Immune Response to Invasive Group B<i>Streptococcus</i>Disease in Adults

Ms, Edwards; Ma, Rench; Cd, Rinaudo; Fabbrini, Monica; Tuscano, Giovanna; Buffi, Giada; Bartolini, Erika; Bonacci, S; Cj, Baker; Margarit, I.

doi:10.3201/eid2211.160914

Cited by 22 publications

(26 citation statements)

References 33 publications

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“…Group B streptococcus is also recognized as an important health threat in immunocompromised adults, i.e., the elderly and patients with diabetes mellitus or HIV infections. Notably, the most common manifestations are skin/soft tissue infections and bacteremia ( 127 – 129 ), indicating that in these patients barrier immunity is important for the normal containment of GBS, similar to the situation in infants. The immaturity of the neonatal immune system in comparison to that of the adult was reviewed in detail elsewhere ( 130 – 132 ) and we will therefore focus on selected GBS-related aspects.…”

Section: Cellular Innate Immunity and Resistance To Gbsmentioning

confidence: 95%

Codevelopment of Microbiota and Innate Immunity and the Risk for Group B Streptococcal Disease

Kolter

Henneke

2017

Front. Immunol.

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The pathogenesis of neonatal late-onset sepsis (LOD), which manifests between the third day and the third month of life, remains poorly understood. Group B Streptococcus (GBS) is the most important cause of LOD in infants without underlying diseases or prematurity and the third most frequent cause of meningitis in the Western world. On the other hand, GBS is a common intestinal colonizer in infants. Accordingly, despite its adaption to the human lower gastrointestinal tract, GBS has retained its potential virulence and its transition from a commensal to a dangerous pathogen is unpredictable in the individual. Several cellular innate immune mechanisms, in particular Toll-like receptors, the inflammasome and the cGAS pathway, are engaged by GBS effectors like nucleic acids. These are likely to impact on the GBS-specific host resistance. Given the long evolution of streptococci as a normal constituent of the human microbiota, the emergence of GBS as the dominant neonatal sepsis cause just about 50 years ago is remarkable. It appears that intensive usage of tetracycline starting in the 1940s has been a selection advantage for the currently dominant GBS clones with superior adhesive and invasive properties. The historical replacement of Group A by Group B streptococci as a leading neonatal pathogen and the higher frequency of other β-hemolytic streptococci in areas with low GBS prevalence suggests the existence of a confined streptococcal niche, where locally competing streptococcal species are subject to environmental and immunological selection pressure. Thus, it seems pivotal to resolve neonatal innate immunity at mucous surfaces and its impact on microbiome composition and quality, i.e., genetic heterogeneity and metabolism, at the microanatomical level. Then, designer pro- and prebiotics, such as attenuated strains of GBS, and oligonucleotide priming of mucosal immunity may unfold their potential and facilitate adaptation of potentially hazardous streptococci as part of a beneficial local microbiome, which is stabilized by mucocutaneous innate immunity.

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Section: Cellular Innate Immunity and Resistance To Gbsmentioning

confidence: 95%

Codevelopment of Microbiota and Innate Immunity and the Risk for Group B Streptococcal Disease

Kolter

Henneke

2017

Front. Immunol.

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“…To our knowledge, studies on the seroprevalence against GBS CPS in various age groups have not been performed worldwide. Baker et al 31 and Edwards et al 32 reported opsonophagocytic antibodies against type III or V during the third trimester of pregnant women, while the DEVANI program described the prevalence of antibodies against CPS for Ia, Ib, and III serotypes in pregnant women. 10 In non-pregnant adults, Edwards et al 32 reported a CPS-specific IgG response after invasive GBS infection in acute and convalescent-phase serum.…”

Section: Discussionmentioning

confidence: 99%

“…Baker et al 31 and Edwards et al 32 reported opsonophagocytic antibodies against type III or V during the third trimester of pregnant women, while the DEVANI program described the prevalence of antibodies against CPS for Ia, Ib, and III serotypes in pregnant women. 10 In non-pregnant adults, Edwards et al 32 reported a CPS-specific IgG response after invasive GBS infection in acute and convalescent-phase serum. However, as described, their study did not evaluate the functional aspect of immune responses, which is a critical limitation for the study in adults and the elderly populations.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Opsonophagocytic Antibodies against Serotype Ia, Ib, II, III, and V Group B Streptococcus among Korean Population

