1
|
Chen Y, Liu L, Liu J, Ji T, Gao Y, Yang D, Zhao M, Zhai Y, Cao Z. Serotype distribution, antimicrobial resistance, and molecular characterization of group B Streptococcus isolates from Chinese pregnant woman. J Matern Fetal Neonatal Med 2024; 37:2295805. [PMID: 38124302 DOI: 10.1080/14767058.2023.2295805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study was aimed to investigate the serotypes, antibiotic susceptibilities, and multi-locus sequence type (MLST) profiles of group B Streptococcus (GBS) in the Beijing area. METHODS Lower vaginal and rectal swabs were obtained from pregnant women of 35-37 gestational weeks (GWs) who attended the Beijing Obstetrics and Gynecology Hospital. All GBS isolates were identified with Gram staining, catalase reaction assays, and CAMP tests, followed by antibiotic susceptibility testing, serotype identification, multilocus sequence typing and erythromycin resistance gene analysis (ermB and mefE). RESULTS From July 2020 to June 2022, 311 (5.17%) of 6012 pregnant women that were screened for GBS colonization were detected positive. Of the eight serotypes identified (III, Ia, Ib, IV, II, VIII, V, and NT), serotypes III (43.09%), Ia (34.08%) and Ib (17.04%) were the predominant species. In the antimicrobial susceptibility experiments, the resistant rates measured for erythromycin, clindamycin, levofloxacin, and tetracycline were 76.21%, 63.99%, 50.80%, and 81.03%, respectively, and 7.6% of GBS isolates showed inducible clindamycin in resistance (D-test phenotype). Meanwhile, the multilocus sequence typing analysis showed that sequence type 19 (ST19) (30.34%) and ST10 (18.62%) were the dominant sequence types. Among the 237 erythromycin-resistant isolates, 176 harbored ermB (128, 54.00%) or mefE (48, 20.30%) gene alone. CONCLUSION The infection rates, serotypes or MSLT distribution, and antimicrobial resistance of GBS in Beijing area were investigated, which may be applied in analyses of the epidemiological characteristics of GBS. This contributes to the basic knowledge required for successful GBS vaccine development suited for disease prevention and treatment in China, as well as the implementation of effective clinical antimicrobials.
Collapse
Affiliation(s)
- Yifei Chen
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lin Liu
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jing Liu
- Laboratory Department of Tsinghua University Hospital, Beijing, China
| | - Tongzhen Ji
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yang Gao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Dongmei Yang
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Mohan Zhao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yanhong Zhai
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zheng Cao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| |
Collapse
|
2
|
Al Aamri R, Al Yazidi L, Al Hashami H, Al Jabri A, Al Haddabi R, Al Adawi B. Burden of Invasive Group B Streptococcus Infection Among Omani Infants Less Than 90 Days Old: A Multicenter Study. Pediatr Infect Dis J 2024:00006454-990000000-00880. [PMID: 38808975 DOI: 10.1097/inf.0000000000004412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Group B Streptococcus (GBS) infection is the leading cause of neonatal morbidity and mortality worldwide. This study aims to investigate the incidence of invasive GBS disease among infants less than 90 days old in Oman and to describe their risk factors, clinical presentations and clinical outcomes. METHODS We retrospectively collected the data of less than 90-day-old Omani infants with culture-positive GBS from sterile samples. This study was conducted in 3 tertiary hospitals in Oman from 2009 to 2018. RESULTS Over 10 years, we identified 92 cases of culture-confirmed invasive GBS infection from 178,285 live births in the 3 hospitals, giving an overall incidence of 0.53 per 1000 live births [95% confidence interval (CI): 0.4-0.7)]. Of those, 59 (64.1%) had early-onset neonatal GBS disease and 33 (35.9%) had late-onset neonatal GBS disease. The incidence of invasive GBS disease was significantly higher in the last 5 years from 2014 to 2018 (0.69 per 1000 live births, 95% CI: 0.5-0.9) compared to the previous years from 2009 to 2013 (0.36 per 1000 live births, 95% CI: 0.2‒0.5), (P = 0.004). Infants with late-onset neonatal GBS disease had a higher risk of meningitis compared to infants with early-onset neonatal GBS disease (30.3% vs. 10.2%, P = 0.021). The mortality rate was 13.5%. CONCLUSIONS The incidence of invasive GBS disease in Oman is similar to what was reported worldwide, however, the burden of the disease in terms of mortality is high. In addition, a significant increase in the annual incidence of invasive GBS disease in Omani infants was found over the study period.
Collapse
Affiliation(s)
- Rajaa Al Aamri
- From the Department of Microbiology, Nizwa Hospital, Nizwa
| | - Laila Al Yazidi
- Child Health Department, Sultan Qaboos University Hospital, Sultan Qaboos University
- Paediatric Department, Oman Medical Speciality Board
| | - Hilal Al Hashami
- Paediatric Department, Oman Medical Speciality Board
- Paediatric Infectious Disease Unit, The Royal Hospital
| | - Amal Al Jabri
- Paediatric Department, Oman Medical Speciality Board
- Department of Infection Prevention and Control, Khoula Hospital, Muscat
| | | | - Badriya Al Adawi
- Paediatric Department, Oman Medical Speciality Board
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| |
Collapse
|
3
|
De Gaetano GV, Lentini G, Coppolino F, Famà A, Pietrocola G, Beninati C. Engagement of α 3β 1 and α 2β 1 integrins by hypervirulent Streptococcus agalactiae in invasion of polarized enterocytes. Front Microbiol 2024; 15:1367898. [PMID: 38511003 PMCID: PMC10951081 DOI: 10.3389/fmicb.2024.1367898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
The gut represents an important site of colonization of the commensal bacterium Streptococcus agalactiae (group B Streptococcus or GBS), which can also behave as a deadly pathogen in neonates and adults. Invasion of the intestinal epithelial barrier is likely a crucial step in the pathogenesis of neonatal infections caused by GBS belonging to clonal complex 17 (CC17). We have previously shown that the prototypical CC17 BM110 strain invades polarized enterocyte-like cells through their lateral surfaces using an endocytic pathway. By analyzing the cellular distribution of putative GBS receptors in human enterocyte-like Caco-2 cells, we find here that the alpha 3 (α3) and alpha 2 (α2) integrin subunits are selectively expressed on lateral enterocyte surfaces at equatorial and parabasal levels along the vertical axis of polarized cells, in an area corresponding to GBS entry sites. The α3β1 and α2β1 integrins were not readily accessible in fully differentiated Caco-2 monolayers but could be exposed to specific antibodies after weakening of intercellular junctions in calcium-free media. Under these conditions, anti-α3β1 and anti-α2β1 antibodies significantly reduced GBS adhesion to and invasion of enterocytes. After endocytosis, α3β1 and α2β1 integrins localized to areas of actin remodeling around GBS containing vacuoles. Taken together, these data indicate that GBS can invade enterocytes by binding to α3β1 and α2β1 integrins on the lateral membrane of polarized enterocytes, resulting in cytoskeletal remodeling and bacterial internalization. Blocking integrins might represent a viable strategy to prevent GBS invasion of gut epithelial tissues.
Collapse
Affiliation(s)
| | - Germana Lentini
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Francesco Coppolino
- Department of Biomedical, Dental and Imaging Sciences, University of Messina, Messina, Italy
| | - Agata Famà
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Giampiero Pietrocola
- Department of Molecular Medicine, Biochemistry Section, University of Pavia, Pavia, Italy
| | - Concetta Beninati
- Department of Human Pathology, University of Messina, Messina, Italy
- Scylla Biotech Srl, Messina, Italy
| |
Collapse
|
4
|
d'Otreppe S, Lefèvre P, Meex C, Devey A, Sacheli R, Gerard M, Melin P. Multicenter Performance Evaluation of the Revogene ® GBS DS Real-Time PCR Assay for Group B Streptococcus Detection During Labor. Mol Diagn Ther 2023; 27:611-620. [PMID: 37470972 DOI: 10.1007/s40291-023-00660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE This study aimed to evaluate the performance and ease of use of the Revogene® GBS DS PCR assay for the intrapartum detection of Group B Streptococcus (GBS) colonization, as compared with intrapartum culture and antenatal culture-based screening. METHODS Between April and August 2019, 398 women who gave birth in one of the three maternities participating in this study agreed to the collection of a vaginal swab when they arrived in the labor ward. The samples were immediately sent to the adjacent laboratory where they were discharged into the buffer provided with the Revogene® GBS DS assay. Part of the buffer was used to perform the Revogene® GBS DS test, and part of the same buffer was used for GBS culture. RESULTS The Revogene® GBS DS assay provided a valid result in less than 70 min for 356 (89%) women. The sensitivity of the test was 85.7% (66.4-95.3%). The specificity of the test was 99.1% (97.3-99.8%). The positive predictive value was 88.9% (69.7-97.1%). The negative predictive value was 98.9% (96.9-99.6%). CONCLUSION The easy-to-use Revogene® GBS DS assay provides a valuable tool for the detection of GBS colonization at the beginning of labor. The sensitivity and turn-around time are adequate. The high number of invalid results needs to be addressed before the Revogene® GBS DS test can be expected to replace the current screening-based approach.
Collapse
Affiliation(s)
- Stéphanie d'Otreppe
- Department of Clinical Biology, Hôpital de Marche, Vivalia, Marche-en-Famenne, Belgium. stephanie.d'
| | - Philippe Lefèvre
- Department of Clinical Biology, Hôpital de Marche, Vivalia, Marche-en-Famenne, Belgium
| | - Cécile Meex
- Department of Clinical Microbiology, University Hospital of Liege, Liege, Belgium
- National Reference Center Streptococcus agalactiae, Department of Clinical Microbiology, University Hospital Center of Liege, Liege, Belgium
| | - Anaïs Devey
- Department of Clinical Biology, Hôpital de Libramont, Vivalia, Libramont-Chevigny, Belgium
| | - Rosalie Sacheli
- National Reference Center Streptococcus agalactiae, Department of Clinical Microbiology, University Hospital Center of Liege, Liege, Belgium
| | - Martin Gerard
- Department of Obstetrics and Gynecology, Hôpital de Marche, Vivalia, Marche-en-Famenne, Belgium
| | - Pierrette Melin
- Department of Clinical Microbiology, University Hospital of Liege, Liege, Belgium
- National Reference Center Streptococcus agalactiae, Department of Clinical Microbiology, University Hospital Center of Liege, Liege, Belgium
| |
Collapse
|
5
|
Briaud P, Gautier T, Rong V, Mereghetti L, Lanotte P, Hiron A. The Streptococcus agalactiae Exonuclease ExoVII Is Required for Resistance to Exogenous DNA-Damaging Agents. J Bacteriol 2023; 205:e0002423. [PMID: 37162366 PMCID: PMC10294681 DOI: 10.1128/jb.00024-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
Streptococcus agalactiae is a human pathogen responsible for severe invasive infections in newborns. In this bacterium, XseB, a part of the ExoVII exonuclease, was shown to be specifically more abundant in the hypervirulent ST-17 strains. In Escherichia coli, ExoVII is associated either with mismatch repair or with recombinational DNA repair and is redundant with other exonucleases. In this study, the biological role of S. agalactiae ExoVII was examined. The ΔexoVII mutant strain was subjected to different DNA-damaging agents, as well as a large set of mutants impaired either in the mismatch repair pathway or in processes of recombinational DNA repair. Our results clarified the role of this protein in Gram-positive bacteria as we showed that ExoVII is not significantly involved in mismatch repair but is involved in bacterial recovery after exposure to exogenous DNA-damaging agents such as ciprofloxacin, UV irradiation, or hydrogen peroxide. We found that ExoVII is more particularly important for resistance to ciprofloxacin, likely as part of the RecF DNA repair pathway. Depending on the tested agent, ExoVII appeared to be fully redundant or nonredundant with another exonuclease, RecJ. The importance of each exonuclease, ExoVII or RecJ, in the process of DNA repair is thus dependent on the considered DNA lesion. IMPORTANCE This study examined the role of the ExoVII exonuclease of Streptococcus agalactiae within the different DNA repair processes. Our results concluded that ExoVII is involved in bacterial recovery after exposure to different exogenous DNA-damaging agents but not in the mismatch repair pathway. We found that ExoVII is particularly important for resistance to ciprofloxacin, likely as part of the RecF DNA repair pathway.
