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Choi JH, Kim TH, Kim ET, Kim YR, Lee H. Molecular epidemiology and virulence factors of group B Streptococcus in South Korea according to the invasiveness. BMC Infect Dis 2024; 24:740. [PMID: 39060964 PMCID: PMC11282841 DOI: 10.1186/s12879-024-09625-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Group B Streptococcus (GBS) causes invasive infections in newborns and elderly individuals, but is a noninvasive commensal bacterium in most immunocompetent people. Recently, the incidence of invasive GBS infections has increased worldwide, and there is growing interest in the molecular genetic characteristics of invasive GBS strains. Vaccines against GBS are expected in the near future. Here, we aimed to analyze the molecular epidemiology of GBS according to the invasiveness in South Korea. METHODS We analyzed GBS isolates collected and stored in two hospitals in South Korea between January 2015 and December 2020. The invasiveness of these isolates was determined via a retrospective review of clinical episodes. Totally, 120 GBS isolates from 55 children and 65 adults were analyzed. Serotype and sequence type (ST) were determined using multiplex polymerase chain reaction (PCR) and multilocus sequence typing, respectively. Fourteen virulence factor-encoding genes of GBS were analyzed using multiplex PCR. RESULTS Forty one (34.2%) were invasive infection-related GBS isolates (iGBS). The most frequently detected serotype was III (39/120, 32.5%), and it accounted for a high proportion of iGBS (21/41, 51.2%). The most frequent ST was ST19 (18/120, 15.0%), followed by ST2 (17/120, 14.2%). Serotype III/ST17 was predominant in iGBS (12/41, 29.3%), and all 17 ST2 strains were noninvasive. The distribution of most of the investigated virulence factors was not significantly related to invasiveness; noteworthily, most of the serotype III/ST17 iGBS carried pilus island (PI) 2b (10/12, 83.3%), and the prevalence of fbsB was significantly low compared with noninvasive GBS isolates (P = 0.004). Characteristically, the combination of bca(+)-cspA(+)-pavA(+)-fbsB(-)-rib(+)-bac(-) was predominant in iGBS (24.4%, 10/41). CONCLUSIONS Serotype III/ST17 GBS carrying PI-2b was frequently detected in iGBS. There was no significant association between invasiveness and the pattern of virulence factors; however, a specific combination of virulence factors was predominant in iGBS.
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Affiliation(s)
- Jae Hong Choi
- Pediatrics, Jeju National University College of Medicine, Jeju, Republic of Korea
- Pediatrics, Jeju National University Hospital, Jeju, Republic of Korea
| | - Tae Hyoung Kim
- Biomedicine and Drug Development, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Eui Tae Kim
- Biomedicine and Drug Development, Jeju National University College of Medicine, Jeju, Republic of Korea
- Microbiology and Immunology, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Young Ree Kim
- Laboratory Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Hyunju Lee
- Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
- Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Liu Y, Ai H. Current research update on group B streptococcal infection related to obstetrics and gynecology. Front Pharmacol 2024; 15:1395673. [PMID: 38953105 PMCID: PMC11215423 DOI: 10.3389/fphar.2024.1395673] [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: 03/04/2024] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
Group B streptococcal (GBS) is a Gram-positive bacterium that is commonly found in the gastrointestinal tract and urogenital tract. GBS infestation during pregnancy is a significant contributor to maternal and neonatal morbidity and mortality globally. This article aims to discuss the infectious diseases caused by GBS in the field of obstetrics and gynecology, as well as the challenges associated with the detection, treatment, and prevention of GBS.
