Association between capsular serotype V and macrolide resistance in group B <i>Streptococcus</i>

Sendi, Parham; Fröhlicher, Simone

doi:10.1017/s0950268814001320

Cited by 1 publication

(1 citation statement)

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“…Tetracycline resistance has been reported in 78% of GBS isolates in the United Kingdom [24] and it has been suggested that acquisition of tetM was a driving force for emergence of GBS as a human pathogen in the 1960s [25]. Erythromycin and clindamycin resistance conferred by ermB is increasingly observed among serotype V GBS [26] and is a concern because erythromycin has been used as prophylaxis for preterm premature rupture of membranes, and clindamycin has been used for peripartum sepsis or intrapartum antibiotic prophylaxis in those allergic to penicillin or in severe sepsis. The high prevalence of macrolide and lincosamide resistance determinants supports revision of these protocols (Supplementary Table 1).…”

Section: Discussionmentioning

confidence: 99%

Serial Clustering of Late-Onset Group B Streptococcal Infections in the Neonatal Unit: A Genomic Re-evaluation of Causality

Jauneikaite

Kapatai

Davies

et al. 2018

Clinical Infectious Diseases

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BackgroundInvasive Group B streptococcus (GBS) is a major cause of serious neonatal infection. Current strategies to reduce early-onset GBS disease have no impact on late-onset disease (LOD). Although GBS LOD is viewed as a sporadic event in the community, LOD arising within the neonatal intensive care unit (ICU) raises questions about mode of acquisition.MethodsFollowing a cluster of 4 GBS LOD cases, enhanced surveillance for all GBS LOD was undertaken over 2 years in the neonatal ICU supported by neonatal rectal screening. GBS isolates were serotyped and genome-sequenced.ResultsTwelve late -onset invasive GBS episodes were identified (incidence 0.6/1000 live births). Genomic analysis revealed that 11/12 GBS isolates (92%) were linked to at least one other LOD isolate. Isolates from the first cluster were serotype V, resistant to macrolides and lincosamides, and sequencing confirmed isolates were indistinguishable, or distinguishable by only one SNP difference, from each other. Rectal carriage was rare. Prospective surveillance identified three further clusters of LOD due to serotypes Ia (3 cases), Ib (2 cases), and III (2 cases), that would not have been identified without surveillance and genome sequencing, leading to a re-evaluation of interventions required to prevent GBS LOD.ConclusionAcquisition routes for LOD GBS in the neonatal ICU are poorly understood; cases may not necessarily be sporadic. Within this neonatal ICU, our data suggest that a single case of LOD GBS sepsis should be considered a potential nosocomial transmission event warranting prompt investigation, heightened infection prevention vigilance and action where required.

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Section: Discussionmentioning

confidence: 99%