Collapse
Affiliation(s)
- P. Briaud
- Université de Tours, INRAE, ISP, Tours, France
| | - T. Gautier
- Université de Tours, INRAE, ISP, Tours, France
| | - V. Rong
- Université de Tours, INRAE, ISP, Tours, France
| | - L. Mereghetti
- Université de Tours, INRAE, ISP, Tours, France
- CHRU de Tours, Service de Bactériologie-Virologie-Hygiène, Tours, France
| | - P. Lanotte
- Université de Tours, INRAE, ISP, Tours, France
- CHRU de Tours, Service de Bactériologie-Virologie-Hygiène, Tours, France
| | - A. Hiron
- Université de Tours, INRAE, ISP, Tours, France
| |
Collapse
|
6
|
Tsai IA, Su Y, Wang YH, Chu C. Alterations in Genes rib, scpB and Pilus Island Decrease the Prevalence of Predominant Serotype V, Not III and VI, of Streptococcus agalactiae from 2008 to 2012. Pathogens 2022; 11:pathogens11101145. [PMID: 36297202 PMCID: PMC9611264 DOI: 10.3390/pathogens11101145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Streptococcus agalactiae (GBS) can infect newborns, pregnant women and immunocompromised or elderly people. This study aimed to investigate differences in three pilus genes and virulence genes pavA, cfb, rib and scpB and changes in predominant serotypes III, V and VI from 2008 to 2012. The susceptibilities to penicillin, ceftriaxone, azithromycin, erythromycin, clindamycin, levofloxacin and moxifloxacin of 145 GBS strains of serotype III, V and VI strains from 2008 and 2012 were determined using disc diffusion method. PCR identification of ST-17, the pilus genes and virulence genes; multilocus sequence typing (MLST); and conserved domain and phylogenetic analysis of scpB-1 and scpB-2 proteins were performed. A dramatic number reduction was observed in serotype V, not III and V, from 2008 to 2012. The rate of resistance to azithromycin, clindamycin and erythromycin was the highest in serotype V. ST-17 was only found in serotype III with pilus genes PI-1+PI-2b. The major pilus genotype was PI-1+PI-2a. Serotype V without the rib gene was reduced in number between two studied years. Compared to scpB-1, scpB-2 had a 128-bp deletion in a PA C5a-like peptidase domain and putative integrin-binding motif RGD. In conclusion, reduction in serotype V may be due to presence of scpB-2 or lack of genes scpB and rib.
Collapse
Affiliation(s)
- I-An Tsai
- Ph.D. Program of Agriculture Science, College of Agriculture, National Chiayi University, Chiayi City 600, Taiwan
| | - Yaochi Su
- Ph.D. Program of Agriculture Science, College of Agriculture, National Chiayi University, Chiayi City 600, Taiwan
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chiayi University, Chiayi City 600, Taiwan
| | - Ying-Hsiang Wang
- Department of Pediatrics, Chang Gung Memorial Hospital, Puzi City 613, Taiwan
| | - Chishih Chu
- Department of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi City 600, Taiwan
- Correspondence: ; Tel.: +886-5-2717898
| |
Collapse
|
7
|
Andersen M, Smith B, Murra M, Nielsen SY, Slotved HC, Henriksen TB. Invasive group B Streptococcus strains and clinical characteristics in Danish infants from 1999 to 2009. Front Microbiol 2022; 13:1001953. [PMID: 36246253 PMCID: PMC9554412 DOI: 10.3389/fmicb.2022.1001953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundGroup B Streptococcus (GBS) infection in infants may result in both respiratory, cardiovascular, and neurological dysfunction and ultimately death of the infant. Surveillance of GBS strains in infants and their clinical characteristics guide development of effective vaccines and other potential treatments and may have implications for future prognostics and infant care. Therefore, we aimed to study GBS serotypes and clonal complexes (CC) in Danish infants with early onset infection (EOD) (0–6 days of life) and late-onset infection (LOD) (7–89 days of life) and to estimate the association between GBS strain and different clinical outcomes.MethodsWe included Danish infants less than 3 months of age with GBS isolates from blood or cerebrospinal fluid between 1999 and 2009. GBS isolates were analyzed by serotyping and multilocus sequence typing with classification of isolates into clonal complexes. Clinical characteristics were obtained by questionnaires completed by tending pediatrician including gestational age, Apgar scores, age at onset, meningitis, symptom severity, treatment duration, and mortality. Symptom severities were reported within neurological symptoms, need for respiratory or circulatory support, and treatment of disseminated intravascular coagulation.ResultsA total of 212 GBS isolates were collected with 129 from EOD and 83 from LOD. The dominating GBS strains were III/CC17 (41%), Ia/CC23 (17%), III/CC19 (15%), Ib/CC8-10 (7%), and V/CC1 (6%). Strain Ia/CC23 was mostly found in EOD, while III/CC17 was widespread in LOD, though being the most common in both EOD and LOD. Strain III/CC17 and Ia/CC23 had highest percentage of samples from cerebrospinal fluid (26%), while III/CC19 had the least (8%). Strain III/CC19 had highest mortality with about one fifth of infected infants dying (22%) followed by Ia/CC23 (16%), Ib/CC8-10 (9%), and then III/CC17 (6%). The symptom severity varied between strains, but with no strain consistently resulting in more severe symptoms.ConclusionSome potential differences in disease severity were observed between the different strains. These findings emphasize the continuous need for multimodal surveillance of infant GBS strains and their clinical characteristics to optimize development of GBS vaccines and other potential treatments.
Collapse
Affiliation(s)
- Mads Andersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- *Correspondence: Mads Andersen,
| | - Birgitte Smith
- Department of Pediatrics and Adolescent Medicine, Hvidovre Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - May Murra
- Department of Microbiology, Vejle Hospital, Vejle, Denmark
| | - Stine Yde Nielsen
- Department of Microbiology, Vejle Hospital, Vejle, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Tine Brink Henriksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
8
|
Boonsilp S, Nealiga MJ, Wangchuk K, Homkaew A, Wongsuk T, Thuncharoon H, Suksomchit P, Wasipraphai D, Chaturongakul S, Dubbs P. Differential Interaction between Invasive Thai Group B Streptococcus Sequence Type 283 and Caco-2 Cells. Microorganisms 2022; 10:microorganisms10101917. [PMID: 36296194 PMCID: PMC9611625 DOI: 10.3390/microorganisms10101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
The emergence in Southeast Asia of invasive group B Streptococcus (GBS) infections in adults by sequence type (ST) 283 is suggested to be associated with fish consumption. Genotyping of 55 GBS clinical isolates revealed that 33/44 invasive isolates belonged to ST283/capsular polysaccharide type (CPS) III. This included 15/16 isolates recovered from younger adults aged 16–36 years. Seven ST283/CPSIII isolates from the blood, cerebrospinal fluid, or joint fluid were selected by the patient’s age at random to perform interaction studies with intestinal epithelial Caco-2 monolayers. The invasion efficiency profiles from this study classified these isolates into two groups; a higher invasion efficiency group 1 recovered from patients aged between 23 and 36 years, and a lower invasion efficiency group 2 recovered from the elderly and neonate. Intracellular survival tests revealed that only group 1 members could survive inside Caco-2 cells up to 32 h without replication. Additionally, all isolates tested were able to traverse across polarized Caco-2 monolayers. However, the timing of translocation varied among the isolates. These results indicated the potential of GBS invasion via the gastrointestinal tract and showed phenotypic variations in invasiveness, intracellular survival, and translocation efficiency between genetically closely related ST283 isolates infecting young adults and those infecting the elderly.
Collapse
Affiliation(s)
- Siriphan Boonsilp
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Marea Jikka Nealiga
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Kinley Wangchuk
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Anchalee Homkaew
- Microbiological Unit, Central Laboratory and Blood Bank, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Thanwa Wongsuk
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | | | - Paveesuda Suksomchit
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Daranee Wasipraphai
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Soraya Chaturongakul
- Molecular Medical Biosciences Cluster, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Padungsri Dubbs
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
- Center for Emerging Bacterial Infections, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
- Correspondence:
| |
Collapse
|
9
|
Genomic Traits Associated with Virulence and Antimicrobial Resistance of Invasive Group B Streptococcus Isolates with Reduced Penicillin Susceptibility from Elderly Adults. Microbiol Spectr 2022; 10:e0056822. [PMID: 35639001 PMCID: PMC9241772 DOI: 10.1128/spectrum.00568-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study aimed to investigate genomic traits underlying the antimicrobial resistance and virulence of multidrug-resistant (MDR) group B streptococci with reduced penicillin susceptibility (PRGBS) recovered from elderly patients with bloodstream infections, which remain poorly characterized. The pangenome was found to be open, with the predicted pan- and core genome sizes being 3,531 and 1,694 genes, respectively. Accessory and unique genes were enriched for the Clusters of Orthologous Groups (COG) categories L, Replication, recombination, and repair, and K, Transcription. All MDR PRGBS isolates retained a core virulence gene repertoire (bibA, fbsA/-B/-C, cspA, cfb, hylB, scpB, lmb, and the cyl operon), supporting an invasive ability similar to that of the other invasive GBS, penicillin-susceptible GBS (PSGBS), and noninvasive PRGBS isolates. The putative sequence type 1 (ST1)-specific AlpST-1 virulence gene was also retained among the serotype Ia/ST1 PRGBS isolates. In addition to tet(M) and erm(B), mef(A)-msr(D) elements or the high-level gentamicin resistance gene aac(6′)-aph(2″), which are both rare in PSGBS, were detected among those MDR PRGBS isolates. In the core single-nucleotide polymorphism (SNP) phylogenetic tree, all invasive ST1 PRGBS isolates with serotypes Ia and III were placed together in a clade with a recombination rate of 3.97, which was 36 times higher than the value found for a clade formed by serotype V/ST1 PSGBS isolates derived mostly from human blood. ST1 has been the predominant sequence type among the PRGBS isolates in Japan, and serotypes Ia and III have been very rare among the ST1 PSGBS isolates. Thus, these lineages that mostly consisted of serotypes Ia/ST1 and III/ST1 PRGBS could possibly emerge through recombination within the ST1 populations. IMPORTANCEStreptococcus agalactiae, or group B Streptococcus (GBS), is recognized as the leading cause of neonatal invasive infections. However, an increasing incidence of invasive GBS infections among nonpregnant adults, particularly the elderly and those with underlying diseases, has been observed. There is a trend toward the increasing occurrence of penicillin nonsusceptibility among GBS clinical isolates, from 4.8% in 2008 to 5.8% in 2020 in Japan. Also, in the United States, the frequency of adult invasive GBS isolates suggestive of β-lactam nonsusceptibility increased from 0.7% in 2015 to 1.0% in 2016. In adults, mortality has been significantly higher among patients with bacteremia than among those without bacteremia. Our study revealed that invasive GBS with reduced penicillin susceptibility (PRGBS) isolates harbor major virulence and resistance genes known among GBS, highlighting the need for large population-based genomic surveillance studies to better understand the clinical relevance of invasive PRGBS isolates.
Collapse
|
10
|
Impact of tissue processing on microbiological colonization in the context of placentophagy. Sci Rep 2022; 12:5307. [PMID: 35351937 PMCID: PMC8964728 DOI: 10.1038/s41598-022-09243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 03/14/2022] [Indexed: 11/08/2022] Open
Abstract
A mother’s postpartum ingestion of raw or processed placental tissue—referred to as human maternal placentophagy—is an emerging health trend observed in industrialized nations. Placenta is commonly consumed as small pieces of raw tissue, or as raw or steamed dehydrated pulverized and encapsulated tissue. To investigate the potential neonatal health risks of this behavior, the present study focused on microbial colonization of processed placenta preparations with potentially pathogenic bacteria Streptococcus agalactiae (Group-B-Streptococci; GBS) and Escherichia coli (E. coli). In the clinical approach placentas from 24 mothers were analyzed. Two placentas, from 13 mothers with confirmed positive maternal GBS status, showed GBS-growth on their surface (2/13; 15.4%) independent from delivery mode or antibiotic treatment. All processed samples (n = 24) were free from GBS. In the experimental approach, a standardized inoculation protocol was introduced to resemble ascending vaginal and hematogenous colonization. Six placentas from elective term C-sections of GBS negative mothers were collected and artificially inoculated with highly concentrated suspensions of GBS and E. coli. Heat processing significantly reduced the number of colony forming units (CFU) for GBS and E. coli. Our results suggest placentophagy of processed tissue is an unlikely source of clinical infection.