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Affiliation(s)
| | - Hao Ai
- Liaoning Provincial Key Laboratory of Follicular Development and Reproductive Health, Jinzhou Medical University, Jinzhou, Liaoning, China
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3
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Petca A, Șandru F, Negoiță S, Dumitrașcu MC, Dimcea DAM, Nedelcu T, Mehedințu C, Filipov MM, Petca RC. Antimicrobial Resistance Profile of Group B Streptococci Colonization in a Sample Population of Pregnant Women from Romania. Microorganisms 2024; 12:414. [PMID: 38399818 PMCID: PMC10893514 DOI: 10.3390/microorganisms12020414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/31/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
Group B Streptococcus (GBS) represents one of the leading causes of life-threatening invasive disease in pregnant women and neonates. Rates of GBS colonization vary by region, but studies on maternal GBS status are limited in Romania. This study aims to identify the prevalence of colonization with GBS and whether the obstetrical characteristics are statistically associated with the study group's antimicrobial susceptibility patterns of tested GBS strains. This observational study was conducted between 1 May and 31 December 2021 at The Department of Obstetrics and Gynecology at Elias University Emergency Hospital (EUEH) in Bucharest, Romania. A total of 152 samples were positive for GBS and included in the study according to the inclusion criteria. As a result, the prevalence of colonized patients with GBS was 17.3%. GBS isolated in this population had the highest resistance to erythromycin (n = 38; 25%), followed by clindamycin (n = 36; 23.7%). Regarding the susceptibility patterns of tested strains to penicillin, the 152 susceptible strains had MIC breakpoints less than 0.06 μg/μL. The susceptibility patterns of tested strains to linezolid indicated three resistant strains with low levels of resistance (MICs ranging between 2 and 3 μg/μL). Multidrug resistance (at least three antibiotic classes) was not observed. In conclusion, although GBS naturally displays sensitivity to penicillin, the exact bacterial susceptibility testing should be performed in all cases where second-line therapy is taken into consideration for treatment. We acknowledge the need for future actions to limit multidrug-resistant bacteria.
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Affiliation(s)
- Aida Petca
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (A.P.); (M.C.D.); (D.A.-M.D.); (C.M.)
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Marasti Blvd., 011461 Bucharest, Romania
| | - Florica Șandru
- Department of Dermatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, Elias University Emergency Hospital, 17 Marasti Blvd., 011461 Bucharest, Romania
| | - Silvius Negoiță
- Department of Anesthesiology and Critical Care, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Anesthesiology and Critical Care, Elias University Emergency Hospital, 17 Marasti Blvd., 011461 Bucharest, Romania
| | - Mihai Cristian Dumitrașcu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (A.P.); (M.C.D.); (D.A.-M.D.); (C.M.)
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Daiana Anne-Marie Dimcea
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (A.P.); (M.C.D.); (D.A.-M.D.); (C.M.)
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Marasti Blvd., 011461 Bucharest, Romania
| | - Tiberiu Nedelcu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
| | - Claudia Mehedințu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (A.P.); (M.C.D.); (D.A.-M.D.); (C.M.)
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Marinela Magdalena Filipov
- Department of Laboratory Medicine, Elias University Emergency Hospital, 17 Marasti Blvd., 011461 Bucharest, Romania;
| | - Răzvan-Cosmin Petca
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
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Le TM, Choi Y, Nguyen HDT, Lee D, Lee OE, Chong GO, Seong WJ, Cha HH, Han HS. Relationship between maternal Group B Streptococcal colonization and gestational vaginal microbiome composition: A pilot study. Indian J Med Microbiol 2023; 46:100426. [PMID: 37945119 DOI: 10.1016/j.ijmmb.2023.100426] [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: 02/05/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Group B Streptococcus (GBS) colonization and vaginal microbiome (VMB) dysbiosis are associated with adverse perinatal outcomes. However, the role of GBS colonization in maternal VMB remains unclear. Herein, we aimed to investigate this relationship and identify additional pathogens associated with GBS colonization for potential implications in understanding their clinical significance. MATERIALS AND METHODS Vaginal swab samples were obtained before delivery from nine women with normal pregnancies for GBS detection and 16S rRNA gene sequencing. The diversity analysis and community state types clustering were used to compare the GBS-positive vs. GBS-negative groups. ANCOM-BC was implemented to identify differentially abundant microbes (DAMs) associated with GBS colonization. The correlation and receiver operating characteristic analysis were used to evaluate the relationship between DMAs and clinical parameters. RESULTS There were 6/9 (66,7%) GBS-negative pregnant women. The α-diversity index (p = 0.71 for observed operational taxonomic units and p = 0.90 for Shannon diversity), β-diversity index (p = 0.583), and community state types clustering (p = 0.23) were not significantly different between the GBS-positive and -negative groups. Four DAMs, namely, Actinomyces, Shigella, Fenollaria, and Gemella, were significantly associated with GBS colonization, reflecting the dynamicity of the gestational VMB. Their abundances were negatively correlated with birth weight and had acceptable discriminating ability in premature membrane rupture (area under the curve, 0.9). CONCLUSIONS Despite the absence of significant effects on overall VMB composition, our preliminary results investigated that maternal GBS colonization related to high abundance of four pathogens with potential clinical utility as microbial signatures.
