive serotype V GBS disease significantly increased starting in the early 1990s. We found that 210 of 229 serotype V GBS strains (92%) isolated from the bloodstream of nonpregnant adults in the United States and Canada between 1992 and 2013 were multilocus sequence type (ST) 1. Elucidation of the complete genome of a 1992 ST-1 strain revealed that this strain had the highest homology with a GBS strain causing cow mastitis and that the 1992 ST-1 strain differed from serotype V strains isolated in the late 1970s by acquisition of cell surface proteins and antimicrobial resistance determinants. Whole-genome comparison of 202 invasive ST-1 strains detected significant recombination in only eight strains. The remaining 194 strains differed by an average of 97 SNPs. Phylogenetic analysis revealed a temporally dependent mode of genetic diversification consistent with the emergence in the 1990s of ST-1 GBS as major agents of human disease. Thirty-one loci were identified as being under positive selective pressure, and mutations at loci encoding polysaccharide capsule production proteins, regulators of pilus expression, and two-component gene regulatory systems were shown to affect the bacterial phenotype. These data reveal that phenotypic diversity among ST-1 GBS is mainly driven by small genetic changes rather than extensive recombination, thereby extending knowledge into how pathogens adapt to humans.
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Puymège A, Bertin S, Guédon G, Payot S. Analysis of Streptococcus agalactiae pan-genome for prevalence, diversity and functionality of integrative and conjugative or mobilizable elements integrated in the tRNA(Lys CTT) gene. Mol Genet Genomics 2015; 290:1727-40. [PMID: 25832353 DOI: 10.1007/s00438-015-1031-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/17/2015] [Indexed: 11/27/2022]
Abstract
Streptococcus agalactiae is the first cause of invasive infections in human neonates and is also a major bovine and fish pathogen. High genomic diversity was observed in this species that hosts numerous mobile genetic elements, in particular elements transferable by conjugation. This works aims to evaluate the contribution of these elements to GBS genome diversity. Focusing on genomic islands integrated in the tRNA(Lys) (CTT) gene, a known hotspot of recombination, an extensive in silico search was performed on the sequenced genome of 303 strains of S. agalactiae isolated from different hosts. In all the isolates (except 9), whatever their origin (human, bovine, camel, dog, gray seal, dolphin, fish species or bullfrog), this locus carries highly diverse genomic islands transferable by conjugation such as integrative and conjugative elements (ICEs), integrative and mobilizable elements (IMEs), CIs-mobilizable elements (CIMEs) or composite elements. Transfer of an ICE from an ST67 bovine strain to a phylogenetically distant ST23 human isolate was obtained experimentally indicating that there was no barrier to ICE transfer between strains from different hosts. Interestingly, a novel family of putative IMEs that site-specifically integrate in the nic site of oriT of ICEs belonging to Tn916/ICESt3 superfamily was detected in silico. These elements carry an antibiotic resistance gene (lsa(C)) already described to confer cross-resistance to lincosamides, streptogramins A and pleuromutilins. Further work is needed to evaluate the impact of these IMEs on the transfer of targeted ICEs and the mobility and the dissemination of these IMEs.
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Affiliation(s)
- Aurore Puymège
- Faculté des Sciences et Technologies, INRA, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France.,Faculté des Sciences et Technologies, Université de Lorraine, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France
| | - Stéphane Bertin
- Faculté des Sciences et Technologies, INRA, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France.,Faculté des Sciences et Technologies, Université de Lorraine, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France
| | - Gérard Guédon
- Faculté des Sciences et Technologies, INRA, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France.,Faculté des Sciences et Technologies, Université de Lorraine, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France
| | - Sophie Payot
- Faculté des Sciences et Technologies, INRA, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France. .,Faculté des Sciences et Technologies, Université de Lorraine, UMR1128 DynAMic, Bd des Aiguillettes, BP70239, 54506, Vandœuvre-lès-Nancy, France.