Collapse
|
11
|
Furuta A, Brokaw A, Manuel G, Dacanay M, Marcell L, Seepersaud R, Rajagopal L, Adams Waldorf K. Bacterial and Host Determinants of Group B Streptococcal Infection of the Neonate and Infant. Front Microbiol 2022; 13:820365. [PMID: 35265059 PMCID: PMC8899651 DOI: 10.3389/fmicb.2022.820365] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/27/2022] [Indexed: 12/15/2022] Open
Abstract
Group B streptococci (GBS) are Gram-positive β-hemolytic bacteria that can cause serious and life-threatening infections in neonates manifesting as sepsis, pneumonia, meningitis, osteomyelitis, and/or septic arthritis. Invasive GBS infections in neonates in the first week of life are referred to as early-onset disease (EOD) and thought to be acquired by the fetus through exposure to GBS in utero or to vaginal fluids during birth. Late-onset disease (LOD) refers to invasive GBS infections between 7 and 89 days of life. LOD transmission routes are incompletely understood, but may include breast milk, household contacts, nosocomial, or community sources. Invasive GBS infections and particularly meningitis may result in significant neurodevelopmental injury and long-term disability that persists into childhood and adulthood. Globally, EOD and LOD occur in more than 300,000 neonates and infants annually, resulting in 90,000 infant deaths and leaving more than 10,000 infants with a lifelong disability. In this review, we discuss the clinical impact of invasive GBS neonatal infections and then summarize virulence and host factors that allow the bacteria to exploit the developing neonatal immune system and target organs. Specifically, we consider the mechanisms known to enable GBS invasion into the neonatal lung, blood vessels and brain. Understanding mechanisms of GBS invasion and pathogenesis relevant to infections in the neonate and infant may inform the development of therapeutics to prevent or mitigate injury, as well as improve risk stratification.
Collapse
Affiliation(s)
- Anna Furuta
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Alyssa Brokaw
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Gygeria Manuel
- Morehouse School of Medicine, Atlanta, GA, United States
| | - Matthew Dacanay
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States
| | - Lauren Marcell
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States
| | - Ravin Seepersaud
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Lakshmi Rajagopal
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States.,Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Kristina Adams Waldorf
- Department of Global Health, University of Washington, Seattle, WA, United States.,Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States.,Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
12
|
Lemaire C, Le Gallou B, Lanotte P, Mereghetti L, Pastuszka A. Distribution, Diversity and Roles of CRISPR-Cas Systems in Human and Animal Pathogenic Streptococci. Front Microbiol 2022; 13:828031. [PMID: 35173702 PMCID: PMC8841824 DOI: 10.3389/fmicb.2022.828031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/10/2022] [Indexed: 12/26/2022] Open
Abstract
Streptococci form a wide group of bacteria and are involved in both human and animal pathologies. Among pathogenic isolates, differences have been highlighted especially concerning their adaptation and virulence profiles. CRISPR-Cas systems have been identified in bacteria and many streptococci harbor one or more systems, particularly subtypes I-C, II-A, and III-A. Since the demonstration that CRISPR-Cas act as an adaptive immune system in Streptococcus thermophilus, a lactic bacteria, the diversity and role of CRISPR-Cas were extended to many germs and functions were enlarged. Among those, the genome editing tool based on the properties of Cas endonucleases is used worldwide, and the recent attribution of the Nobel Prize illustrates the importance of this tool in the scientific world. Another application is CRISPR loci analysis, which allows to easily characterize isolates in order to understand the interactions of bacteria with their environment and visualize species evolution. In this review, we focused on the distribution, diversity and roles of CRISPR-Cas systems in the main pathogenic streptococci.
Collapse
Affiliation(s)
- Coralie Lemaire
- Université de Tours, INRAE, Infectiologie et Santé Publique, BRMF, Tours, France
- Service de Bactériologie-Virologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Brice Le Gallou
- Université de Tours, INRAE, Infectiologie et Santé Publique, BRMF, Tours, France
- Service de Bactériologie-Virologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Philippe Lanotte
- Université de Tours, INRAE, Infectiologie et Santé Publique, BRMF, Tours, France
- Service de Bactériologie-Virologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
- *Correspondence: Philippe Lanotte,
| | - Laurent Mereghetti
- Université de Tours, INRAE, Infectiologie et Santé Publique, BRMF, Tours, France
- Service de Bactériologie-Virologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Adeline Pastuszka
- Université de Tours, INRAE, Infectiologie et Santé Publique, BRMF, Tours, France
- Service de Bactériologie-Virologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| |
Collapse
|
13
|
van Kassel MN, Gonçalves BP, Snoek L, Sørensen HT, Bijlsma MW, Lawn JE, Horváth-Puhó E. Sex Differences in Long-term Outcomes After Group B Streptococcal Infections During Infancy in Denmark and the Netherlands: National Cohort Studies of Neurodevelopmental Impairments and Mortality. Clin Infect Dis 2022; 74:S54-S63. [PMID: 34725694 PMCID: PMC8775649 DOI: 10.1093/cid/ciab822] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Male infants have a higher incidence of invasive group B Streptococcus disease (iGBS) compared with female infants; however, data on sex differences in mortality and long-term outcomes after iGBS are lacking. We assessed whether a child's sex influences the effects of iGBS on mortality and risk of neurodevelopmental impairments (NDIs). METHODS We used Danish and Dutch registry data to conduct a nationwide cohort study of infants with a history of iGBS. A comparison cohort, children without a history of iGBS, was randomly selected and matched on relevant factors. Effect modification by sex was assessed on additive and multiplicative scales. RESULTS Our analyses included data from children with a history of iGBS in Denmark (period 1997 -2017; n = 1432) and the Netherlands (2000 -2017; n = 697) and from 21 172 children without iGBS. There was no clear evidence of between-sex heterogeneity in iGBS-associated mortality. Boys had a higher risk of NDI, with evidence for effect modification on additive scale at the age of 5 years for any NDI (relative excess risk due to interaction = 1.28; 95% confidence interval [CI], -0.53 to 3.09 in Denmark and 1.14; 95% CI, -5.13 to 7.41 in the Netherlands). A similar pattern was observed for moderate/severe NDI at age 5 years in Denmark and age 10 years in the Netherlands. CONCLUSION Boys are at higher risk of NDI ; our results suggest this is disproportionally increased in those who develop iGBS. Future studies should investigate mechanisms of this effect modification by sex.
Collapse
Affiliation(s)
- Merel N van Kassel
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bronner P Gonçalves
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Linde Snoek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark
| | - Merijn W Bijlsma
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Joy E Lawn
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | |
Collapse
|
14
|
Liu J, Chen F, Guan H, Yu J, Yu J, Zhao J, Liu Y, Shen L. Emerging Fatal Ib/CC12 Hypervirulent Multiresistant Streptococcus agalactiae in Young Infants With Bloodstream Infection in China. Front Microbiol 2021; 12:767803. [PMID: 34975795 PMCID: PMC8715515 DOI: 10.3389/fmicb.2021.767803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
Streptococcus agalactiae [also known as group B Streptococcus (GBS)] is a tremendous threat to young infants. Eighty pediatric GBS infection cases were enrolled from a teaching hospital in Shanghai between 2009 and 2020; among them, 72.5% (58/80) were diagnosed with bloodstream infection (BSI). Sequence types (STs) and serotypes of associated GBS strains were identified, and most of the Ib/clonal complex (CC)12 (86.7%, 13/15) strains caused BSIs, which was significantly higher than that of the genetically related clone Ib/CC10 (20%, 2/10; p < 0.05). Ib/CC12 BSI (30.8%) mortality was significantly higher than that of non-Ib/CC12 BSI (2.2%; p < 0.05). Virulence genes associated with adhesion, invasion, and immune evasion were detected using polymerase chain reaction. The fbsA and gbsPC1 positive rates of Ib/CC12 strains was higher than that of non-Ib/CC12 strains, whereas cpsIaJ, cpsJ, cpsI, and cpsG positive rates were lower than those of non-Ib/CC12 (p < 0.05). In in vitro studies, the Ib/CC12 strains had strong invasiveness in RAW264.7 cells, but less invasiveness in human umbilical vein endothelial cells, human brain microvascular endothelial cells, and human mammary epithelial cells when compared to other two clones. In the in vivo model, the Ib/CC12 GBS invaded the circulation system more rapidly after intraperitoneal injection, was more difficult to eradicate by phagocytes, and caused significantly higher mortality than Ib/CC10 and III/ST17 (p < 0.05). Genome analysis showed that the Ib/CC12 strains had two clustered regularly interspaced short palindromic repeat-Cas systems and carried more antibiotic resistant genes, which conferred resistance to macrolides, clindamycin, aminoglycosides, and tetracycline. The Ib/CC12 strains had 45 unique annotated genes compared to that of Ib/CC10, including the pathogen-related toxin/antitoxin system, PezA/T. In conclusion, Ib/CC12 is an emerging hypervirulent multiresistant GBS clone that causes invasive and fatal infections in pediatric patients. The prevention and control of Ib/CC12 GBS infection should be emphasized.
Collapse
Affiliation(s)
- Jingxian Liu
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Chen
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyan Guan
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajia Yu
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Yu
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhao
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Liu
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lisong Shen, ; Ying Liu,
| | - Lisong Shen
- Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Faculty of Medical Laboratory Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lisong Shen, ; Ying Liu,
| |
Collapse
|
15
|
McCutcheon CR, Pell ME, Gaddy JA, Aronoff DM, Petroff MG, Manning SD. Production and Composition of Group B Streptococcal Membrane Vesicles Vary Across Diverse Lineages. Front Microbiol 2021; 12:770499. [PMID: 34880842 PMCID: PMC8645895 DOI: 10.3389/fmicb.2021.770499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Although the neonatal and fetal pathogen Group B Streptococcus (GBS) asymptomatically colonizes the vaginal tract of ∼30% of pregnant women, only a fraction of their offspring develops invasive disease. We and others have postulated that these dimorphic clinical phenotypes are driven by strain variability; however, the bacterial factors that promote these divergent clinical phenotypes remain unclear. It was previously shown that GBS produces membrane vesicles (MVs) that contain active virulence factors capable of inducing adverse pregnancy outcomes. Because the relationship between strain variation and vesicle composition or production is unknown, we sought to quantify MV production and examine the protein composition, using label-free proteomics on MVs produced by diverse clinical GBS strains representing three phylogenetically distinct lineages. We found that MV production varied across strains, with certain strains displaying nearly twofold increases in production relative to others. Hierarchical clustering and principal component analysis of the proteomes revealed that MV composition is lineage-dependent but independent of clinical phenotype. Multiple proteins that contribute to virulence or immunomodulation, including hyaluronidase, C5a peptidase, and sialidases, were differentially abundant in MVs, and were partially responsible for this divergence. Together, these data indicate that production and composition of GBS MVs vary in a strain-dependent manner, suggesting that MVs have lineage-specific functions relating to virulence. Such differences may contribute to variation in clinical phenotypes observed among individuals infected with GBS strains representing distinct lineages.