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Affiliation(s)
- Tan Minh Le
- Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu 41944, South Korea; BK21 Four Program, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
| | - Yeseul Choi
- Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu 41944, South Korea; BK21 Four Program, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
| | - Hong Duc Thi Nguyen
- Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu 41944, South Korea; BK21 Four Program, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
| | - Donghyeon Lee
- Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu 41944, South Korea; BK21 Four Program, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
| | - Olive Em Lee
- Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu 41944, South Korea; BK21 Four Program, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
| | - Gun Oh Chong
- Clinical Omics Institute, Kyungpook National University, Daegu 41405, South Korea; Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu 41404, South Korea.
| | - Won Joon Seong
- Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu 41404, South Korea.
| | - Hyun-Hwa Cha
- Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu 41404, South Korea.
| | - Hyung Soo Han
- Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu 41944, South Korea; BK21 Four Program, School of Medicine, Kyungpook National University, Daegu 41944, South Korea; Clinical Omics Institute, Kyungpook National University, Daegu 41405, South Korea; Department of Physiology, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
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Husen O, Kannaiyan Abbai M, Aliyo A, Daka D, Gemechu T, Tilahun D, Dedecha W. Prevalence, Antimicrobial Susceptibility Pattern and Associated Factors of Group B Streptococcus Among Pregnant Women Attending Antenatal Care at Bule Hora University Teaching Hospital, Southern Ethiopia. Infect Drug Resist 2023; 16:4421-4433. [PMID: 37435237 PMCID: PMC10332419 DOI: 10.2147/idr.s415414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023] Open
Abstract
Background In many parts of the world, Group B Streptococcus (GBS) is a major cause of maternal and neonatal illness and mortality. It has a negative impact on neonatal and pregnancy outcomes. A worrisome problem in Ethiopia is the unknown rate of antibiotic resistance and the risk factors connected to GBS infections. Objective This study was to determine the prevalence, antibiotic susceptibility pattern, and related variables of Group B Streptococcus among pregnant women receiving prenatal treatment conducted at Bule Hora University Teaching Hospital, Southern Ethiopia, between June 1 and August 30, 2022. Methods An institutional-based cross-sectional study was conducted among 213 pregnant women attending antenatal care at Bule Hora University Teaching Hospital. Data on sociodemographic and related factors were gathered using structured questionnaires. The study's participants were selected using the consecutive sampling method. The lower vaginal/rectum area was brushed with a sterile cotton swab to capture the vaginal/rectum swab sample, which was then examined using microbiological techniques. The Kirby-Bauer disc diffusion method was used to assess antibiotic susceptibility in GBS isolates. Logistic regression analysis was performed on the data using SPSS version 26. It was deemed statistically significant when the p-value was 0.05 with a 95% confidence interval (CI). Results The overall prevalence of GBS was 16.9% (CI: 0.12-0.23). A history of prematurity of the membrane (AOR: 3.35, 95% CI: 1.19-9.45), a history of stillbirth (AOR: 2.88, 95% CI: 1.07-7.71), and preterm delivery history (AOR: 3.41, 95% CI: 1.31-8.89) (p 0.05) were independent predictors of GBS infection. Cefepime had the highest resistance at 58.3%. Most GBS isolates showed high susceptibility to vancomycin (97.2%) and ampicillin (91.7%). Multidrug resistance was 13.9%. Conclusion The prevalence of GBS was considerably high among pregnant women in this study. This finding emphasises the need for routine screening and testing of antimicrobial susceptibility to provide antibiotic prophylaxis and minimise newborn infection and comorbidity.