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Sundaresan R, Samen U, Ponnuraj K. Structure of KRT4 binding domain of Srr-1 from Streptococcus agalactiae reveals a novel β-sheet complementation. Int J Biol Macromol 2015; 75:97-105. [PMID: 25603146 DOI: 10.1016/j.ijbiomac.2014.12.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 12/23/2014] [Accepted: 12/24/2014] [Indexed: 10/24/2022]
Abstract
The serine rich repeat protein-1 (Srr-1) is an adhesive protein of Streptococcus agalactiae. It is the first bacterial protein identified to interact with human keratin 4 (K4 or KRT4). Within Srr-1, the residues 311-641 constitute the non-repeat ligand binding region (Srr-1-BR(311-641)). The C-terminal part of Srr-1-BR(311-641), comprising of residues 485-642 (termed Srr-1-K4BD), have been identified to bind to K4. Here we report the crystal structure of recombinant Srr-1-K4BD(485-642) and its possible mode of interaction with K4 through docking studies. The dimeric structure of Srr-1-K4BD(485-642) reveals a novel two way "slide lock" parallel β-sheet complementation where the C-terminal strand of one monomer is positioned anti-parallel to the N-terminal strand of the adjacent monomer and this arrangement is not seen so far in any of the homologous structures. The dimerization of Srr-1-K4BD(485-642) observed both in the crystal structure and in solution suggests that similar domain association could also be possible in in vivo and we propose this association would likely generate a new binding site for another host molecule. It is likely that the adhesin can recognize multiple ligands using its ligand binding sub-domains through their intra and inter domain association with one another.
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Affiliation(s)
- Ramya Sundaresan
- Centre of Advanced Study in Crystallography and Biophysics, University of Madras, Guindy Campus, Chennai 600 025, India
| | - Ulrike Samen
- Institute of Microbiology and Biotechnology, University of Ulm, Albert-Einstein-Allee 11 89081, Ulm, Germany
| | - Karthe Ponnuraj
- Centre of Advanced Study in Crystallography and Biophysics, University of Madras, Guindy Campus, Chennai 600 025, India.
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Bekker V, Bijlsma MW, van de Beek D, Kuijpers TW, van der Ende A. Incidence of invasive group B streptococcal disease and pathogen genotype distribution in newborn babies in the Netherlands over 25 years: a nationwide surveillance study. THE LANCET. INFECTIOUS DISEASES 2014; 14:1083-1089. [DOI: 10.1016/s1473-3099(14)70919-3] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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40
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Elayappen A, Jain SK, Loeffelholz MJ, Patel J. Purpura fulminans and late onset group B streptococcal sepsis in a premature twin. AJP Rep 2014; 4:e69-72. [PMID: 25452884 PMCID: PMC4239141 DOI: 10.1055/s-0034-1376186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/20/2014] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Purpura fulminans (PF) is a skin manifestation due to hemorrhagic infarction caused by intravascular thrombosis secondary to bacterial infections or deficiency of anticoagulants such as protein C and protein S. Neonatal PF is a rare but potentially disabling disorder associated with a high mortality and severe long term morbidity in those who survive. CASE DESCRIPTION We report a case of a premature infant who developed extensive PF due to late onset group B streptococcus sepsis. Despite early identification and initiation of antibiotic therapy in our patient, PF progressed rapidly, leading to autoamputation of fingers and toes and severe brain injury. CONCLUSION In conclusion, our case highlights the severe sequelae of PF due to late onset GBS sepsis in a premature infant.
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Affiliation(s)
- Avanikkha Elayappen
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Sunil K Jain
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | | | - Janak Patel
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
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Capsular polysaccharide of Group B Streptococcus mediates biofilm formation in the presence of human plasma. Microbes Infect 2014; 17:71-76. [PMID: 25448634 DOI: 10.1016/j.micinf.2014.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 10/15/2014] [Accepted: 10/19/2014] [Indexed: 11/20/2022]
Abstract
Group B Streptococcus (GBS) is an asymptomatic colonizer of human mucosal surfaces that is responsible for sepsis and meningitis in neonates. Bacterial persistence and pathogenesis often involves biofilm formation. We previously showed that biofilm formation in medium supplemented with glucose is mediated by the PI-2a pilus. Here, biofilm formation was tested in cell culture medium supplemented with human plasma. GBS strains were able to form biofilms in these conditions unlike Group A Streptococcus (GAS) or Staphylococcus aureus. Analysis of mutants impaired for various surface components revealed that the GBS capsule is a key component in this process.