Collapse
Affiliation(s)
- Cole R. McCutcheon
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States
| | - Macy E. Pell
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States
| | - Jennifer A. Gaddy
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
- Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN, United States
| | - David M. Aronoff
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Margaret G. Petroff
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States
- Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, MI, United States
| | - Shannon D. Manning
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States
| |
Collapse
|
16
|
Baeringsdottir B, Erlendsdottir H, Bjornsdottir ES, Martins ER, Ramirez M, Haraldsson A, Thorkelsson T. Group B streptococcal infections in infants in Iceland: clinical and microbiological factors. J Med Microbiol 2021; 70:001426. [PMID: 34554080 PMCID: PMC8697508 DOI: 10.1099/jmm.0.001426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/19/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction. Group B streptococcus (GBS) is a leading cause of invasive neonatal infections. These have been divided into early-onset disease (EOD; <7 days) and late-onset disease (LOD; 7-89 days), with different GBS clonal complexes (CCs) associated with different disease presentations.Hypothesis. Different GBS CCs are associated with timing of infection (EOD or LOD) and clinical presentation (sepsis, meningitis or pneumonia).Aim. To study infant GBS infections in Iceland from 1975 to 2019. Are specific GBS CCs related to disease presentation? Is CC17 overrepresented in infant GBS infections in Iceland?Methodology. All culture-confirmed invasive GBS infections in infants (<90 days) in Iceland from 1975 to 2019 were included. Clinical information was gathered from medical records.Results. A total of 127 invasive GBS infections in infants were diagnosed, but 105 infants were included in the study. Of these, 56 had EOD and 49 had LOD. The incidence of GBS infections declined from 2000 onwards but increased again at the end of the study period. Furthermore, there was a significant increase in LOD over the study period (P=0.0001). The most common presenting symptoms were respiratory difficulties and fever and the most common presentation was sepsis alone. Approximately one-third of the cases were caused by GBS CC17 of serotype III with surface protein RIB and pili PI-1+PI-2b or PI-2b. CC17 was significantly associated with LOD (P<0.001).Conclusion. CC17 is a major cause of GBS infection in infants in Iceland. This clone is associated with LOD, which has been increasing in incidence. Because intrapartum antibiotic prophylaxis only prevents EOD, it is important to continue the development of a GBS vaccine in order to prevent LOD infections.
Collapse
Affiliation(s)
| | - Helga Erlendsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Clinical Microbiology, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Elisabete R. Martins
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Mário Ramirez
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Asgeir Haraldsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- The Children’s Hospital, Landspitali University Hospital, Reykjavik, Iceland
| | - Thordur Thorkelsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- The Children’s Hospital, Landspitali University Hospital, Reykjavik, Iceland
| |
Collapse
|
17
|
Trends in molecular characteristics and antimicrobial resistance of group B streptococci: a multicenter study in Serbia, 2015-2020. Sci Rep 2021; 11:540. [PMID: 33436658 PMCID: PMC7804007 DOI: 10.1038/s41598-020-79354-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/07/2020] [Indexed: 01/29/2023] Open
Abstract
Group B Streptococcus (GBS) is a major cause of neonatal morbidity and mortality. Serbia has not fully implemented preventive measures against GBS neonatal diseases. Therefore, we aimed to assess the maternal GBS colonisation and invasive neonatal disease rate, to reveal the trends of antimicrobial resistance and serotype distribution of GBS from various patient groups. Randomly selected non-invasive (n = 991) and all invasive GBS (n = 80) collected throughout Serbia from 2015 to 2020 were tested for antimicrobial susceptibility, capsular typing, and hvgA detection. Overall, 877/5621 (15.6%) pregnant women were colonised with GBS. Invasive GBS infections incidence in infants (0.18/1000 live births) showed a decreasing trend (0.3 to 0.1/1000 live births). Type III was overrepresented in infants with invasive infections (n = 35, 58.3%), whereas type V predominated among colonised adults (n = 224, 25.5%) and those with noninvasive (n = 37, 32.5%) and invasive infections (n = 8, 40%). The hypervirulent clone III/ST17 was highly associated with invasive infections (n = 28, 35%), particularly late-onset disease (n = 9, 47.4%), showing an increase from 12.3 to 14.8%. The GBS resistance to erythromycin and clindamycin was 26.7% and 22.1%, respectively, with an upward trend. The emergence of the hypervirulent clone III/ST17 and the escalation in GBS resistance highlight an urgent need for continuous monitoring of GBS infections.
Collapse
|
18
|
Molecular epidemiology and mortality of group B streptococcal meningitis and infant sepsis in the Netherlands: a 30-year nationwide surveillance study. LANCET MICROBE 2021; 2:e32-e40. [DOI: 10.1016/s2666-5247(20)30192-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/19/2022]
|
19
|
Phylogeny, recombination, and invasiveness of group B Streptococcus revealed by genomic comparisons of its global strains. Eur J Clin Microbiol Infect Dis 2020; 40:581-590. [PMID: 33067737 PMCID: PMC7567417 DOI: 10.1007/s10096-020-04067-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 10/09/2020] [Indexed: 11/26/2022]
Abstract
Capsular polysaccharide (CPS) genes and pilus islands encode important virulence factors for group B Streptococcus (GBS) genomes. This study aims to detect phylogenetic inconsistency in CPS genes and pilus islands in GBSs and to explore its relationship with invasiveness. A total of 1016 GBS genomes were downloaded from the NCBI public database. The multi-locus sequence typing (MLST) and Bayesian analysis of Population Structure (BAPS) analyses were both conducted for phylogeny construction. Serotyping and pilus typing were determined in silico using the genomic sequences. The CPS and pilus typing results were generally consistent with MLST and BAPS clustering. GBS isolates of serotype II and of the PI-1 + PI-2b and PI-2a types were more prone to phylogenetic inconsistency than the others. Isolates of serotype Ib and of PI-1 + PI-2a were more likely to appear as colonizing strains, whereas PI-2b was more likely to appear in invasive strains. For serotype V, phylogenetic inconsistency occurred more commonly in colonizing isolates, while for serotype III, the opposite occurred. The present study profiles for the first time the phylogenetic inconsistency of CPS genes and pilus islands in global GBS isolates, which is helpful for infection control and the development of new vaccines for the prevention of GBS occurrence.
Collapse
|
20
|
Systematic review of Group B Streptococcal capsular types, sequence types and surface proteins as potential vaccine candidates. Vaccine 2020; 38:6682-6694. [PMID: 32888741 PMCID: PMC7526974 DOI: 10.1016/j.vaccine.2020.08.052] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 01/31/2023]
Abstract
Most comprehensive review of Group B Streptococcal serotypes through 2018. First systematic review of Group B Streptococcal strain type and protein data. Theoretically candidate vaccines may protect against 93-99% disease-causing strains. More studies on GBS strains in low- and middle-income countries are needed.
Background 21 million pregnant women worldwide (18%) are estimated to carry Group B Streptococcus (GBS), which is a risk for invasive disease in newborns, pregnant women, and stillbirths. Adults ≥ 60 years or with underlying health conditions are also vulnerable to invasive GBS disease. We undertook systematic reviews on GBS organism characteristics including: capsular polysaccharide (serotype), sequence type (multi-locus sequence types (MLST)), and virulence proteins. We synthesised data by at-risk populations, to inform vaccine development. Methods We conducted systematic reviews and meta-analyses to estimate proportions of GBS serotypes for at risk populations: maternal colonisation, invasive disease in pregnant women, stillbirths, infants 0–90 days age, and older adults (≥60 years). We considered regional variation and time trends (2001–2018). For these at-risk population groups, we summarised reported MLST and surface proteins. Results Based on 198 studies (29247isolates), 93–99% of GBS isolates were serotypes Ia, Ib, II, III, IV and V. Regional variation is likely, but data gaps are apparent, even for maternal colonisation which has most data. Serotype III dominates for infant invasive disease (60%) and GBS-associated stillbirths (41%). ST17 accounted for a high proportion of infant invasive disease (41%; 95%CI: 35–47) and was found almost exclusively in serotype III strains, less present in maternal colonisation (9%; 95%CI:6–13),(4%; 95%CI:0–11) infant colonisation, and adult invasive disease (4%, 95%CI:2–6). Percentages of strains with at least one of alp 1, alp2/3, alpha C or Rib surface protein targets were 87% of maternal colonisation, 97% infant colonisation, 93% infant disease and 99% adult invasive disease. At least one of three pilus islands proteins were reported in all strains. Discussion A hexavalent vaccine (serotypes Ia, Ib, II, III, IV and V) might provide comprehensive cover for all at-risk populations. Surveillance of circulating, disease-causing target proteins is useful to inform vaccines not targeting capsular polysaccharide. Addressing data gaps especially by world region and some at-risk populations (notably stillbirths) is fundamental to evidence-based decision-making during vaccine design.
Collapse
|
21
|
Microarray Analysis of Group B Streptococci Causing Invasive Neonatal Early- and Late-onset Infection. Pediatr Infect Dis J 2020; 39:449-453. [PMID: 32091495 DOI: 10.1097/inf.0000000000002627] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Group B Streptococcus is the leading cause of meningitis and sepsis in newborns. Until now, there is no data of fast and simple typing of group B Streptococcus virulence factors using a genetic microarray and comparing these data to clinical manifestations. METHODS A prospective active surveillance study was conducted via 2 independent and nationwide reporting systems, the German Pediatric Surveillance Unit (ESPED) and the Laboratory Sentinel Group at Robert Koch-Institute. Surveillance was performed between 2001 and 2003 and between 2008 and 2010. Typing of virulence factors, serotypes, pilus islands and alpha-like proteins was done by means of a newly developed microarray method. RESULTS We evaluated 475 isolates of invasive neonatal infections. Predominant virulence factors were serotype III (63%), pilus island 2b and pilus island 1 (50%) and alp rib (64%) (alp - alpha-like protein, rib -resistance to proteases, immunity, group B). There was no significant change over time or geographically within Germany. Serotype III, pilus island 2b + 1 and alp rib showed significant associations with late-onset disease and meningitis, whereas alp 5 had a significant association with early-onset disease. Based on serotypes, pilus islands and alpha-like proteins, it was possible to cluster 86% of all isolates into 5 genetic groups. CONCLUSIONS The molecular epidemiology of a large collection of invasive neonatal infections showed similar distributions, as shown in smaller cohorts before. The microarray used proved to be a fast and reliable technique. Using this new tool, we were able to cluster the isolates according to their virulence factors. The clusters showed a better association with clinical data than single virulence factors.
Collapse
|
22
|
Palang I, Withyachumnarnkul B, Senapin S, Sirimanapong W, Vanichviriyakit R. Brain histopathology in red tilapia Oreochromis sp. experimentally infected with Streptococcus agalactiae serotype III. Microsc Res Tech 2020; 83:877-888. [PMID: 32243694 DOI: 10.1002/jemt.23481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/07/2020] [Accepted: 03/12/2020] [Indexed: 01/04/2023]
Abstract
One of the clinical manifestations of streptococcosis is swimming errors of the infected fish, which is likely caused by lesions in the brain. As most studies described brain histopathology in streptococcosis as meningitis, with a limited description of lesions in the whole brain, the aim of this study was therefore to explore histopathology of the whole brain of red tilapia experimentally infected with Streptococcus agalactiae serotype III. Transcripts relating to motoneuron functions and inflammatory responses were also investigated. In the S. agalactiae-infected fish, the parenchyma of the whole brain and its associated meninx primitiva were found to be markedly infiltrated by mononuclear cells and Gram-positive cocci. Hemorrhage, neuronal necrosis, and localized spongiform histopathology were observed, especially within the midbrain and the cerebellum. The lesion was observed in the medial longitudinal fasciculus and its nucleus. Expressions of the transcripts CD166, GAP43, SMN, and SV2B of the infected fish did not change, while those of IL-1β and TNF-α were significantly upregulated. It is likely that S. agalactiae cause extensive damage to the fish brain, especially in areas that control swimming activities, through both direct invasion of the bacteria and acute inflammatory responses of the brain resident macrophages, or microglia.