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Affiliation(s)
- Oliyad Husen
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Moorthy Kannaiyan Abbai
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Alqeer Aliyo
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Deresse Daka
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Tibeso Gemechu
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Dagnamyelew Tilahun
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Wako Dedecha
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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Williams AN, Croxen MA, Demczuk WHB, Martin I, Tyrrell GJ. Genomic characterization of emerging invasive Streptococcus agalactiae serotype VIII in Alberta, Canada. Eur J Clin Microbiol Infect Dis 2023; 42:747-757. [PMID: 37084119 PMCID: PMC10120474 DOI: 10.1007/s10096-023-04606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Abstract
Invasive Group B Streptococcus (GBS) can infect pregnant women, neonates, and older adults. Invasive GBS serotype VIII is infrequent in Alberta; however, cases have increased in recent years. Here, genomic analysis was used to characterize fourteen adult invasive serotype VIII isolates from 2009 to 2021. Trends in descriptive clinical data and antimicrobial susceptibility results were evaluated for invasive serotype VIII isolates from Alberta. Isolate genomes were sequenced and subjected to molecular sequence typing, virulence and antimicrobial resistance gene identification, phylogenetic analysis, and pangenome determination. Multilocus sequencing typing identified eight ST42 (Clonal Complex; CC19), four ST1 (CC1), and two ST2 (CC1) profiles. Isolates were susceptible to penicillin, erythromycin, chloramphenicol, and clindamycin, apart from one isolate that displayed erythromycin and inducible clindamycin resistance. All isolates carried genes for peptide antibiotic resistance, three isolates for tetracycline resistance, and one for macrolide, lincosamide, and streptogramin resistance. All genomes carried targets currently being considered for protein-based vaccines (e.g., pili and/or Alpha family proteins). Overall, invasive GBS serotype VIII is emerging in Alberta, primarily due to ST42. Characterization and continued surveillance of serotype VIII will be important for outbreak prevention, informing vaccine development, and contributing to our understanding of the global epidemiology of this rare serotype.
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Affiliation(s)
- Ashley N Williams
- University of Alberta, Edmonton, AB, Canada
- Alberta Precision Laboratories-Public Health Laboratory (ProvLab), Edmonton, AB, Canada
| | - Matthew A Croxen
- University of Alberta, Edmonton, AB, Canada
- Alberta Precision Laboratories-Public Health Laboratory (ProvLab), Edmonton, AB, Canada
| | - Walter H B Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Gregory J Tyrrell
- University of Alberta, Edmonton, AB, Canada.
- Alberta Precision Laboratories-Public Health Laboratory (ProvLab), Edmonton, AB, Canada.
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
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Yoon Y, So H, Lee JK, Kim D, Jo KJ, Kim HH, Kim YJ, Lee J, Jo DS, Kim YK, Park SE, Chang YS, Kim YJ. Microbiologic Epidemiology of Early-onset Sepsis in Neonates Born at ≥35 0/7 Weeks' Gestation in Korea During 2009-2018. Pediatr Infect Dis J 2023:00006454-990000000-00414. [PMID: 37054389 DOI: 10.1097/inf.0000000000003931] [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: 04/15/2023]
Abstract
BACKGROUND Sepsis within the first 3 days of life remains a leading cause of neonatal mortality and morbidity. However, few studies have addressed the epidemiology of sepsis in late preterm and term neonates, particularly in Asia. We aimed to estimate the epidemiology of early-onset sepsis (EOS) in neonates born at ≥35 0/7 weeks' gestation in Korea. METHODS A retrospective study was conducted in neonates with proven EOS born at ≥35 0/7 weeks' gestation from 2009 to 2018 at seven university hospitals. EOS was defined as identifying bacteria from a blood culture within 72 hours after birth. RESULTS A total of 51 neonates (0.36/1,000 live births) with EOS were identified. The median duration from birth to the first positive blood culture collection was 17 hours (range, 0.2-63.9). Among the 51 neonates, 32 (63%) patients were born by vaginal delivery. The median Apgar score was 8 (range, 2-9) at 1 minute and 9 (range, 4-10) at 5 minutes. The most common pathogen was group B Streptococcus (n = 21; 41.2%), followed by coagulase-negative staphylococci (n = 7; 13.7%) and Staphylococcus aureus (n = 5, 9.8%). Forty-six (90.2%) neonates were treated with antibiotics on the first day of symptom onset, and 34 (73.9%) neonates received susceptible antibiotics. The overall 14-day case-fatality rate was 11.8%. CONCLUSION This is the first multicenter study on the epidemiology of proven EOS in neonates born at ≥35 0/7 weeks' gestation and found that group B Streptococcus was the most common pathogen in Korea.
