Serotypes and clinical manifestations of invasive group B streptococcal infections in western Sweden 1998-2001

Persson, Elisabeth; Berg, Stefan; Trollfors, Birger; Larsson, Peter; Ek, Elisabeth; Backhaus, Erik; Claesson, Berndt E. B.; Jönsson, Lars; Rådberg, Gunilla; Ripa, Torvald; Johansson, S. G. O.

doi:10.1111/j.1469-0691.2004.00931.x

Cited by 66 publications

(69 citation statements)

References 47 publications

(81 reference statements)

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“…This different finding is still unclear but confirms the higher degree of variability of serotypes in distinct regions even within the same country. Overall, serotype V was described elsewhere as an important serotype causing invasive infections in adults (21,39,40,48). In this study, serotype V was also identified among adult patients, but most of them consisted of colonizing isolates (15 of 21).…”

Section: Discussionmentioning

confidence: 70%

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Phenotypic and Genotypic Characterization of Group B Streptococcal Isolates in Southern Brazil

et al. 2010

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One-hundred sixty-eight group B streptococcal (GBS) isolates from a Brazilian hospital were phenotypically and genotypically characterized. Isolates were recovered from human sources from April 2006 to May 2008 and classified as either invasive, noninvasive, or colonizing isolates. Classical methods for serotyping and antibiotic resistance profiling were employed. Clonal groups were also defined by pulsed-field gel electrophoresis (PFGE). Results showed that susceptibility to beta-lactam antimicrobials was predominant among the isolates. Only 4.7% were resistant to erythromycin and clindamycin. The erm(B) gene was widely detected in our GBS isolates, according to our phenotypic results (constitutive macrolide-lincosamide-streptogramin B [cMLS B ] resistance phenotype), and the erm(A) gene was also detected in some isolates. MLS B resistance was restricted to strains isolated from patients with noninvasive infections and carriers. Serotype Ia was predominant (38.1%), serotype IV isolates were found at a high frequency (13.1%), and few isolates of serotype III were identified (3%). Pulsed-field gel electrophoresis results revealed a variety of types, reflecting the substantial genetic diversity among GBS strains, although a great number of isolates could be clustered into two major groups with a high degree of genetic relatedness. Three main PFGE clonal groups were found, and isolates sharing the same PFGE type were grouped into different serotypes. Furthermore, in a few cases, isolates from the same patients and possessing the same PFGE type were of different serotypes. These findings could be related to the occurrence of capsular switching by horizontal transfer of capsular genes.In the last 40 years, Streptococcus agalactiae (group B streptococcus [GBS]) has been described as an important pathogen in neonates and pregnant women. Vaginal colonization with GBS during pregnancy is significantly associated with infections in newborns and requires investigation (40,46,48). Despite the reduction in the incidence of early-onset neonatal disease by using antimicrobial intrapartum prophylaxis, mortality and permanent disability rates caused by GBS continue to be significant. However, GBS has also emerged as an important pathogen in other patient groups, such as children, young adults with underlying medical conditions, and elderly individuals (40). Penicillin is the drug of choice for prevention and treatment of GBS infections, which remain universally susceptible. Erythromycin and clindamycin are recommended when risks of anaphylaxis or therapeutic failure are present. However, resistance to erythromycin and clindamycin has increased in many countries in North America (2,6,16,40), Europe (21,22,42,45), and Asia (24) but not in Brazil (18,50) and other Latin American countries (23,35,36). Such a resistance profile is mainly due to two mechanisms: a methylasemediated target site modification and an active efflux pump (53). In GBS, coresistance to macrolide, lincosamide, and streptogramin B (MLS B ) is due to methylases e...

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Section: Discussionmentioning

confidence: 70%

“…Data collected from different geographic areas revealed considerable variation in the phenotypic and genotypic characteristics of GBS isolates (15,18,21,22,23,24,30,31,39,42,45). In Brazil, data on the distribution of serotypes, as well as the molecular epidemiology of GBS isolates, are still scarce.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic and Genotypic Characterization of Group B Streptococcal Isolates in Southern Brazil

et al. 2010

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“…We also gathered data on potential explanatory variables (ie, variables that might explain variance in incidence or risk of group B streptococcus; 21 Andersen et al 22 Ekelund et al 23 Kuhn et al 24 Fluegge et al 25 Berardi et al 26 Trijbels-Smeulders et al 27 van den Hoogen et al 28 Hasseltvedt et al 29 Hajdu et al 30 Neto et al 31 Janek et al 32 Carbonell-Estrany et al 33 Lopez Sastre et al 34 Andreu et al 35 Persson et al 36 Heath et al 37 Oddie et al 38 Weisner et al 39 Vergnano et al 40 Subtotal (I 2 =98·6%, p=0·000)…”