Collapse
Affiliation(s)
- Iyapa Palang
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand.,Center of Excellence for Shrimp Molecular Biology and Biotechnology (Centex Shrimp), Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Boonsirm Withyachumnarnkul
- Faculty of Science and Industrial Technology, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,AquaAcademy Farm, Tha Chana, Surat Thani, Thailand
| | - Saengchan Senapin
- Center of Excellence for Shrimp Molecular Biology and Biotechnology (Centex Shrimp), Faculty of Science, Mahidol University, Bangkok, Thailand.,National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Khlong Luang, Pathumthani, Thailand
| | - Wanna Sirimanapong
- Veterinary Aquatic Animal Research Health Care Unit, Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Bangkok, Thailand
| | - Rapeepun Vanichviriyakit
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand.,Center of Excellence for Shrimp Molecular Biology and Biotechnology (Centex Shrimp), Faculty of Science, Mahidol University, Bangkok, Thailand
| |
Collapse
|
23
|
Butin M, Dumont Y, Monteix A, Raphard A, Roques C, Martins Simoes P, Picaud JC, Laurent F. Sources and reservoirs of Staphylococcus capitis NRCS-A inside a NICU. Antimicrob Resist Infect Control 2019; 8:157. [PMID: 31636900 PMCID: PMC6798403 DOI: 10.1186/s13756-019-0616-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/01/2019] [Indexed: 12/23/2022] Open
Abstract
Background The methicillin-resistant clone Staphylococcus capitis NRCS-A, involved in sepsis in neonatal intensive care units (NICUs) worldwide, is able to persist and spread in NICUs, suggesting the presence of reservoirs inside each setting. The purpose of the present study was to identify these reservoirs and to investigate the cycle of transmission of NRCS-A in one NICU. Methods In a single institution study, NRCS-A was sought in 106 consecutive vaginal samples of pregnant women to identify a potential source of NRCS-A importation into the NICU. Additionally NICU caregivers and environmental including incubators were tested to identify putative secondary reservoirs. Finally, the efficacy of disinfection procedure in the elimination of NRCS-A from incubators was evaluated. Results No S. capitis was isolated from vaginal samples of pregnant women. Three of the 21 tested caregivers (14%) carried S. capitis on their hands, but none remain positive after a five-day wash-out period outside NICU. Moreover, the clone NRCS-A persisted during six consecutive weeks in the NICU environment, but none of the sampled sites was constantly contaminated. Finally in our before/after disinfection study, all of 16 incubators were colonized before disinfection and 10 (62%) incubators remained colonized with NRCS-A after the disinfection procedure. Conclusions The partial ineffectiveness of incubators’ disinfection procedures is responsible for persistence of NRCS-A inside a NICU, and the passive hand contamination of caregivers could be involved in the inter-patient transmission of S. capitis.
Collapse
Affiliation(s)
- Marine Butin
- 1Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.,2Réanimation Néonatale, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France
| | - Yann Dumont
- 3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Alice Monteix
- 3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Aurane Raphard
- 3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Christine Roques
- Laboratoire de Génie Chimique UMR 5503, Université de Toulouse, CNRS, INPT, UPS, Faculté des Sciences Pharmaceutiques, 35 chemin des maraîchers, 31062 Toulouse cedex 4, France
| | - Patricia Martins Simoes
- 1Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.,3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Jean-Charles Picaud
- 5Réanimation Néonatale, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France.,6CarMeN, INSERM U1060, INRA U1397, Université de Lyon, 165 Chemin du Grand Revoyet, 69310 Pierre Bénite, France
| | - Frédéric Laurent
- 1Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.,3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France.,7Département de Microbiologie et Mycologie, Institut des Sciences Pharmaceutiques et Biologiques de Lyon, Université de Lyon, 6 Avenue Rockefeller, 69008 Lyon, France
| |
Collapse
|
24
|
Li J, Ji W, Gao K, Zhou H, Zhang L, Mu X, Yuan C, Guan X, Deng Q, Zhang L, Zhong H, Gao X, Gao F, Long Y, Chang CY, McIver DJ, Liu H. Molecular characteristics of group B Streptococcus isolates from infants in southern mainland China. BMC Infect Dis 2019; 19:812. [PMID: 31533652 PMCID: PMC6751900 DOI: 10.1186/s12879-019-4434-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/30/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Invasive group B Streptococcus (GBS) disease in Chinese infants has gradually gained attention in recent years, but the molecular epidemiology of the pathogen is still not well known. METHODS This multicenter study retrospectively investigated distribution of capsular serotypes, sequence types (STs), and hypervirulent GBS adhesin gene (hvgA) in clinical GBS isolates that caused invasive disease in infants aged < 3 months of age in southern mainland China between January 2013 and June 2016. Genes for antibiotic resistance to tetracycline, erythromycin, and clindamycin were also examined. RESULTS From a total of 93 GBS isolates taken from 34 early-onset disease (EOD, 0-6 days after birth) and 59 late-onset disease (LOD, 7-89 days after birth) cases, four serotypes were identified: serotypes III (79.6%), Ib (12.9%), Ia (4.3%), and V (3.2%). Serotype III accounted for 73.5% of EOD and 83.1% of LOD and was responsible for 75.5% of cases involving meningitis. Fifteen STs were found, with the majority being ST17 (61.3%), ST12 (7.5%), ST19 (7.5%), and others (23.7%). 96.8% of STs belonged to only five clonal complexes (CCs): CC17 (64.5%), CC10 (12.9%), CC19 (9.7%), CC23 (6.5%), and CC1 (3.2%). The hvgA gene was detected in 66.7% of GBS isolates and 95% of CC17 isolates, all of which were serotype III except one serotype Ib/CC17 isolate. A large proportion of GBS isolates were found to be resistant to tetracycline (93.5%), clindamycin (65.5%), and erythromycin (60.2%). Genes of tetO (74.7%) and tetM (46.0%) were found in tetracycline resistant isolates, linB (24.6%) in clindamycin resistant isolates, and ermB (87.5%) and mefA (3.6%) in erythromycin resistant isolates. CONCLUSION Our results reveal higher prevalence of serotype III, ST17, CC17, hvgA expressing, and antibiotic resistant GBS isolates than previously reported in southern mainland China. This study provides guidance for appropriate measures of prevention and control to be taken in the future.
Collapse
Affiliation(s)
- Juan Li
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
- Clinical Laboratory, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095 Guangdong China
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi China
| | - Kankan Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Haijian Zhou
- National Institute for Communicable Disease Control and Prevention, and State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, 102206 China
| | - Lihua Zhang
- Clinical Laboratory, Dongguan Tungwah Hospital, Sun Yat-Sen Universtiy, Dongguan, 523110 Guangdong China
| | - Xiaoping Mu
- Clinical Laboratory, Guangdong Women and Children’s Hospital, Guangzhou, 511400 Guangdong China
| | - Chunlei Yuan
- Clinical Laboratory, ZhongshanBoai Hospital, Zhongshan, 528403 Guangdong China
| | - Xiaoshan Guan
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Qiulian Deng
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Lian Zhang
- Department of Neonatalogy, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong China
| | - Huamin Zhong
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Xiurong Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Fei Gao
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Yan Long
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Chien-Yi Chang
- School of Chemistry and Biosceinces, University of Bradford, Bradford, UK
| | | | - Haiying Liu
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| |
Collapse
|
25
|
Spencer BL, Deng L, Patras KA, Burcham ZM, Sanches GF, Nagao PE, Doran KS. Cas9 Contributes to Group B Streptococcal Colonization and Disease. Front Microbiol 2019; 10:1930. [PMID: 31497003 PMCID: PMC6712506 DOI: 10.3389/fmicb.2019.01930] [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: 06/13/2019] [Accepted: 08/05/2019] [Indexed: 12/20/2022] Open
Abstract
Group B Streptococcus (GBS) is a major opportunistic pathogen in certain adult populations, including pregnant women, and remains a leading etiologic agent of newborn disease. During pregnancy, GBS asymptomatically colonizes the vaginal tract of 20-30% of healthy women, but can be transmitted to the neonate in utero or during birth resulting in neonatal pneumonia, sepsis, meningitis, and subsequently 10-15% mortality regardless of antibiotic treatment. While various GBS virulence factors have been implicated in vaginal colonization and invasive disease, the regulation of many of these factors remains unclear. Recently, CRISPR-associated protein-9 (Cas9), an endonuclease known for its role in CRISPR/Cas immunity, has also been observed to modulate virulence in a number of bacterial pathogens. However, the role of Cas9 in GBS colonization and disease pathogenesis has not been well-studied. We performed allelic replacement of cas9 in GBS human clinical isolates of the hypervirulent sequence-type 17 strain lineage to generate isogenic Δcas9 mutants. Compared to parental strains, Δcas9 mutants were attenuated in murine models of hematogenous meningitis and vaginal colonization and exhibited significantly decreased invasion of human brain endothelium and adherence to vaginal epithelium. To determine if Cas9 alters transcription in GBS, we performed RNA-Seq analysis and found that 353 genes (>17% of the GBS genome) were differentially expressed between the parental WT and Δcas9 mutant strain. Significantly dysregulated genes included those encoding predicted virulence factors, metabolic factors, two-component systems (TCS), and factors important for cell wall formation. These findings were confirmed by qRT-PCR and suggest that Cas9 may regulate a significant portion of the GBS genome. We studied one of the TCS regulators, CiaR, that was significantly downregulated in the Δcas9 mutant strain. RNA-Seq analysis of the WT and ΔciaR strains demonstrated that almost all CiaR-regulated genes were also significantly regulated by Cas9, suggesting that Cas9 may modulate GBS gene expression through other regulators. Further we show that CiaR contributes to GBS vaginal colonization and persistence. Altogether, these data highlight the potential complexity and importance of the non-canonical function of Cas9 in GBS colonization and disease.
Collapse
Affiliation(s)
- Brady L. Spencer
- Department of Immunology & Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Liwen Deng
- Department of Immunology & Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Department of Biology, San Diego State University, San Diego, CA, United States
| | - Kathryn A. Patras
- Department of Biology, San Diego State University, San Diego, CA, United States
| | - Zachary M. Burcham
- Department of Animal Sciences, Colorado State University, Fort Collins, CO, United States
| | - Glenda F. Sanches
- Department of Immunology & Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Roberto Alcântara Gomes Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Prescilla E. Nagao
- Roberto Alcântara Gomes Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Kelly S. Doran
- Department of Immunology & Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Department of Biology, San Diego State University, San Diego, CA, United States
| |
Collapse
|
26
|
Abstract
BACKGROUND Despite a risk-based peripartum chemoprophylaxis approach in Iceland since 1996, Streptococcus agalactiae [group B streptococci (GBS)] remains an important cause of early-onset [<7 days, early-onset disease (EOD)] and late-onset disease (LOD; 7 days to 3 months). METHODS We studied GBS invasive disease in children <1 year in Iceland in 1976-2015. Bacteria (n = 98) were characterized by susceptibility to a panel of antimicrobials, capsular serotyping, resistance genes, surface protein and pilus-locus profiling and multilocus sequence typing. RESULTS Both EOD and LOD increased during the early years, but while EOD subsequently decreased from 0.7/1000 live births in 1991-1995 to 0.2/1000 in 2011-2015, LOD showed a nonsignificant decrease from its peak value of 0.6/1000 in 2001-2005 to 0.4/1000 in 2006-2015. Serotype III was the most frequently found (n = 48), represented mostly by the hypervirulent lineage CC17/III/rib/PI-1+PI-2b (62%), but also by CC19/III/rib/PI-1+PI-2a (35%) frequently associated with colonization. Serotype Ia (n = 22) was represented by CC23/Ia/eps/PI-2a (68%) and CC7/Ia/bca/PI-1+PI-2b (23%) of possible zoonotic origin. Resistance to erythromycin and clindamycin was increasingly detected in the last years of the study (5 of the 9 cases were isolated after 2013), including representatives of a multiresistant CC17/III/rib/PI-2b sublineage described recently in other countries and expressing resistance to erythromycin, clindamycin and streptomycin. CONCLUSIONS The risk-based chemoprophylaxis adopted in Iceland possibly contributed to the decline of EOD but has had limited effect on LOD. GBS causing neonatal and early infancy invasive infections in Iceland are genetically diverse, and the recent emergence of antimicrobial resistant lineages may reduce the choices for prophylaxis and therapy of these infections.
Collapse
|
27
|
Gres V, Kolter J, Erny D, Henneke P. The role of CNS macrophages in streptococcal meningoencephalitis. J Leukoc Biol 2019; 106:209-218. [PMID: 30762892 DOI: 10.1002/jlb.4mr1118-419r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 12/18/2022] Open
Abstract
In the healthy brain, microglia and other CNS macrophages are the most abundant immune cell type. Thus, they form the natural immune cell interface with streptococci, which are the leading cause of bacterial meningitis and encephalitis in infants and young children. In homeostasis, the blood-brain barrier allows for very limited access of immune cells circulating in the periphery. During bacterial meningoencephalitis, however, origin and fate of CNS macrophages are massively altered. This review summarizes the emerging knowledge on the sequence of reciprocal events between streptococci and CNS macrophages leading to host resistance, acute inflammation, changes in resident innate immune cells of the brain, and long-term neuronal damage.