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42
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Association and virulence gene expression vary among serotype III group B streptococcus isolates following exposure to decidual and lung epithelial cells. Infect Immun 2014; 82:4587-95. [PMID: 25135682 DOI: 10.1128/iai.02181-14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Group B Streptococcus (GBS) causes severe disease in neonates, the elderly, and immunocompromised individuals. GBS species are highly diverse and can be classified by serotype and multilocus sequence typing. Sequence type 17 (ST-17) strains cause invasive neonatal disease more frequently than strains of other STs. Attachment and invasion of host cells are key steps in GBS pathogenesis. We investigated whether four serotype III strains representing ST-17 (two strains), ST-19, and ST-23 differ in their abilities to attach to and invade both decidual cells and lung epithelial cells. Virulence gene expression following host cell association and exposure to amnion cells was also tested. The ST-17 strains differed in their abilities to attach to and invade decidual cells, whereas there were no differences with lung epithelial cells. The ST-19 and ST-23 strains, however, attached to and invaded decidual cells less than both ST-17 strains. Although the ST-23 strain attached to lung epithelial cells better than ST-17 and -19 strains, none of the strains effectively invaded the lung epithelial cells. Notably, the association with host cells resulted in the differential expression of several virulence genes relative to basal expression levels. Similar expression patterns of some genes were observed regardless of cell type used. Collectively, these results show that GBS strains differ in their abilities to attach to distinct host cell types and express key virulence genes that are relevant to the disease process. Enhancing our understanding of pathogenic mechanisms could aid in the identification of novel therapeutic targets or vaccine candidates that could potentially decrease morbidity and mortality associated with neonatal infections.
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43
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Da Cunha V, Davies MR, Douarre PE, Rosinski-Chupin I, Margarit I, Spinali S, Perkins T, Lechat P, Dmytruk N, Sauvage E, Ma L, Romi B, Tichit M, Lopez-Sanchez MJ, Descorps-Declere S, Souche E, Buchrieser C, Trieu-Cuot P, Moszer I, Clermont D, Maione D, Bouchier C, McMillan DJ, Parkhill J, Telford JL, Dougan G, Walker MJ, Holden MTG, Poyart C, Glaser P. Streptococcus agalactiae clones infecting humans were selected and fixed through the extensive use of tetracycline. Nat Commun 2014; 5:4544. [PMID: 25088811 PMCID: PMC4538795 DOI: 10.1038/ncomms5544] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 06/27/2014] [Indexed: 11/17/2022] Open
Abstract
Streptococcus agalactiae (Group B Streptococcus, GBS) is a commensal of the digestive and genitourinary tracts of humans that emerged as the leading cause of bacterial neonatal infections in Europe and North America during the 1960s. Due to the lack of epidemiological and genomic data, the reasons for this emergence are unknown. Here we show by comparative genome analysis and phylogenetic reconstruction of 229 isolates that the rise of human GBS infections corresponds to the selection and worldwide dissemination of only a few clones. The parallel expansion of the clones is preceded by the insertion of integrative and conjugative elements conferring tetracycline resistance (TcR). Thus, we propose that the use of tetracycline from 1948 onwards led in humans to the complete replacement of a diverse GBS population by only few TcR clones particularly well adapted to their host, causing the observed emergence of GBS diseases in neonates.