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Affiliation(s)
- Yoonsun Yoon
- From the Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyungwan University, Seoul, Korea
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea (current affiliation)
| | - Hyejin So
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong, Korea (current affiliation)
| | - Joon Kee Lee
- Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Dongsub Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Kyo Jin Jo
- Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyun Ho Kim
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonbuk National University, Jeonju, Korea
| | - Yoo-Jin Kim
- Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jina Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Sun Jo
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonbuk National University, Jeonju, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Su Eun Park
- Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yun Sil Chang
- From the Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyungwan University, Seoul, Korea
| | - Yae-Jean Kim
- From the Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyungwan University, Seoul, Korea
- Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
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Lee Y, Bae HG, Won D, Yun W, Lee H, Choi JR, Uh Y, Lee K. Comparative Analysis of the Molecular Characteristics of Group B Streptococcus Isolates Collected from Pregnant Korean Women Using Whole-genome Sequencing. Ann Lab Med 2023; 43:180-186. [PMID: 36281512 PMCID: PMC9618906 DOI: 10.3343/alm.2023.43.2.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/06/2022] [Accepted: 09/14/2022] [Indexed: 12/27/2022] Open
Abstract
Background The incidence of early- and late-onset sepsis and meningitis in neonates due to maternal rectovaginal group B Streptococcus (GBS) colonization may differ with serotype distribution and clonal complex (CC). CC17 strains are associated with hypervirulence and poor disease outcomes. GBS serotypes are distinguished based on the polysaccharide capsule, the most important virulence factor. We determined the sequence type distribution of GBS isolates from pregnant women in Korea and validated whole-genome sequencing (WGS)-based prediction of antimicrobial susceptibility and capsular serotypes in GBS isolates. Methods Seventy-five GBS isolates collected from pregnant Korean women visiting Wonju Severance Christian Hospital, Wonju, Korea between 2017 and 2019 were subjected to WGS using the NovaSeq 6000 system (Illumina, San Diego, CA, USA). Multilocus sequence types, serotypes, antimicrobial resistance genes, and hemolysin operon mutations were determined by WGS, and the latter three were compared with the results of conventional phenotypic methods. Results The predominant lineage was CC1 (37.3%), followed by CC19 (32.0%), CC12 (17.3%), and CC17 (4.0%). All isolates were cps typeable (100%, (75/75), and 89.3% of cps genotypes (67/75) were concordant with serotypes obtained using latex agglutination. The cps genotypes of the 75 isolates were serotypes III (24.0%), V (22.7%), and VIII (17.3%). All isolates harboring intact ermB and tet were non-susceptible to erythromycin and tetracycline, respectively. Three non-hemolytic strains had 1-bp frameshift insertions in cylE. Conclusions The low prevalence of CC17 GBS colonization may explain the low frequency of neonatal GBS infections. WGS is a useful tool for simultaneous genotyping and antimicrobial resistance determination.