Section: Data Extractionmentioning

confidence: 99%

“…Strakova et al 21 Fluegge et al 25 Berardi et al 26 Trijbels-Smeulders et al 27 Hasseltvedt et al 29 Hajdu et al 30 Neto et al 31 Carbonell-Estrany et al 33 Persson et al 36 Heath et al 37 Oddie et al 38 Weisner et al 39 Subtotal (I 2 =87·8%, p=0·000)…”

Section: Year Europementioning

confidence: 99%

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

Edmond¹,

Kortsalioudaki²,

Scott³

et al. 2012

The Lancet

533

457

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SummaryBackground Despite widespread use of intrapartum antibiotic prophylaxis, group B streptococcus remains a leading cause of morbidity and mortality in infants in Europe, the Americas, and Australia. However, estimates of disease burden in many countries outside of these regions is not available. We aimed to examine the current global burden of invasive disease and the serotype distribution of group B streptococcus isolates.

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“…There are major differences between countries in the distribution of GBS serotypes. In the USA, Germany and Sweden, the most common serotypes isolated from infants and colonized mothers have been types Ia, III, and V (Persson et al, 2004;Brimil et al, 2006;Harrison et al, 1998). Serotype V strains emerged in the 1990s as a frequent cause of neonatal sepsis and adult diseases in the USA.…”

Section: Introductionmentioning

confidence: 99%

Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

Boswihi

Udo

Al‐Sweih

2012

Journal of Medical Microbiology

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A total of 143 group B streptococcus (GBS) isolates collected from mothers at the Maternity Hospital in Kuwait were investigated for their serotypes and antibiotic resistance, and screened by PCR for the carriage of genes for resistance to tetracycline (tetk, tetM, tetL, tetO), erythromycin (ermA, ermB, ermC, ermTR, ermM, mefA, mefE, msrA) and aminoglycosides (aph3, ant4, ant6). All isolates were serotyped using a latex agglutination test. Most of the isolates belonged to serotypes V (38.5 %), III (20.9 %), Ia (7.7 %) and II (11.2 %). Sixteen isolates (11.2 %) were nontypable. All isolates were susceptible to penicillin, ampicillin and cefotaxime (MICs 0.016-0.094 mg ml "1 ) but were resistant to trimethoprim (92.3 %), tetracycline (89.5 %), minocycline (89.5 %), high-level kanamycin (76.9 %), chloramphenicol (30.0 %), erythromycin (12.6 %), clindamycin (7.0 %), high-level streptomycin (3.5 %) and ciprofloxacin (0.7 %). The tetracycline-resistant isolates contained tetM (94.5 %), tetO (3.9 %), tetL (1.6 %) and tetK (0.8 %). The erythromycin-resistant isolates contained ermB (61.1 %), ermTR (38.9 %), ermA (5.5 %), mefA (5.5 %) and mefE (11 %). All high-level kanamycin-resistant isolates contained aph3. One of the high-level streptomycin-resistant isolates contained ant6. Partial DNA sequencing of aph3 revealed sequences with 99 % similarity to aph3 found in Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis, suggesting that the GBS isolates could have acquired aph3 from other Gram-positive cocci. The high proportion of isolates with resistance to tetracycline, high-level kanamycin and trimethoprim, and the increase in the prevalence of erythromycin resistance, represents an emerging public health concern that needs further surveillance. INTRODUCTIONGroup B streptococcus (GBS), also known as Streptococcus agalactiae, is a leading cause of serious infections in neonates and immunocompromised adults (Truog et al., 1976;Baker, 1979;High et al., 2005).GBS are encapsulated and have been classified into ten serotypes (Ia, Ib, II, III, IV, V, VI, VII, VIII and IX) on the basis of the capsular polysaccharide components of their cell wall (Victor & Rubens, 2000;Slotved et al., 2007). The capsular polysaccharide, as a virulence factor, assists GBS survival in vivo by avoiding recognition by the host defence system (Rubens et al., 1987). There are major differences between countries in the distribution of GBS serotypes. In the USA, Germany and Sweden, the most common serotypes isolated from infants and colonized mothers have been types Ia, III, and V (Persson et al., 2004;Brimil et al., 2006;Harrison et al., 1998). Serotype V strains emerged in the 1990s as a frequent cause of neonatal sepsis and adult diseases in the USA. On the other hand, serotypes VI and VIII represented 35.6 % and 24.7 %, respectively, of GBS isolated from pregnant women in Japan (Lachenauer et al., 1999).Penicillin G is the drug of choice for the intrapartum prophylaxis of GBS infections (Figueira-Coelho e...

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Serotypes and clinical manifestations of invasive group B streptococcal infections in western Sweden 1998-2001

Cited by 66 publications

References 47 publications

Phenotypic and Genotypic Characterization of Group B Streptococcal Isolates in Southern Brazil

Phenotypic and Genotypic Characterization of Group B Streptococcal Isolates in Southern Brazil

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

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