Collapse
Affiliation(s)
- Vitka Gres
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Julia Kolter
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Daniel Erny
- Institute of Neuropathology, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Henneke
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Pediatrics and Adolescent Medicine, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
28
|
Gajic I, Plainvert C, Kekic D, Dmytruk N, Mijac V, Tazi A, Glaser P, Ranin L, Poyart C, Opavski N. Molecular epidemiology of invasive and non-invasive group B Streptococcus circulating in Serbia. Int J Med Microbiol 2018; 309:19-25. [PMID: 30389335 DOI: 10.1016/j.ijmm.2018.10.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/19/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022] Open
Abstract
Streptococcus agalactiae (group B Streptococcus, GBS) remains the leading cause of invasive diseases in neonates and an important cause of infections in the elderly. The aim of this study was to access the prevalence of GBS genito-rectal colonisation of pregnant women and to evaluate the genetic characteristics of invasive and non-invasive GBS isolates recovered throughout Serbia. A total of 432 GBS isolates were tested for antimicrobial susceptibility, capsular polysaccharide (CPS) types and the presence of the hvgA gene. One hundred one randomly selected isolates were further characterized by clustered regularly interspaced short palindromic repeats (CRISPRs) analysis and/or multilocus sequence typing (MLST). The prevalence of GBS colonization in pregnant women was 15%. Overall, six capsular types (Ia, Ib, II to V) were identified, the most common being III (32.2%) and V (25.2%). The hiper-virulent clone type III/ST17 was present in 43.1% and 6.3% (p < 0.05) of paediatric and adults isolates, respectively. Comparative sequence analysis of the CRISPR1 spacers content indicated that a few clones comprised the vast majority of the tested GBS isolates. Thus, it was estimated that dominant clones recovered from infants were CPS III/ST17 in late-onset infections (19/23; 82.6%), and Ia/ST23 in early-onset disease (44.4%). Conversely, genotype CPS V/ST1 was the most prevalent in adults (4/9; 25.4%). All isolates were susceptible to penicillin. Macrolide resistance (23.1%) was strongly associated with the ermB gene and constitutive resistance to clindamycin (63.9%). The majority of strains was resistant to tetracycline (86.6%), mostly mediated by the tetM gene (87.7%). GBS isolates of CPS V/ST1 and CPS III/ST23 were significantly associated with macrolide and tetracycline resistance, respectively. In conclusion, hyper-virulent CPS III/ST17 and V/ST1 were recognized as dominant GBS clones in this study.
Collapse
Affiliation(s)
- Ina Gajic
- Institute of Microbiology and Immunology, Medical Faculty, University of Belgrade, Dr Subotica 1, 11000, Belgrade, Serbia; National Reference Laboratory for Streptococci, Dr Subotica 1, 11000, Belgrade, Serbia
| | - Celine Plainvert
- Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; Centre National de Référence des Streptocoques, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006, Paris, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; CNRS UMR 8104, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; Unité de Biologie des Bactéries Pathogènes à Gram-positif, CNRS ERL3526, 25-28 Rue du Dr Roux, 75015, Paris, France
| | - Dusan Kekic
- Institute of Microbiology and Immunology, Medical Faculty, University of Belgrade, Dr Subotica 1, 11000, Belgrade, Serbia; National Reference Laboratory for Streptococci, Dr Subotica 1, 11000, Belgrade, Serbia
| | - Nicolas Dmytruk
- Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; Centre National de Référence des Streptocoques, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004, Paris, France
| | - Vera Mijac
- Institute of Microbiology and Immunology, Medical Faculty, University of Belgrade, Dr Subotica 1, 11000, Belgrade, Serbia; National Reference Laboratory for Streptococci, Dr Subotica 1, 11000, Belgrade, Serbia
| | - Asmaa Tazi
- Centre National de Référence des Streptocoques, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006, Paris, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; CNRS UMR 8104, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; Unité de Biologie des Bactéries Pathogènes à Gram-positif, CNRS ERL3526, 25-28 Rue du Dr Roux, 75015, Paris, France
| | - Philippe Glaser
- Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, 25-28 Rue du Dr Roux, 75015, Paris, France
| | - Lazar Ranin
- Institute of Microbiology and Immunology, Medical Faculty, University of Belgrade, Dr Subotica 1, 11000, Belgrade, Serbia; National Reference Laboratory for Streptococci, Dr Subotica 1, 11000, Belgrade, Serbia
| | - Claire Poyart
- Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; Centre National de Référence des Streptocoques, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006, Paris, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; CNRS UMR 8104, 27, rue du Faubourg-Saint-Jacques, 75014, Paris, France; Unité de Biologie des Bactéries Pathogènes à Gram-positif, CNRS ERL3526, 25-28 Rue du Dr Roux, 75015, Paris, France
| | - Natasa Opavski
- Institute of Microbiology and Immunology, Medical Faculty, University of Belgrade, Dr Subotica 1, 11000, Belgrade, Serbia; National Reference Laboratory for Streptococci, Dr Subotica 1, 11000, Belgrade, Serbia.
| |
Collapse
|
29
|
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.
Collapse
|
30
|
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.
Collapse
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
| |
Collapse
|
31
|
Pietrocola G, Arciola CR, Rindi S, Montanaro L, Speziale P. Streptococcus agalactiae Non-Pilus, Cell Wall-Anchored Proteins: Involvement in Colonization and Pathogenesis and Potential as Vaccine Candidates. Front Immunol 2018; 9:602. [PMID: 29686667 PMCID: PMC5900788 DOI: 10.3389/fimmu.2018.00602] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/09/2018] [Indexed: 11/13/2022] Open
Abstract
Group B Streptococcus (GBS) remains an important etiological agent of several infectious diseases including neonatal septicemia, pneumonia, meningitis, and orthopedic device infections. This pathogenicity is due to a variety of virulence factors expressed by Streptococcus agalactiae. Single virulence factors are not sufficient to provoke a streptococcal infection, which is instead promoted by the coordinated activity of several pathogenicity factors. Such determinants, mostly cell wall-associated and secreted proteins, include adhesins that mediate binding of the pathogen to host extracellular matrix/plasma ligands and cell surfaces, proteins that cooperate in the invasion of and survival within host cells and factors that neutralize phagocytosis and/or modulate the immune response. The genome-based approaches and bioinformatics tools and the extensive use of biophysical and biochemical methods and animal model studies have provided a great wealth of information on the molecular structure and function of these virulence factors. In fact, a number of new GBS surface-exposed or secreted proteins have been identified (GBS immunogenic bacterial adhesion protein, leucine-rich repeat of GBS, serine-rich repeat proteins), the three-dimensional structures of known streptococcal proteins (αC protein, C5a peptidase) have been solved and an understanding of the pathogenetic role of "old" and new determinants has been better defined in recent years. Herein, we provide an update of our current understanding of the major surface cell wall-anchored proteins from GBS, with emphasis on their biochemical and structural properties and the pathogenetic roles they may have in the onset and progression of host infection. We also focus on the antigenic profile of these compounds and discuss them as targets for therapeutic intervention.
Collapse
Affiliation(s)
- Giampiero Pietrocola
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Carla Renata Arciola
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Simonetta Rindi
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Lucio Montanaro
- Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Pietro Speziale
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Department of Industrial and Information Engineering, University of Pavia, Pavia, Italy
| |
Collapse
|
32
|
Hung LC, Kung PT, Chiu TH, Su HP, Ho M, Kao HF, Chiu LT, Huang KH, Tsai WC. Risk factors for neonatal early-onset group B streptococcus-related diseases after the implementation of a universal screening program in Taiwan. BMC Public Health 2018; 18:438. [PMID: 29609583 PMCID: PMC5880064 DOI: 10.1186/s12889-018-5358-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/22/2018] [Indexed: 12/03/2022] Open
Abstract
Background We examined the risk for Group B streptococcus (GBS)-related diseases in newborns born to mothers who participated in a universal GBS screening program and to determine whether differences are observed in factors affecting the morbidity for neonatal early-onset GBS-related diseases. Methods This is a retrospective study and the study subjects were women who had undergone GBS screening and who gave birth naturally and their newborns between April 15, 2012 and December 31, 2013. Data from the GBS screening system database and the National Health Insurance database were collected to calculate the GBS prevalence in pregnant women and morbidity of newborns with early-onset GBS-related diseases. Results The GBS prevalence in pregnant women who gave birth naturally was 19.58%. The rate of early-onset infection caused by GBS in newborns decreased from the original 0.1% to 0.02%, a decrease of as high as 80%. After the implementation of the universal GBS screening program, only three factors, including positive GBS screening result (OR = 2.84), CCI (OR = 2.45), and preterm birth (OR = 4.81) affected the morbidity for neonatal early-onset GBS-related diseases, whereas other factors had no significant impact. Conclusion The implementation of the universal GBS screening program decreased the infection rate of neonatal early-onset GBS diseases. The effects of socioeconomic factors and high-risk pregnancy on early-onset GBS infections were weakened.
Collapse
Affiliation(s)
- Li-Chen Hung
- Department of Public Health, China Medical University, Taichung, Taiwan, Republic of China.,Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan, Republic of China
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, Republic of China.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, Republic of China
| | - Tsan-Hung Chiu
- Department of Obstetrics and Gynecology, China Medical University Hospital, China Medical University, Taichung, Taiwan, Republic of China
| | - Hsun-Pi Su
- Department of Dental Hygiene, China Medical University, Taichung, Taiwan, Republic of China
| | - Ming Ho
- Department of Obstetrics and Gynecology, China Medical University Hospital, China Medical University, Taichung, Taiwan, Republic of China
| | - Hui-Fen Kao
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, Republic of China.,Department of Obstetrics and Gynecology, Asia University Hospital, Taichung, Taiwan, Republic of China
| | - Li-Ting Chiu
- Department of Health Services Administration, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan, Republic of China, 40402
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan, Republic of China, 40402
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan, Republic of China, 40402.
| |
Collapse
|
33
|
Serotype, Genotype, and Clinical Manifestations of Group B Streptococcus (GBS) Isolated from Neonates in China. IRANIAN JOURNAL OF PEDIATRICS 2018. [DOI: 10.5812/ijp.14580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
34
|
Abstract
Group B streptococcus (GBS) is one of the most common causes of neonatal sepsis and meningitis. Intra-partum antibiotic prophylaxis does not play a significant role in reducing the risk of GBS late-onset disease. One of the proposed mechanisms for GBS late-onset disease is infection through contaminated breast milk. Infants in whom breast milk is thought to be the source for GBS late-onset disease are more heavily colonised and reports suggest they have a higher recurrence rate compared to infants with other potential sources. There is no consensus whether the breast milk of mothers of infants with GBS late-onset disease, especially those with recurrent episodes, should be tested for GBS. In addition, recommendations differ on whether breast-feeding should be interrupted or breast milk pasteurised, or whether the mother and infant should be treated for colonisation. In this review we discuss these different approaches.
Collapse
Affiliation(s)
- Petra Zimmermann
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia
| | - Amanda Gwee
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia
| | - Nigel Curtis
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia.
| |
Collapse
|
35
|
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.
Collapse
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
| |
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
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.
Collapse
|
38
|
Clinical and microbiological features associated with group B Streptococcus bone and joint infections, France 2004–2014. Eur J Clin Microbiol Infect Dis 2017; 36:1679-1684. [DOI: 10.1007/s10096-017-2983-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/04/2017] [Indexed: 12/27/2022]
|
39
|
Cools P, Melin P. Group B Streptococcus and perinatal mortality. Res Microbiol 2017; 168:793-801. [PMID: 28435137 DOI: 10.1016/j.resmic.2017.04.002] [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] [Received: 03/23/2017] [Accepted: 04/03/2017] [Indexed: 12/12/2022]
Abstract
The World Health Organization estimates that every year, one million neonatal deaths occur because of neonatal infection. Furthermore, an equal number of stillbirths are thought to be caused by infections. Here we discuss the role of Streptococcus agalactiae (group B Streptococcus, GBS) in neonatal disease and stillbirth.