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Affiliation(s)
- Yangsoon Lee
- Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, Korea
| | | | - Dongju Won
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Woobin Yun
- Department of Laboratory Medicine, Graduate School of Medical Sciences, Brain, Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Rak Choi
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyungwon Lee
- Seoul Clinical Laboratories, Yongin, Korea.,Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
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Changes in Etiology of Invasive Bacterial Infections in Infants Under 3 Months of Age in Korea, 2006-2020. Pediatr Infect Dis J 2022; 41:941-946. [PMID: 36375095 DOI: 10.1097/inf.0000000000003714] [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: 11/16/2022]
Abstract
OBJECTIVES Invasive bacterial infection (IBI) causes a significant burden in infants. In this study, we analyzed changes in epidemiology of IBI among infants in Korea. METHODS A retrospective multicenter-based surveillance for IBIs in infants <3 months of age was performed during 2006-2020. Cases were classified as an early-onset disease (EOD) (0-6 days) or late-onset disease (LOD) (7-89 days). The temporal trend change in proportion of pathogens was analyzed. RESULTS Among 1545 cases, the median age was 28 days (IQR: 12, 53) and EOD accounted for 17.7%. Among pathogens, S. agalactiae (40.4%), E. coli (38.5%), and S. aureus (17.8%) were the most common and attributed for 96.7%. Among EOD (n = 274), S. agalactiae (45.6%), S. aureus (31.4%), E. coli (17.2%) and L. monocytogenes (2.9%) were most common. Among LOD (n = 1274), E. coli (43.1%), S. agalactiae (39.3%), S. aureus (14.9%) and S. pneumoniae (1.3%) were most common. In the trend analysis, the proportion of S. aureus (r s = -0.850, P < 0.01) decreased significantly, while that of S. agalactiae increased (r s = 0.781, P < 0.01). CONCLUSION During 2006-2020, among IBI in infants <3 months of age, S. agalactiae, E. coli, and S. aureus were most common and an increasing trend of S. agalactiae was observed.
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An Application of Real-Time PCR and CDC Protocol May Significantly Reduce the Incidence of Streptococcus agalactiae Infections among Neonates. Pathogens 2022; 11:pathogens11091064. [PMID: 36145496 PMCID: PMC9502553 DOI: 10.3390/pathogens11091064] [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: 08/24/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
Streptococcus agalactiae is an important human opportunistic pathogen, especially infectious for pregnant women and neonates. This pathogen belongs to beta hemolytic Streptococcus spp. representatives and accounts for a significant part of early infections in newborns, including serious life-threatening infections. This research investigated the usefulness of Centers for Disease Control and Prevention (CDC) protocol for S. agalactiae DNA detection in 250 samples of recto-vaginal swabs collected from pregnant women (at 35-37 weeks of gestation) and pre-cultured overnight in liquid medium. With an application of the CDC protocol-based real-time PCR, the cfb gene was detected in 68 (27.2%) samples compared to 41 (16.4%) for the standard culture-based methodology. The applied molecular method presented high sensitivity (100.0%) and specificity (87.1%). Therefore, it allowed for more precise detection of S. agalactiae bacteria, compared to the reference diagnostic method, culture on solid media with the following strain identification. The increased sensitivity of GBS detection may result in a reduced number of infections in newborns and leads to more targeted antimicrobial prophylaxis therapy of GBS infections in pregnant women. In addition, the use of the molecular method allows for a significant reduction in the time needed to obtain a result for GBS detection, and interpretation of the results is relatively simple. Therefore, it enables a faster intervention in case of a necessity of an antibiotic therapy introduction in pregnant women whose GBS status is unknown at the time of delivery.
