Abstract
Group B Streptococcus (GBS) is one of the most important pathogens for neonates. This study included 69 invasive GBS diseases in neonates, including 7 early-onset disease (EOD), 55 late-onset disease, and 7 very-late-onset disease from 2013 to 2017. A significant reduction of EOD after the deployment of intrapartum antibiotic prophylaxis (IAP) in 2012 was observed. A previously-recognized hypervirulent clone GBS III ST17, accounting for 68% of the overall infections and 71% of the meningitis, was identified among the 69 cases. A novel GBS Ia ST890 emerged, becoming the fourth most common clone. Overall 96% of the invasive GBS infections were caused by serotypes Ia, Ib, and III. We collected 300 GBS isolates from vagina of the healthy pregnant women in 2014 and 2017. The serotype distribution of the maternal colonization isolates was VI (35%), III (21%), V (15%), Ib (13%) and Ia (11%) in 2014, and VI (32%), III (22%), V (16%), Ia (16%), and Ib (8%) in 2017. The most common sequence types were ST1 (32%), ST12 (22%), and ST23 (15%). Serotype diversity of maternal colonization strains did not change between 2014 and 2017. The study provides useful information in surveillance of GBS disease in the era of IAP.
Highlights
Group B Streptococcus (GBS) is one of the most important pathogens for neonates
Much remains unknown about the distribution of the serotypes and genotypes of maternal GBS colonisation isolates, and those of invasive GBS diseases isolates in infants in the era of intrapartum antibiotic prophylaxis (IAP)
One mother had initially negative GBS carriage at 35-week pregnancy, but become positive after rechecking maternal GBS carriage because we found that her 38-week baby developed early-onset disease (EOD) at two days old
Summary
Group B Streptococcus (GBS) is one of the most important pathogens for neonates. This study included 69 invasive GBS diseases in neonates, including 7 early-onset disease (EOD), 55 late-onset disease, and 7 very-late-onset disease from 2013 to 2017. Overall 96% of the invasive GBS infections were caused by serotypes Ia, Ib, and III. Group B Streptococcus (GBS) often colonizes the gastrointestinal and genital tract of 15–40% of pregnant women, and can cause GBS infection in neonates and young infants. GBS infections, according to timing, are further divided into early-onset (EOD; birth to 6 days), late-onset (LOD; 7 to 89 days), and very-late-onset disease (VLOD; older than 3 months of age). GBS infections remain a burden of neonatal sepsis worldwide that estimation of EOD incidence was 0.41 per 1000 live births, LOD incidence was 0.26, case fatality risk (CFR) was 8.4%6. Much remains unknown about the distribution of the serotypes and genotypes of maternal GBS colonisation isolates, and those of invasive GBS diseases isolates in infants in the era of IAP. This study was carried out to fill this information gap
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