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Affiliation(s)
- Violette Da Cunha
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS UMR3525, Paris 75015, France.,Institut Pasteur, Bioinformatics platform, Paris 75015, France
| | - Mark R Davies
- The Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 15A, UK.,Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, 4072 Queensland, Australia
| | - Pierre-Emmanuel Douarre
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS UMR3525, Paris 75015, France
| | - Isabelle Rosinski-Chupin
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS UMR3525, Paris 75015, France
| | | | - Sebastien Spinali
- Centre National de Référence des Streptocoques, Hôpitaux Universitaires, Paris Centre Cochin-Hôtel Dieu-Broca, Paris 75014, France
| | - Tim Perkins
- Novartis Vaccines and Diagnostics, Siena 53100, Italy
| | - Pierre Lechat
- Institut Pasteur, Bioinformatics platform, Paris 75015, France
| | - Nicolas Dmytruk
- Centre National de Référence des Streptocoques, Hôpitaux Universitaires, Paris Centre Cochin-Hôtel Dieu-Broca, Paris 75014, France
| | - Elisabeth Sauvage
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS UMR3525, Paris 75015, France
| | - Laurence Ma
- Institut Pasteur Genomic platform, Paris 75015, France
| | | | - Magali Tichit
- Institut Pasteur Genomic platform, Paris 75015, France
| | - Maria-José Lopez-Sanchez
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS UMR3525, Paris 75015, France
| | | | - Erika Souche
- Institut Pasteur, Bioinformatics platform, Paris 75015, France
| | - Carmen Buchrieser
- CNRS UMR3525, Paris 75015, France.,Institut Pasteur, Biologie des Bactéries Intracellulaires, Paris 75015, France
| | - Patrick Trieu-Cuot
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS ERL3526, Paris 75015, France
| | - Ivan Moszer
- Institut Pasteur, Bioinformatics platform, Paris 75015, France
| | - Dominique Clermont
- Institut Pasteur, Collection de l'Institut Pasteur (CIP), Paris 75015, France
| | | | | | - David J McMillan
- QIMR Berghofer Medical Research Institute, Brisbane, 7006 Queensland, Australia.,Inflammation and Healing Research Cluster, University of the Sunshine Coast, Sippy Downs, 4556 Queensland, Australia
| | - Julian Parkhill
- The Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 15A, UK
| | | | - Gordan Dougan
- The Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 15A, UK
| | - Mark J Walker
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, 4072 Queensland, Australia
| | | | | | - Claire Poyart
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,Centre National de Référence des Streptocoques, Hôpitaux Universitaires, Paris Centre Cochin-Hôtel Dieu-Broca, Paris 75014, France.,Institut Cochin, Université Sorbonne Paris Descartes, Paris 75014, France.,INSERM, U1016, Paris 75014, France
| | - Philippe Glaser
- Institut Pasteur, Unité de Biologie des Bacteries Pathogènes à Gram-positif, Paris 75015, France.,CNRS UMR3525, Paris 75015, France.,Institut Pasteur, Bioinformatics platform, Paris 75015, France
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Fléchard M, Gilot P. Physiological impact of transposable elements encoding DDE transposases in the environmental adaptation of Streptococcus agalactiae. Microbiology (Reading) 2014; 160:1298-1315. [DOI: 10.1099/mic.0.077628-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
We have referenced and described Streptococcus agalactiae transposable elements encoding DDE transposases. These elements belonged to nine families of insertion sequences (ISs) and to a family of conjugative transposons (TnGBSs). An overview of the physiological impact of the insertion of all these elements is provided. DDE-transposable elements affect S. agalactiae in a number of aspects of its capability to adapt to various environments and modulate the expression of several virulence genes, the scpB–lmB genomic region and the genes involved in capsule expression and haemolysin transport being the targets of several different mobile elements. The referenced mobile elements modify S. agalactiae behaviour by transferring new gene(s) to its genome, by modifying the expression of neighbouring genes at the integration site or by promoting genomic rearrangements. Transposition of some of these elements occurs in vivo, suggesting that by dynamically regulating some adaptation and/or virulence genes, they improve the ability of S. agalactiae to reach different niches within its host and ensure the ‘success’ of the infectious process.