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Clinical Profile and Risk Factors of Group B Streptococcal Colonization in Mothers from the Eastern District of China. J Trop Med 2022; 2022:5236430. [PMID: 36211624 PMCID: PMC9534697 DOI: 10.1155/2022/5236430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
Objective The main aim of this study was to determine the prevalence, capsular genotyping, antimicrobial susceptibility, and associated factors of colonizing Group B Streptococcus (GBS) in pregnant women admitted to a hospital in Jinan, East China. Methods Demographic data, clinical characteristics, and vaginal and rectal swabs were obtained from a group of expecting mothers subjected to GBS screening at the late stage of pregnancy who went into labor over the period from November 2019 to October 2020. Identification of GBS and determination of antimicrobial resistance patterns were performed using a BD Phoenix-100 system. Capsular genotypes were analyzed using polymerase chain reaction and the associated factors were evaluated via logistic regression. Result A total of 2761 pregnant women were recruited for this study. The GBS colonization rate was 6.70% (185/2761). Among the 172 GBS strains examined, all were susceptible to vancomycin and linezolid. Resistance was the highest for erythromycin (80.2%), followed by clindamycin (75.0%), levofloxacin (65.1%), and tetracycline (57.6%). The most common serotype identified was Ia (61.0%), followed by III (29.7%), VI (4.6%), II (3.5%), VII (0.6%), and a nontypeable strain. Risk factors for maternal GBS colonization included maternal age (older than 30 years) (OR = 1.913 (1.662, 2.478)), gestational age at birth (average gestational age) (OR = 1.992 (1.445, 2.746)), and prelabor rupture of membrane (OR = 3.838 (1.619, 9.099)). Conclusion The prevalence of GBS was relatively low. The maternal age was a factor associated with GBS colonization. Subjects showing GBS positivity during late pregnancy were prone to prolonged rupture of the membrane (PROM) and birth at lower a gestation age than the GBS-negative group. Penicillin could still be used as the first agent of choice for intrapartum antibiotic prophylaxis (IAP).
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Bae HG, Hong J, Kim YJ, Lee KR, Lee K, Choi SJ, Uh Y. A Retrospective National Study on Colonization Rate and Antimicrobial Susceptibility of Streptococcus agalactiae in Pregnant Korean Women, 2018-2020. Yonsei Med J 2022; 63:717-723. [PMID: 35914753 PMCID: PMC9344270 DOI: 10.3349/ymj.2022.63.8.717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/07/2022] [Accepted: 05/19/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The prevalence of Group B Streptococcus (GBS) colonization in pregnant Korean women is increasing; however, nationwide studies are lacking. Therefore, we aimed to analyze regional colonization rates and antimicrobial susceptibility for GBS in pregnant Korean women through a nationwide survey. MATERIALS AND METHODS From January 2018 to December 2020, data from the Seoul Clinical Laboratories on vaginal swab cultures were retrospectively analyzed to detect maternal GBS carriers. Each swab specimen was inoculated onto a 5% blood agar plate and incubated at 35℃-37℃ in a 5% CO2 incubator for 24 h. GBS isolates were identified using a Microflex MALDI Biotyper. Antimicrobial susceptibility tests were performed using the Vitek 2 automated system. RESULTS The overall nationwide GBS colonization rate in pregnant Korean women was found to be 10.6% (3578/33721). The maternal GBS colonization rates ranged from 10.5%-10.8% over the 3-year study period. The GBS colonization rates by province, in descending order, were as follows: Jeolla-do, 13.2%; Gangwon-do, 12.0%; Chungcheong-do, 11.8%; Gyeonggi-do, 11.3%; Seoul, 10.2%; and Gyeongsang-do, 9.6%. During the study period, the resistance rates against chloramphenicol, levofloxacin, clindamycin, erythromycin, and tetracycline were 2.6%-2.7%, 18.2%-19.6%, 33.4%-35.7%, 35.6%-36.8%, and 50.5%-53.3%, respectively. CONCLUSION In pregnant Korean women, GBS colonization rates were in the range of 9.6%-13.2%, with Gyeongsang-do being the lowest and Jeolla-do the highest. The resistance rate against clindamycin was high (33.4%-35.7%). GBS colonization rates during pregnancy should be studied nationwide according to the Centers for Disease Control and Prevention-recommended guidelines with periodic antimicrobial resistance monitoring.
