Prospective studies of group B streptococcal infections in infants

Pass, Mary Ann; Gray, Barry M.; Khare, Santosh; Dillon, Hugh C.

doi:10.1016/s0022-3476(79)80531-4

Cited by 150 publications

(57 citation statements)

References 29 publications

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“…Prospective studies of GBS infections in newborns have shown that GBS can colonize four different body sites (ear, anus, throat, and umbilicus) (25). It is likely, but not proven, that colonization of the oropharynx (throat) is the route by which neonatal meningitis is initiated.…”

Section: Discussionmentioning

confidence: 99%

Removal of Group B Streptococci Colonizing the Vagina and Oropharynx of Mice with a Bacteriophage Lytic Enzyme

Cheng

Nelson

Zhu

et al. 2005

Antimicrob Agents Chemother

197

165

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Group B streptococci (GBS) are the leading cause of neonatal meningitis and sepsis worldwide. The current treatment strategy is limited to intrapartum antibiotic prophylaxis in pregnant women to prevent early-onset neonatal diseases, but considering the potential for antibiotic resistance, the risk of losing control over the disease is high. To approach this problem, we have developed a bacteriophage (phage) lytic enzyme to remove colonizing GBS. Bacteriophage muralytic enzymes, termed lysins, are highly evolved molecules designed to degrade the cell wall of host bacteria to release phage particles from the bacterial cytoplasm. Several different lysins have been developed to specifically kill bacterial pathogens both on mucosal surfaces and in blood and represent a novel approach to control infection. A lysin cloned from a phage infecting GBS was found to contain two putative catalytic domains and one putative binding domain, which is similar to the domain organization of some staphylococcal phage lysins. The lysin (named PlyGBS) was recombinantly expressed in Escherichia coli, and purified PlyGBS efficiently killed all tested GBS serotypes in vitro. In a mouse model, a single dose of PlyGBS significantly reduced bacterial colonization in both the vagina and oropharynx. As an alternative strategy for intrapartum antibiotic prophylaxis, this approach may be used to reduce vaginal GBS colonization in pregnant women before delivery or to decontaminate newborns, thus reducing the incidence of GBSassociated neonatal meningitis and sepsis.Group B streptococci (GBS), or Streptococcus agalactiae, are the leading cause of neonatal sepsis and meningitis in the United States and Europe (1). First identified as a pathogen in bovine mastitis, GBS were later found to colonize the human genital and lower gastrointestinal tract, where the organism can be transmitted perinatally to the fetus. In addition to newborn infections, GBS can also cause substantial morbidity and mortality in adults, particularly those who are immunocompromised or elderly (6). GBS are classified into nine serotypes based on differences in the polysaccharide capsule (24). Historically, the most commonly reported serotype associated with diseases is type III; however, recent epidemiological studies found that serotype V now accounts for approximately 30% of nonpregnant adults (11) and 14 to 23% of pregnant women and neonates (30).The efficacy of antibiotic administration during various stages of pregnancy in order to reduce the rate of early-onset GBS infection in neonates has been tested. Hall et al. (10) demonstrated that treatment during pregnancy (antepartum prophylaxis) reduced maternal GBS colonization transiently, but colonization recurred at delivery. For postpartum prophylaxis, universal administration of penicillin to neonates shortly after birth reduced the early-onset GBS infection by 68%, but it was also associated with a 40% increase in overall mortality and therefore is not recommended (2). The most successful approach to block vertical tr...

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Section: Discussionmentioning

confidence: 99%

Removal of Group B Streptococci Colonizing the Vagina and Oropharynx of Mice with a Bacteriophage Lytic Enzyme

Cheng

Nelson

Zhu

et al. 2005

Antimicrob Agents Chemother

197

165

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show abstract

“…Approximately 1% of neonates exposed to GBS via maternal exposure during vaginal delivery developed early-onset disease resulting in attack rates of one or two per 1000 live births at most centers [1, 5,6]. Late-onset disease occurs about seven days after birth and is usually acquired nasocomially.…”

Section: Discussionmentioning

confidence: 99%

Group B streptococcal endocarditis in a neonate

Agarwala

1988

Pediatr Cardiol

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This is a case of bacterial endocarditis and dissecting aneurysm of the ascending aorta secondary to group B streptococcal (GBS) septicemia in a one-mouth-old infant girl who presented with meningitis. A large aortic vegetation and a large dissecting aneurysm of the root of the aorta were detected by two-dimensional (2D) echocardiography. Apparently the infant did not have any preexisting cardiac anomaly. She received intravenous ampicillin for six weeks. She also underwent successful surgery for the replacement of the ascending aorta with an aortic homograft. This occurrence reemphasizes the value of 2D echocardiography in detecting vegetations for endocarditis.

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“…It has been used to great advantage in tracing the spread of group-B streptococci in several hospitals (Stringer and Maxted 1979;Parker 1979). With a prevalence of serious neonatal infection caused by group-B streptococci reported variously from 1.1 to 6 per 1000 live births (Finch, French and Phillips 1976;Pass et al, 1979), the study of the spread of this organism is of clinical importance.…”

Section: Discussionmentioning

confidence: 99%

The Development of a Phage-Typing System for Group-B Streptococci

Stringer¹

1980

Journal of Medical Microbiology

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Prospective studies of group B streptococcal infections in infants

Cited by 150 publications

References 29 publications

Removal of Group B Streptococci Colonizing the Vagina and Oropharynx of Mice with a Bacteriophage Lytic Enzyme

Removal of Group B Streptococci Colonizing the Vagina and Oropharynx of Mice with a Bacteriophage Lytic Enzyme

Group B streptococcal endocarditis in a neonate

The Development of a Phage-Typing System for Group-B Streptococci

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