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Affiliation(s)
- Maud Fléchard
- Biochimie et Génétique Moléculaire Bactérienne, Institut des Sciences de la Vie, Université Catholique de Louvain, B-1348 Louvain-la-Neuve, Belgium
| | - Philippe Gilot
- INRA, UMR1282 Infectiologie et Santé Publique, F-37380 Nouzilly, France
- Université de Tours, UMR1282 Infectiologie et Santé Publique, Bactéries et Risque Materno-Foetal, F-37032 Tours, France
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45
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Le Doare K, Heath PT. An overview of global GBS epidemiology. Vaccine 2014; 31 Suppl 4:D7-12. [PMID: 23973349 DOI: 10.1016/j.vaccine.2013.01.009] [Citation(s) in RCA: 233] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 02/08/2023]
Abstract
Streptococcus agalactiae (group B streptococcus (GBS)), remains the leading cause of neonatal sepsis and meningitis in many countries and an important cause of disease in pregnant women, immunocompromised adults and the elderly. Intrapartum antibiotic strategies have reduced the incidence of early-onset neonatal GBS where applied, but have had no impact on late onset GBS infection and only a limited impact on disease in pregnant women. In low/middle income settings, the disease burden remains uncertain although in several countries of Southern Africa appears comparable to that of high-income countries. Disease may be rapidly fulminating and cases therefore missed before appropriate samples are obtained. This may lead to significant underestimation of the true burden and be a particular issue in many African and Asian countries; comprehensive epidemiological data from such countries are urgently required. The available data suggest that the serotype distribution of GBS isolates is similar in Africa, Western Pacific, Europe, the Americas and the Eastern Mediterranean regions and has not changed over the past 30 years. Five serotypes (Ia, Ib, II, III, V) account for the majority of disease; conjugate vaccines including some or all of these serotypes therefore hold great promise for preventing this important disease.
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Affiliation(s)
- Kirsty Le Doare
- Paediatric Infectious Diseases Research Group, St Georges, University of London, London, UK
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46
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Usein CR, Militaru M, Cristea V, Străuţ M. Genetic diversity and antimicrobial resistance in Streptococcus agalactiae strains recovered from female carriers in the Bucharest area. Mem Inst Oswaldo Cruz 2014; 109:189-96. [PMID: 24676662 PMCID: PMC4015262 DOI: 10.1590/0074-0276140431] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 01/29/2014] [Indexed: 11/23/2022] Open
Abstract
For the first time, we used multilocus sequence typing (MLST) to understand how
Romanian group B streptococcus (GBS) strains fit into the global GBS population
structure. Colonising isolates recovered from adult human females were tested for
antibiotic resistance, were molecularly serotyped based on the capsular
polysaccharide synthesis (cps) gene cluster and further
characterised using a set of molecular markers (surface protein genes, pilus-encoded
islands and mobile genetic elements inserted in the scpB-lmb
intergenic region). Pulsed-field gel electrophoresis was used to complement the MLST
clonal distribution pattern of selected strains. Among the 55 strains assigned to six
cps types (Ia, Ib, II-V), 18 sequence types (STs) were identified
by MLST. Five STs represented new entries to the MLST database. The prevalent STs
were ST-1, ST-17, ST-19 and ST-28. Twenty molecular marker profiles were identified.
The most common profiles (rib+GBSi1+PI-1,
rib+GBSi1+PI-1, PI-2b and alp2/3+PI-1, PI-2a) were
associated with the cps III/ST-17 and cps V/ST-1
strains. A cluster of fluoroquinolone-resistant strains was detected among the
cps V/ST-19 members; these strains shared alp1
and IS1548 and carried PI-1, PI-2a or both. Our results
support the usefulness of implementing an integrated genotyping system at the
reference laboratory level to obtain the reliable data required to make comparisons
between countries.