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Affiliation(s)
| | | | | | | | - Kyungwon Lee
- Seoul Clinical Laboratories, Yongin, Korea
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Jin Choi
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Singh A, Husein A, Singh S, Ghattargi V, Dhotre D, Shouche YS, Colaco S, Abhyankar V, Patekar S, Chhabria K, Kumar S, Urhekar AD, Modi D. False-positive detection of Group B Streptococcus (GBS) in chromogenic media (Strep B Carrot Broth) due to presence of Enterococcus faecalis in High Vaginal swabs. J Med Microbiol 2022; 71. [PMID: 35972461 DOI: 10.1099/jmm.0.001577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Vaginal colonization of Group B Streptococcus (GBS) is associated with preterm births and neonatal sepsis. Thus routine screening of GBS in prenatal care is recommended.Hypothesis. Chromogenic media (carrot broth) aids in specific and rapid detection of GBS.Aim. To investigate the efficiency of Strep B Carrot Broth for detection of GBS in high vaginal swabs from pregnant women.Methods. In this study 201 vaginal swab samples were collected from pregnant women. Swabs were inoculated in chromogenic media (Strep B Carrot Broth). The positive and negative cultures were inoculated on blood agar and crome agar plates. The colonies were subjected to 16S rRNA sequencing and gene-specific PCR for confirmation. The Christie Atkins Munch Peterson (CAMP) and bile esculin agar (BEA) tests were used for biochemical confirmation. PCR was performed on genomic DNA isolated from uncultured vaginal swabs.Results. It was found that 20/201 (9.9 %) vaginal swab samples were positive in the Strep B Carrot Broth and 17/20 (85 %) and 19/20 (95 %) of these samples yielded colonies on blood agar and crome agar, respectively. Of the 181 carrot broth-negative samples, 1 (0.5 %) and 38 (20.9 %) yielded colonies on blood agar and crome agar plates, respectively. However, 16 s rRNA sequencing revealed that none of the 20 carrot broth-positive cultures were GBS and had sequence similarities to Enterococcus faecalis. This was also confirmed by using gene-specific PCR and BEA positivity. Furthermore, E. faecalis was detected by PCR in DNA isolated from 57 uncultured vaginal swabs samples, GBS could only be detected by PCR in four samples.Conclusion. Carrot broth-based culture can lead to false-positive detection due to the presence of E. faecalis. Thus GBS-positive results in carrot broth must be confirmed by the other molecular and biochemical tests before making a final diagnosis.
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Affiliation(s)
- Abhishek Singh
- Department of Microbiology, MGM Institute of Health Sciences, Kamothe Navi Mumbai, India.,Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Indian Council of Medical Research (ICMR), Parel, Mumbai, India
| | - Atahar Husein
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Indian Council of Medical Research (ICMR), Parel, Mumbai, India
| | - Salomi Singh
- Department of Obstetrics and Gynaecology, MGM Institute of Health Sciences, Kalamboli, Navi Mumbai, India
| | - Vikas Ghattargi
- National Centre for Microbial Resource (NCMR), National Centre for Cell Sciences, Pune, India
| | - Dhiraj Dhotre
- National Centre for Microbial Resource (NCMR), National Centre for Cell Sciences, Pune, India
| | - Yogesh S Shouche
- National Centre for Microbial Resource (NCMR), National Centre for Cell Sciences, Pune, India
| | - Stacy Colaco
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Indian Council of Medical Research (ICMR), Parel, Mumbai, India
| | - Vivek Abhyankar
- National Centre for Microbial Resource (NCMR), National Centre for Cell Sciences, Pune, India
| | - Suyash Patekar
- National Centre for Microbial Resource (NCMR), National Centre for Cell Sciences, Pune, India
| | - Karisma Chhabria
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Indian Council of Medical Research (ICMR), Parel, Mumbai, India
| | - Sushil Kumar
- Department of Obstetrics and Gynaecology, MGM Institute of Health Sciences, Kalamboli, Navi Mumbai, India
| | - A D Urhekar
- Department of Microbiology, MGM Institute of Health Sciences, Kamothe Navi Mumbai, India
| | - Deepak Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Indian Council of Medical Research (ICMR), Parel, Mumbai, India
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