Characterization of Group B Streptococcus Recovered from Pregnant Women and Newborns Attending in a Hospital in Beijing, China

Purpose

We investigate the drug resistance, serotype and multilocus sequence typing (MLST) of Group B streptococcus (GBS) strains obtained from pregnant women and neonates in a hospital in Beijing.

Patients and Methods

In this cross-sectional study, 1470 eligible pregnant women at a gestational age of 35-37 weeks presented to our department between May 2015 and May 2016 were included. Vaginal and rectal samples from pregnant women together with sampling from neonatal samples were collected to screen GBS. GBS strains were subject to drug resistance and serotype analysis and MLST.

Results

GBS strains were isolated from 111 pregnant women (7.6%) and 6 neonates (0.99%) from 606 matched neonates. 102 strains from pregnant women and 3 strains from neonates were included in the drug sensitivity test, serotyping and MLST typing. All these strains were susceptible to ampicillin, penicillin, ceftriaxone, vancomycin, linezolid, and meropenem. Sixty strains (58.8%) showed multi-drug resistance. Serious cross-resistance was seen between erythromycin and clindamycin. There were eight serotypes, and 37 strains (36.3%) showed a serotype of type III serving as the major type. All 102 GBS strains isolated from pregnant samples could be divided into 18 STs types. They belonged to five clonal complexes and five single clones, with the predominant type of ST19/III, ST10/Ib, and ST23/Ia, with CC19 as the most common type. Three GBS strains isolated from neonates covered two serotypes (ie type III and Ia) that were consistent with those of the mothers.

Conclusion

Serotype III was the predominant serotype of GBS in this study. The predominant MLST type was ST19, ST10, and ST23, with ST19/III, ST10/Ib, and ST23/Ia serving as the most prevalent and CC19 as the most common clonal complex. GBS strains from neonates were consistent in the clonal complex, serotype, and MLST with these isolated from the mothers.

Systematic review of carbapenem-resistant Enterobacteriaceae causing neonatal sepsis in China

BACKGROUND

Carbapenems are β-lactam antibiotics which are used to treat severe infections caused by multidrug resistant Enterobacteriacea. The recent emergence and rapid spread of Enterobacteriaceae resistant to carbapenems is a global concern. We undertook a systematic review of the antibiotic susceptibility and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in Chinese neonates.

METHODS

Systematic literature reviews were conducted (PubMed/Medline, Embase, Wanfang medical online databases, China National Knowledge Infrastructure (CNKI) database) regarding sepsis caused by carbapenem-resistant Enterobacteriaceae in Chinese neonates aged 0-30 days.

RESULTS

17 studies were identified. Eleven patients in the six studies reported the source of infection. Ten patients (10/11, 90.9%) were hospital-acquired infections. Genotypic data were available for 21 isolates in 11 studies (20 K. pneumoniae, 1 E. coli). NDM-1 was the most frequently reported carbapenem-resistant genotype (81.0%, 17/21). Carbapenem-resistant Klebsiella pneumoniae and Escherichia coli were resistant to many antibiotic classes with the exception of colistin and fosfomycin. Sequence type 105 (ST105) was the most commonly reported K. pneumoniae ST type (30.8%; 4/13), which was from the same hospital in Western China. ST17 and ST20 were the second and third most common K. pneumoniae ST type, 23.1% (3/13) and 15.4% (2/13) respectively. The three strains of ST17 are all from the same hospital in central China. The two strains of ST20, although not from the same hospital, belong to the eastern part of China.

CONCLUSIONS

Klebsiella pneumoniae with the NDM-1 genotype was the leading cause of neonatal carbapenem resistant sepsis in China. Hospital acquired infection is the main source of carbapenem resistant sepsis. There is currently no licenced antibiotic regimen available to treat such an infection in China. Improved surveillance, controlling nosocomial infection and the rational use of antibiotics are the key factors to prevent and reduce its spread.