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Affiliation(s)
- Codruţa-Romaniţa Usein
- Molecular Epidemiology Laboratory, Cantacuzino National Institute of Research/Development for Microbiology and Immunology, Bucharest, Romania
| | - Mădălina Militaru
- Molecular Epidemiology Laboratory, Cantacuzino National Institute of Research/Development for Microbiology and Immunology, Bucharest, Romania
| | | | - Monica Străuţ
- Molecular Epidemiology Laboratory, Cantacuzino National Institute of Research/Development for Microbiology and Immunology, Bucharest, Romania
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Meehan M, Cunney R, Cafferkey M. Molecular epidemiology of group B streptococci in Ireland reveals a diverse population with evidence of capsular switching. Eur J Clin Microbiol Infect Dis 2014; 33:1155-62. [PMID: 24469423 DOI: 10.1007/s10096-014-2055-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/07/2014] [Indexed: 12/11/2022]
Abstract
The molecular epidemiology of group B Streptococcus (GBS) in Ireland was investigated. Invasive (n = 132) and non-invasive (n = 45) isolates, collected in 2007-2011, were analysed by multilocus locus sequence typing, capsular polysaccharide (CPS) serotyping, profiling of surface proteins, pilus islands (PI), and antimicrobial susceptibility. Isolates grouped into 45 sequence types and five main clonal complexes (CC). CC1, CC17 and CC23 represented 67.2 % of isolates and the most prevalent serotypes Ia, III and V. Serotype and surface protein genes were largely predictive of CC. Accordingly, CPS V/alp3, CPS Ib/CPS II/bca + bac, and CPS Ia/eps predominated in CC1, CC12 and CC23, respectively, and CPS III/rib in CC17 and CC19. Supporting their vaccine potential, all isolates harboured at least one PI, of which the PI-1 + PI-2a combination was most prevalent. Macrolide resistance was found in 18.6 % of isolates. erm(B) and the globally disseminated CC1/CPS V were the most common resistance mechanism and CC/CPS type, respectively. CC17, significantly associated with neonatal disease, was also prevalent in pregnant adults, but was underrepresented among non-pregnant adults. Two of 46 CC17 isolates (typically CPS III) were CPS IV. Sequence analysis confirmed capsular switching and their relatedness to CC17/CPS IV strains recently characterized in France. CPS IV, detected only in invasive isolates (6.8 %), was most prevalent in adults (12 %) and showed an increase in prevalence to that reported (1.4 %) for invasive isolates in Ireland 1997-1999. Increases in serotype IV and evidence of capsular switching in CC17 highlights the importance of ongoing surveillance of GBS and may have implications for vaccine development strategies.
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Affiliation(s)
- Mary Meehan
- Epidemiology and Molecular Biology Unit and Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland,
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48
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Brzychczy-Wloch M, Gosiewski T, Bulanda M. Multilocus sequence types of invasive and colonizing neonatal group B streptococci in Poland. Med Princ Pract 2014; 23:323-30. [PMID: 24820221 PMCID: PMC5586894 DOI: 10.1159/000362368] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 03/20/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The present study aimed to investigate the molecular characterization of Streptococcus agalactiae (group B streptococcus; GBS) strains isolated from newborns with invasive neonatal infections and healthy newborns in Poland. MATERIALS AND METHODS Forty-two GBS isolates were characterized by combining different typing methods, i.e. multilocus sequence typing (MLST), molecular serotyping and protein gene profiling. RESULTS Using MLST, a total of 16 sequence types (STs) were identified, and among these, 11 were clustered into the following 5 clonal complexes (CCs): CC23 (20; 49%), CC19 (7; 17%), CC17 (4; 10%), CC10 (4; 10%) and CC1 (1; 2%). A statistically significant relationship between ST-17 and invasive isolates (p = 0.0398) and ST-23 and colonizing strains (p = 0.0034) was detected. Moreover, 2 novel STs were detected (ST-637 and ST-638). Molecular serotyping showed that in the invasive isolates serotype III was predominant (11; 50%), followed by serotypes II (6; 27%), V (3; 14%) and Ia (2; 9%). In healthy newborns, serotype III was also dominant (12; 60%), followed by serotypes Ia (4; 20%), II (2; 10%), V (1; 5%) and Ib (1; 5%). Protein gene profiling indicated that the rib gene was predominant in the invasive strains (11; 59%), followed by bca (5; 22%), alp2 (2; 9%), alp3 (1; 5%) and epsilon (1; 5%), while in colonizing strains the alp2 gene was most common (10; 50%), followed by epsilon (5; 25%), rib (2; 10%), bca (2; 10%) and alp3 (1; 5%). A statistically significant relationship was noted between the rib gene and invasive GBS (p = 0.0329), whereas alp2 was related to the colonizing strains (p = 0.0495). CONCLUSIONS The investigated GBS isolates originating from infections in newborns and healthy neonates represented serotype III in more than half of the cases and differed from one another in terms of resistance to macrolides, ST type affiliation and the presence of genes encoding surface proteins from the Alp family. Further comparative genetic research on a larger number of strains is necessary for epidemiological investigation and vaccine development.