Collapse
Affiliation(s)
- Piet Cools
- Laboratory Bacteriology Research, Department of Microbiology, Immunology and Clinical Chemistry, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Pierrette Melin
- Clinical Microbiology, National Reference Centre for Streptococcus agalactiae, University Hospital of Liège, Faculty of Medicine, Liege University, Liège, Belgium
| |
Collapse
|
40
|
Loubet P, Launay O. [Adult immunisation: General points, hot topics and perspectives]. Rev Med Interne 2017; 38:749-759. [PMID: 28214181 DOI: 10.1016/j.revmed.2017.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/13/2017] [Indexed: 01/04/2023]
Abstract
Vaccination in immunocompetent adult mainly concerns booster vaccination against diphtheria, tetanus, polio and pertussis. Some chronic diseases may also require the achievement of pneumococcal and influenza vaccines. In addition, from the age of 65, annual influenza vaccination as well as one dose of a live attenuated shingles vaccine between 64 and 75 years are recommended. Immunocompromised adults, due to the increased risk of serious infections responsible of significant morbidity and mortality, are particularly concerned by vaccination. Main issues in this population are the decreased immunogenicity and efficacy of vaccination and the risk of infection with live attenuated vaccines and. Depending on the type of immunosuppression, the recommended vaccines and vaccination schemes differ. Vaccination of healthy persons caring or residing with immunocompromised patients is an important point in the vaccine strategy. The current perspectives in vaccinology concern the development of vaccines against healthcare associated infections (Clostridium difficile and Staphylococcus aureus in particular), the strategy of vaccination during pregnancy to protect new-borns (respiratory syncytial virus, group B streptococcus) and the development of new adjuvants and new routes of immunization. With the overall decline in immunization coverage and increasing distrust of vaccination, the problem of vaccine hesitancy is also a hot topic. The reasons for doubt in the vaccine usefulness and the solutions to be applied are also crucial issues.
Collapse
Affiliation(s)
- P Loubet
- IAME, UMR 1137, Inserm, service de maladies infectieuses et tropicales, hôpital Bichat, université Paris Diderot, Sorbonne Paris Cité, AP-HP, 75018 Paris, France.
| | - O Launay
- Inserm, CIC 1417, F-CRIN I-REIVAC, fédération d'infectiologie, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, AP-HP, 75679 Paris cedex 14, France.
| |
Collapse
|
41
|
Périchon B, Szili N, du Merle L, Rosinski-Chupin I, Gominet M, Bellais S, Poyart C, Trieu-Cuot P, Dramsi S. Regulation of PI-2b Pilus Expression in Hypervirulent Streptococcus agalactiae ST-17 BM110. PLoS One 2017; 12:e0169840. [PMID: 28107386 PMCID: PMC5249243 DOI: 10.1371/journal.pone.0169840] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/22/2016] [Indexed: 11/19/2022] Open
Abstract
The widely spread Streptococcus agalactiae (also known as Group B Streptococcus, GBS) “hypervirulent” ST17 clone is strongly associated with neonatal meningitis. The PI-2b locus is mainly found in ST17 strains but is also present in a few non ST17 human isolates such as the ST-7 prototype strain A909. Here, we analysed the expression of the PI-2b pilus in the ST17 strain BM110 as compared to the non ST17 A909. Comparative genome analyses revealed the presence of a 43-base pair (bp) hairpin-like structure in the upstream region of PI-2b operon in all 26 ST17 genomes, which was absent in the 8 non-ST17 strains carrying the PI-2b locus. Deletion of this 43-bp sequence in strain BM110 resulted in a 3- to 5-fold increased transcription of PI-2b. Characterization of PI-2b promoter region in A909 and BM110 strains was carried out by RNAseq, primer extension, qRT-PCR and transcriptional fusions with gfp as reporter gene. Our results indicate the presence of a single promoter (Ppi2b) with a transcriptional start site (TSS) mapped 37 bases upstream of the start codon of the first PI-2b gene. The large operon of 16 genes located upstream of PI-2b codes for the group B carbohydrate (also known as antigen B), a major constituent of the bacterial cell wall. We showed that the hairpin sequence located between antigen B and PI-2b operons is a transcriptional terminator. In A909, increased expression of PI-2b probably results from read-through transcription from antigen B operon. In addition, we showed that an extended 5’ promoter region is required for maximal transcription of gfp as a reporter gene in S. agalactiae from Ppi2b promoter. Gene reporter assays performed in Lactococcus lactis strain NZ9000, a related non-pathogenic Gram-positive species, revealed that GBS-specific regulatory factors are required to drive PI-2b transcription. PI-2b expression is up-regulated in the BM110ΔcovR mutant as compared to the parental BM110 strain, but this effect is probably indirect. Collectively, our results indicate that PI-2b expression is regulated in GBS ST17 strains, which may confer a selective advantage in the human host either by reducing host immune responses and/or increasing their dissemination potential.
Collapse
Affiliation(s)
- Bruno Périchon
- Institut Pasteur, Biology of Gram-positive Pathogens Unit, Paris, France
- Centre National de la Recherche Scientifique (CNRS) ERL3526, Paris, France
| | - Noémi Szili
- Institut Pasteur, Biology of Gram-positive Pathogens Unit, Paris, France
- Centre National de la Recherche Scientifique (CNRS) ERL3526, Paris, France
| | - Laurence du Merle
- Institut Pasteur, Biology of Gram-positive Pathogens Unit, Paris, France
- Centre National de la Recherche Scientifique (CNRS) ERL3526, Paris, France
| | | | - Myriam Gominet
- Institut Pasteur, Biology of Gram-positive Pathogens Unit, Paris, France
- Centre National de la Recherche Scientifique (CNRS) ERL3526, Paris, France
| | - Samuel Bellais
- Équipe Barrières et Pathogènes, Institut Cochin, Inserm 1016, CNRS UMR, Paris France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre-Site Cochin, France
| | - Claire Poyart
- Équipe Barrières et Pathogènes, Institut Cochin, Inserm 1016, CNRS UMR, Paris France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre-Site Cochin, France
- CNR Streptocoques, Hôpitaux Universitaires Paris Centre, site Cochin, AP-HP
- DHU Risques et Grossesse, AP-HP, Paris, France
| | - Patrick Trieu-Cuot
- Institut Pasteur, Biology of Gram-positive Pathogens Unit, Paris, France
- Centre National de la Recherche Scientifique (CNRS) ERL3526, Paris, France
| | - Shaynoor Dramsi
- Institut Pasteur, Biology of Gram-positive Pathogens Unit, Paris, France
- Centre National de la Recherche Scientifique (CNRS) ERL3526, Paris, France
- * E-mail:
| |
Collapse
|
42
|
Serotype Distribution, Population Structure, and Antimicrobial Resistance of Group B Streptococcus Strains Recovered from Colonized Pregnant Women. J Clin Microbiol 2016; 55:412-422. [PMID: 27852675 DOI: 10.1128/jcm.01615-16] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 11/12/2016] [Indexed: 11/20/2022] Open
Abstract
Using serotyping, multilocus sequence typing, and whole-genome sequencing (WGS) of selected strains, we studied the population structure of 102 group B Streptococcus (GBS) isolates prospectively sampled in 2014 from vaginal/rectal swabs of healthy pregnant women in metropolitan Toronto, Canada. We also determined the susceptibilities of each of the colonizing isolates to penicillin, erythromycin, clindamycin, tetracycline, and other antimicrobial agents. Overall, we observed a high rate of tetracycline resistance (89%) among colonizing GBS isolates. We found resistance to erythromycin in 36% of the strains, and 33% were constitutively or inducibly resistant to clindamycin. The most frequently identified serotypes were III (25%), Ia (23%), and V (19%). Serotype IV accounted for 6% of the colonizing isolates, a rate consistent with that observed among patients with invasive GBS infections in metropolitan Toronto. The majority of serotype IV isolates belonged to sequence type (ST)459, a tetracycline-, erythromycin-, and clindamycin-resistant ST first identified in Minnesota, which is considered to be the main driver of serotype IV GBS expansion in North America. WGS revealed that ST459 isolates from Canada are clonally related to colonizing and invasive ST459 organisms circulating in regions of the United States. We also used WGS to study recombination in selected colonizing strains from metropolitan Toronto, which revealed multiple episodes of capsular switching. Present and future circulating GBS organisms and their genetic diversity may influence GBS vaccine development.
Collapse
|
43
|
Gudjónsdóttir MJ, Hentz E, Berg S, Backhaus E, Elfvin A, Kawash S, Trollfors B. Serotypes of group B streptococci in western Sweden and comparison with serotypes in two previous studies starting from 1988. BMC Infect Dis 2015; 15:507. [PMID: 26553333 PMCID: PMC4640215 DOI: 10.1186/s12879-015-1266-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 11/05/2015] [Indexed: 11/26/2022] Open
Abstract
Background Group B Streptococci (GBS) are the most common neonatal pathogens and infect immunocompromised and elderly individuals. The species has 10 different serotypes. Serotypes have been studied in the south-west area of Sweden in 1988–1997 and 1998–2001. The aim of this study was to study serotypes in the same area from 2004 to 2009. Methods Invasive GBS isolates were collected prospectively from 2004 to 2009 in two counties in western Sweden with a population of 1.8 million, and were serotyped by latex agglutination. Clinical data were obtained from hospital records. During the study period 410 invasive GBS isolates from 398 patients were collected (multiple episodes ≥1 month apart). Clinical data were not available for two patients who are excluded. Four isolates were from stillborn neonates, 88 were from live born neonates and infants, and 318 from adults. Results Serotype III was the most common serotype (48 %) in neonates and infants followed by serotypes Ia (18 %) and V (16 %). In adults serotype V (39 %) dominated followed by serotypes III (20 %) and Ib (14 %). There was a significant increase of serotype V in comparison with the first study (1988–1997) but there were no significant changes in the serotype distribution between the present study and the second study (1998–2001). There were a few cases of serotype VI-IX, both in children and adults, not seen in the previous studies. Serotype V was more common among patients with arthritis than with any other manifestation. Conclusions Changes in GBS serotypes occur over time in the same region, which must be considered when GBS vaccines are formulated.
Collapse
Affiliation(s)
- Margrét Johansson Gudjónsdóttir
- Division of Neonatology, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. .,Department of Pediatrics, Neonatology, Sahlgrenska University Hospital, 41685, Gothenburg, Sweden.
| | - Elisabet Hentz
- Division of Neonatology, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. .,Department of Pediatrics, Neonatology, Sahlgrenska University Hospital, 41685, Gothenburg, Sweden.
| | - Stefan Berg
- Department of Pediatrics, Queen Silvia Childrens' Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Erik Backhaus
- Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden.
| | - Anders Elfvin
- Division of Neonatology, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. .,Department of Pediatrics, Neonatology, Sahlgrenska University Hospital, 41685, Gothenburg, Sweden.
| | - Samir Kawash
- Department of Bacteriology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Birger Trollfors
- Department of Pediatrics, Queen Silvia Childrens' Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
| |
Collapse
|
44
|
Butin M, Rasigade JP, Martins-Simões P, Meugnier H, Lemriss H, Goering RV, Kearns A, Deighton MA, Denis O, Ibrahimi A, Claris O, Vandenesch F, Picaud JC, Laurent F. Wide geographical dissemination of the multiresistant Staphylococcus capitis NRCS-A clone in neonatal intensive-care units. Clin Microbiol Infect 2015; 22:46-52. [PMID: 26404028 DOI: 10.1016/j.cmi.2015.09.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/03/2015] [Accepted: 09/08/2015] [Indexed: 10/23/2022]
Abstract
Nosocomial late-onset sepsis represents a frequent cause of morbidity and mortality in preterm neonates. The Staphylococcus capitis clone NRCS-A has been previously described as an emerging cause of nosocomial bacteraemia in French neonatal intensive-care units (NICUs). In this study, we aimed to explore the possible unrecognized dissemination of this clone on a larger geographical scale. One hundred methicillin-resistant S. capitis strains isolated from neonates (n = 86) and adult patients (n = 14) between 2000 and 2013 in four different countries (France, Belgium, the UK, and Australia) were analysed with SmaI pulsed-field gel electrophoresis (PFGE) and dru typing. The vast majority of NICU strains showed the NRCS-A pulsotype and the dt11c type (96%). We then randomly selected 14 isolates (from neonates, n = 12, three per country; from adult patients, n = 2), considered to be a subset of representative isolates, and performed further molecular typing (SacII PFGE, SCCmec typing, and multilocus sequence typing-like analysis), confirming the clonality of the S. capitis strains isolated from neonates, despite their distant geographical origin. Whole genome single-nucleotide polymorphism-based phylogenetic analysis of five NICU isolates (from the different countries) attested to high genetic relatedness within the NRCS-A clone. Finally, all of the NRCS-A strains showed multidrug resistance (e.g. methicillin and aminoglycoside resistance, and decreased vancomycin susceptibility), with potential therapeutic implications for infected neonates. In conclusion, this study represents the first report of clonal dissemination of methicillin-resistant coagulase-negative Staphylococcus clone on a large geographical scale. Questions remain regarding the origin and means of international spread, and the reasons for this clone's apparent predilection for neonates.