Lee

Kim

2018

J Korean Med Sci

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BackgroundInvasive Streptococcus agalactiae (group B streptococcus, GBS) infection most commonly occurs in infants; however, cases of GBS infection in adults, particularly in the elderly with significant underlying diseases, are being increasingly reported. We analyzed the serotype specific opsonophagocytic antibodies (the major mechanism of protection against GBS) in infants, adults, and the elderly.MethodsThe opsonization indices (OIs) of antibodies against serotype Ia, Ib, II, III, and V GBS were studied in 89 infants, 35 adults (age, 30–50 years), and 62 elderly individuals (age, 65–85 years) according to the University of Alabama at Birmingham GBS opsonophagocytic killing assay protocol (www.vaccine.uab.edu).ResultsIn infants, adults, and elderly groups respectively, geometric mean of OI against GBS serotype Ia were 3, 7, and 32; against GBS serotype Ib were 7, 242, and 252; against serotype II were 93, 363, and 676; against serotype III were 8, 212, and 609; and against serotype V were 4, 639, and 610. The seropositive rate (% of subjects with OI ≥ 4) increased significantly in older age group for all five serotypes.ConclusionDuring infancy, only a limited proportion of infants have functional immunity against serotype Ia, Ib, II, III, and V GBS. Furthermore, a lack of opsonic activities against GBS observed in some adults and the elderly might predispose such individuals to the risk of invasive GBS infection. Epidemiological monitoring and development of suitable vaccine for these populations are needed.

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“…Correlation between MLST typing and drug resistance 63 positive GBS isolates through double disk Vancomycin has a potential damage to animal embryos. GBS vaccines against non-pregnant adults can effectively prevent bacteremia, however, such research has not been applied to clinical treatment in China[37]. Besides, as is known to all, China is a developing country with large population base.…”

mentioning

confidence: 99%

MLST Application in Analysis of Relationship between Group B Streptococcus Resistance Gene and Induction Resistance in Shanghai, China

Gao

Chen

Peng

et al. 2020

Preprint

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Background With the gradual severe bacterial resistance and slow development of antibiotics, drug-resistant bacterial strains are widely distributed and have become a serious public health problem. Group B Streptococcus (GBS) which cause Group B strep-related disease is the major cause of severe infection in newborns. However, Clindamycin resistance of GBS induced by Erythromycin is emerging and become important clinical concerns today. Methods A retrospective study was conducted on the drug resistance analysis of GBS strains isolated from Obstetrics and Gynecology Hospital from Jan 2016 to Dec 2017. The clinical and microbiological data including patient demographics, antimicrobial susceptibility testing, relative distribution drug resistance-associated genes mefA & ermB to Erythromycin, and multilocus sequence typing (MLST typing) were collected and analyzed. The Kirby-Bauer and VITEK2-compact were used to perform the susceptibility testing. The double disk diffusion method (D-test) was used for the detection of inducible clindamycin resistance. MLST was employed to identify sequence types of these strains. Polymerase Chain Reaction (PCR) was conducted to detect the drug resistance genes mefA & ermB to Erythromycin. Results A total of 1021 strains were cultured and isolated from 31894 specimens. Erythromycin and clindamycin resistance was 53.6%（547/1021）and 50.1 % (512/1021), respectively, in which 74.4%（407/547）had harbored constitutive macrolide, lincosamide and streptogramin B resistance (cMLS B ), 45.0%（63/140）were inducible MLS B (iMLS B ). Additionally, MLST identified 12 different ST types including a new ST type ST1072 in 63 iMLS B GBS strains and the dominant STs were ST12 (30.1%) and ST19 (25.4%). The resistance ratio of ST19 to Levofloxacin (75.0%) was higher than that of other ST types. The relevance resistance ratio of mefA and ermB was respectively 27.0% and 41.3% among 63 GBS isolates. Conclusion Our study not only demonstrated a genetic diversity in iMLS B GBS in Shanghai through the analysis of MLST typing and resistance genes, but also found that there exist different distribution patterns of resistance and related resistance genes between different ST types. These findings would provide theoretical support for clinical prevention and treatment of resistant iMLS B GBS infection.

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Immune Response to Invasive Group BStreptococcusDisease in Adults

Abstract: Antibodies to capsular polysaccharides and pilus proteins develop in recovering adults.

Cited by 22 publications

References 33 publications

Codevelopment of Microbiota and Innate Immunity and the Risk for Group B Streptococcal Disease

Codevelopment of Microbiota and Innate Immunity and the Risk for Group B Streptococcal Disease

Seroprevalence of Opsonophagocytic Antibodies against Serotype Ia, Ib, II, III, and V Group B Streptococcus among Korean Population

MLST Application in Analysis of Relationship between Group B Streptococcus Resistance Gene and Induction Resistance in Shanghai, China

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