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Affiliation(s)
- Monika Brzychczy-Wloch
- Department of Bacteriology, Microbial Ecology and Parasitology, Krakow, Poland
- *Monika Brzychczy-Wloch, PhD, Chair of Microbiology, Department of Bacteriology, Microbial Ecology and Parasitology, Jagiellonian University Medical College, 18 Czysta Street, PL-31121 Krakow (Poland) E-Mail
| | - Tomasz Gosiewski
- Department of Bacteriology, Microbial Ecology and Parasitology, Krakow, Poland
| | - Malgorzata Bulanda
- Department of Infection Epidemiology, Jagiellonian University Medical College, Krakow, Poland
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49
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Seo HS, Minasov G, Seepersaud R, Doran KS, Dubrovska I, Shuvalova L, Anderson WF, Iverson TM, Sullam PM. Characterization of fibrinogen binding by glycoproteins Srr1 and Srr2 of Streptococcus agalactiae. J Biol Chem 2013; 288:35982-96. [PMID: 24165132 PMCID: PMC3861647 DOI: 10.1074/jbc.m113.513358] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The serine-rich repeat glycoproteins of Gram-positive bacteria comprise a large family of cell wall proteins. Streptococcus agalactiae (group B streptococcus, GBS) expresses either Srr1 or Srr2 on its surface, depending on the strain. Srr1 has recently been shown to bind fibrinogen, and this interaction contributes to the pathogenesis of GBS meningitis. Although strains expressing Srr2 appear to be hypervirulent, no ligand for this adhesin has been described. We now demonstrate that Srr2 also binds human fibrinogen and that this interaction promotes GBS attachment to endothelial cells. Recombinant Srr1 and Srr2 bound fibrinogen in vitro, with affinities of KD = 2.1 × 10−5 and 3.7 × 10−6m, respectively, as measured by surface plasmon resonance spectroscopy. The binding site for Srr1 and Srr2 was localized to tandem repeats 6–8 of the fibrinogen Aα chain. The structures of both the Srr1 and Srr2 binding regions were determined and, in combination with mutagenesis studies, suggest that both Srr1 and Srr2 interact with a segment of these repeats via a “dock, lock, and latch” mechanism. Moreover, properties of the latch region may account for the increased affinity between Srr2 and fibrinogen. Together, these studies identify how greater affinity of Srr2 for fibrinogen may contribute to the increased virulence associated with Srr2-expressing strains.
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Affiliation(s)
- Ho Seong Seo
- From the Division of Infectious Diseases, Veterans Affairs Medical Center, University of California at San Francisco and the Northern California Institute for Research and Education, San Francisco, California 94121
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50
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Godoy D, Carvalho-Castro G, Leal C, Pereira U, Leite R, Figueiredo H. Genetic diversity and new genotyping scheme for fish pathogenic Streptococcus agalactiae. Lett Appl Microbiol 2013; 57:476-83. [DOI: 10.1111/lam.12138] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 07/05/2013] [Accepted: 07/17/2013] [Indexed: 12/01/2022]
Affiliation(s)
- D.T. Godoy
- AQUAVET - Laboratory of Aquatic Animal Diseases, Veterinary School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - G.A. Carvalho-Castro
- AQUAVET - Laboratory of Aquatic Animal Diseases, Veterinary School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - C.A.G. Leal
- AQUAVET - Laboratory of Aquatic Animal Diseases, Veterinary School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - U.P. Pereira
- AQUAVET - Laboratory of Aquatic Animal Diseases, Veterinary School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - R.C. Leite
- AQUAVET - Laboratory of Aquatic Animal Diseases, Veterinary School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - H.C.P. Figueiredo
- AQUAVET - Laboratory of Aquatic Animal Diseases, Veterinary School; Federal University of Minas Gerais; Belo Horizonte Brazil
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