Collapse
Affiliation(s)
- M Butin
- Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France; International Centre for Research in Infectious Diseases (CIRI), INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France.
| | - J-P Rasigade
- Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France; International Centre for Research in Infectious Diseases (CIRI), INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France; National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Villeurbanne, France
| | - P Martins-Simões
- Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France; International Centre for Research in Infectious Diseases (CIRI), INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France; National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France
| | - H Meugnier
- International Centre for Research in Infectious Diseases (CIRI), INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France; National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France
| | - H Lemriss
- Laboratory of Biotechnology, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Rabat, Morocco
| | | | - A Kearns
- Public Health England, Staphylococcus Reference Service, Colindale, London, UK
| | | | - O Denis
- Erasme Hospital, Université Libre de Bruxelles, Laboratoire de Référence MRSA, Staphylocoques, Department of Microbiology, Brussels, Belgium
| | - A Ibrahimi
- Laboratory of Biotechnology, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University of Rabat, Rabat, Morocco
| | - O Claris
- Claude Bernard University Lyon 1, Villeurbanne, France; Neonatal Intensive Care Unit, Eastern Hospital Group, Hospices Civils de Lyon, Bron, France
| | - F Vandenesch
- International Centre for Research in Infectious Diseases (CIRI), INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France; National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Villeurbanne, France
| | - J-C Picaud
- Claude Bernard University Lyon 1, Villeurbanne, France; Neonatal Intensive Care Unit, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France
| | - F Laurent
- Department of Clinical Microbiology, Northern Hospital Group, Hospices Civils de Lyon, Lyon, France; International Centre for Research in Infectious Diseases (CIRI), INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France; National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Villeurbanne, France
| |
Collapse
|
45
|
Whole-Genome Comparison Uncovers Genomic Mutations between Group B Streptococci Sampled from Infected Newborns and Their Mothers. J Bacteriol 2015; 197:3354-66. [PMID: 26283765 DOI: 10.1128/jb.00429-15] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/05/2015] [Indexed: 12/30/2022] Open
Abstract
UNLABELLED Streptococcus agalactiae (group B Streptococcus or GBS), a commensal of the human gut and genitourinary tract, is a leading cause of neonatal infections, in which vertical transmission from mother to child remains the most frequent route of contamination. Here, we investigated whether the progression of GBS from carriage to disease is associated with genomic adaptation. Whole-genome comparison of 47 GBS samples from 19 mother-child pairs uncovered 21 single nucleotide polymorphisms (SNPs) and seven insertions/deletions. Of the SNPs detected, 16 appear to have been fixed in the population sampled whereas five mutations were found to be polymorphic. In the infant strains, 14 mutations were detected, including two independently fixed variants affecting the covRS locus, which is known to encode a major regulatory system of virulence. A one-nucleotide insertion was also identified in the promoter region of the highly immunogenic surface protein Rib gene. Gene expression analysis after incubation in human blood showed that these mutations influenced the expression of virulence-associated genes. Additional identification of three mutated strains in the mothers' milk raised the possibility of the newborns also being a source of contamination for their mothers. Overall, our work showed that GBS strains in carriage and disease scenarios might undergo adaptive changes following colonization. The types and locations of the mutations found, together with the experimental results showing their phenotypic impact, suggest that those in a context of infection were positively selected during the transition of GBS from commensal to pathogen, contributing to an increased capacity to cause disease. IMPORTANCE Group B Streptococcus (GBS) is a major pathogen responsible for neonatal infections. Considering that its colonization of healthy adults is mostly asymptomatic, the mechanisms behind its switch from a commensal to an invasive state are largely unknown. In this work, we compared the genomic profile of GBS samples causing infections in newborns with that of the GBS colonizing their mothers. Multiple mutations were detected, namely, within key virulence factors, including the response regulator CovR and surface protein Rib, potentially affecting the pathogenesis of GBS. Their overall impact was supported by differences in the expression of virulence-associated genes in human blood. Our results suggest that during GBS's progression to disease, particular variants are positively selected, contributing to the ability of this bacterium to infect its host.
Collapse
|
46
|
Ko DW, Zurynski Y, Gilbert GL. Group B streptococcal disease and genotypes in Australian infants. J Paediatr Child Health 2015; 51:808-14. [PMID: 25656648 DOI: 10.1111/jpc.12830] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Abstract
AIMS Estimate the incidence, risk factors and clinical features of group B streptococcal (GBS) disease in Australian infants and compare bacterial genotypes between infant disease and maternal carriage. METHODS The Australian Paediatric Surveillance Unit conducted a study of invasive GBS disease in infants aged 0-90 days between July 2005 and June 2008. Clinical data were obtained by questionnaire. GBS isolates from affected infants and antenatal carriers were referred for genotyping. RESULTS One hundred fifty confirmed cases were reported: 88 early-onset (EOD; 0-6 days) and 62 late-onset disease (LOD). Based on review of selected laboratory records, they represented ∼1/3 of all cases. Estimated national EOD and LOD rates were 0.38 and 0.19/1000 live births, respectively. Admission to intensive care was common (44%), and 7% of infants died. One or more obstetric indications for intrapartum antibiotic prophylaxis (IAP) were identified in 51% of mothers; 53% of mothers were screened for GBS carriage, and screening was positive in 45%; only 25% of women with clinical or microbiological risk factors were given IAP (no significant differences between EOD and LOD groups). Distribution of GBS genotypes differed significantly between invasive and vaginal isolates: virulent serosubtype III-2/sequence type 17 was strongly associated with LOD but uncommon among EOD and vaginal isolates. CONCLUSIONS Estimated GBS disease rates remain relatively low despite poor predictive values of clinical and microbiological criteria for, and compliance with, IAP. Clinical and microbiological epidemiology of LOD differs significantly from that of EOD. Further reduction in infant morbidity and mortality from GBS disease will require new strategies.
Collapse
Affiliation(s)
- Danny Wh Ko
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Yvonne Zurynski
- Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.,Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Gwendolyn L Gilbert
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, New South Wales, Australia
| | | |
Collapse
|
47
|
Six A, Bellais S, Bouaboud A, Fouet A, Gabriel C, Tazi A, Dramsi S, Trieu-Cuot P, Poyart C. Srr2, a multifaceted adhesin expressed by ST-17 hypervirulent Group B Streptococcus involved in binding to both fibrinogen and plasminogen. Mol Microbiol 2015; 97:1209-22. [PMID: 26094503 DOI: 10.1111/mmi.13097] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2015] [Indexed: 11/30/2022]
Abstract
The Group B Streptococcus (GBS) 'hypervirulent' ST-17 clone is strongly associated with invasive neonatal meningitis. Comparative genome analyses revealed that the serine-rich repeat (Srr) glycoprotein Srr2 is a cell wall-anchored protein specific for ST-17 strains, the non-ST-17 isolates expressing Srr1. Here, we unravel the binding capacity of GBS Srr proteins to relevant components of the host fibrinolysis pathway. We demonstrate that: (i) Srr2 binds plasminogen and plasmin whereas Srr1 does not; (ii) the ability of ST-17 strains to bind fibrinogen reflects a high level surface display of Srr2 combined with a higher affinity of Srr2 than Srr1 to bind this ligand; and (iii) Srr2 binding to host plasma proteins results in the formation of bacterial aggregates that are efficiently endocytosed by phagocytes. Importantly, we show that Srr2 increased bacterial survival to phagocytic killing and bacterial persistence in a murine model of meningitis. We conclude that Srr2 is a multifaceted adhesin used by the ST-17 clone to hijack ligands of the host coagulation system, thereby contributing to bacterial dissemination and invasiveness, and ultimately to meningitis.
Collapse
Affiliation(s)
- Anne Six
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France
| | - Samuel Bellais
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France
| | - Abdelouhab Bouaboud
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France
| | - Agnès Fouet
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France.,Centre National de Référence des Streptocoques, Paris, F-75014, France
| | - Christelle Gabriel
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France
| | - Asmaa Tazi
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France.,Centre National de Référence des Streptocoques, Paris, F-75014, France.,Hôpitaux Universitaires Paris Centre Cochin-Hôtel Dieu-Broca, Assistance Publique Hôpitaux de Paris, Paris, F-75014, France
| | - Shaynoor Dramsi
- Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, Paris, F-74016, France.,CNRS ERL3526, Paris, France
| | - Patrick Trieu-Cuot
- Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, Paris, F-74016, France.,CNRS ERL3526, Paris, France
| | - Claire Poyart
- INSERM U 1016, Institut Cochin, team 'Barriers and Pathogens', Paris, F-75014, France.,CNRS UMR 8104, Paris, F-75014, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75014, France.,DHU 'Risques et grossesse', Assistance Publique Hôpitaux de Paris, Paris, France.,Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, Paris, F-74016, France.,CNRS ERL3526, Paris, France.,Centre National de Référence des Streptocoques, Paris, F-75014, France.,Hôpitaux Universitaires Paris Centre Cochin-Hôtel Dieu-Broca, Assistance Publique Hôpitaux de Paris, Paris, F-75014, France
| |
Collapse
|
48
|
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.
Collapse
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
| |
Collapse
|
49
|
Jost C, Mariani-Kurkdjian P, Biran V, Boissinot C, Bonacorsi S. Intérêt des prélèvements périnataux dans la prise en charge des nouveau-nés suspects d’infections bactériennes précoces. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1773-035x(15)30032-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
50
|
Landwehr-Kenzel S, Henneke P. Interaction of Streptococcus agalactiae and Cellular Innate Immunity in Colonization and Disease. Front Immunol 2014; 5:519. [PMID: 25400631 PMCID: PMC4212683 DOI: 10.3389/fimmu.2014.00519] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/05/2014] [Indexed: 12/18/2022] Open
Abstract
Streptococcus agalactiae (Group B streptococcus, GBS) is highly adapted to humans, where it is a normal constituent of the intestinal and vaginal flora. Yet, GBS has highly invasive potential and causes excessive inflammation, sepsis, and death at the beginning of life, in the elderly and in diabetic patients. Thus, GBS is a model pathobiont that thrives in the healthy host, but has not lost its potential virulence during coevolution with mankind. It remains incompletely understood how the innate immune system contains GBS in the natural niches, the intestinal and genital tracts, and which molecular events underlie breakdown of mucocutaneous resistance. Newborn infants between days 7 and 90 of life are at risk of a particularly striking sepsis manifestation (late-onset disease), where the transition from colonization to invasion and dissemination, and thus from health to severe sepsis is typically fulminant and not predictable. The great majority of late-onset sepsis cases are caused by one clone, GBS ST17, which expresses HvgA as a signature virulence factor and adhesin. In mice, HvgA promotes the crossing of both the mucosal and the blood–brain barrier. Expression levels of HvgA and other GBS virulence factors, such as pili and toxins, are regulated by the upstream two-component control system CovR/S. This in turn is modulated by acidic epithelial pH, high glucose levels, and during the passage through the mouse intestine. After invasion, GBS has the ability to subvert innate immunity by mechanisms like glycerinaldehyde-3-phosphate-dehydrogenase-dependent induction of IL-10 and β-protein binding to the inhibitory phagocyte receptors sialic acid binding immunoglobulin-like lectin 5 and 14. On the host side, sensing of GBS nucleic acids and lipopeptides by both Toll-like receptors and the inflammasome appears to be critical for host resistance against GBS. Yet, comprehensive models on the interplay between GBS and human immune cells at the colonizing site are just emerging.
Collapse
Affiliation(s)
- Sybille Landwehr-Kenzel
- Berlin-Brandenburg Center for Regenerative Therapies, Charité University Medicine Berlin , Berlin , Germany ; Berlin-Brandenburg School for Regenerative Therapies, Charité University Medicine Berlin , Berlin , Germany ; Department of Pediatric Pulmonology and Immunology, Charité University Medicine Berlin , Berlin , Germany
| | - Philipp Henneke
- Center for Pediatrics and Adolescent Medicine, University Medical Center Freiburg , Freiburg , Germany ; Center for Chronic Immunodeficiency, University Medical Center Freiburg , Freiburg , Germany
| |
Collapse
|