Abstract
BackgroundGroup B streptococcus (GBS) is a leading cause of serious infections in infants. The extensive use of tetracycline has led to the selection of specific resistant and infectious GBS clones. The sequence type (ST) 10 GBS strain, causing invasive infections in infants, is becoming prevalent in China. We aimed to understand the clinical and microbiological characteristics of this GBS strain.MethodsWe conducted a retrospective study on infants with invasive GBS disease from the largest women’s and children’s medical center in Shanxi and collected data between January 2017 and October 2020. GBS isolates were analyzed by capsule serotyping, genotyping, antibiotic resistance, and surface protein genes.ResultsAll ST10 isolates belonged to serotype Ib; type Ib/ST10 strains were responsible for 66.7% (14/21, P < 0.05) of infant invasive GBS infections during the period and all resulted in late-onset (LOD) and late LOD disease (14/14). Infants with type Ib/ST10 GBS disease had significantly higher rates of meningitis (9/14, 64.3%, p < 0.05) and clinical complications (5/14, 35.7%, p < 0.05). The Ib/ST10 GBS isolates had limited genetic diversity, clustered in the CC10/bca/PI-1 + PI-2a genetic lineage, showed resistance to erythromycin, lincomycin, and fluoroquinolones and sensitivity to tetracycline, and possessed genes ermT, ermB, and amino acid changes in gyrA and parC.ConclusionsThe probable clonal expansion can result in severe infections in infants and ongoing emergence of multi-drug resistant isolates. Continued monitoring for type Ib/ST10 GBS infections is warranted.
Highlights
Group B streptococcus (GBS) is a leading cause of serious infection in young infants, commonly resulting in sepsis, pneumonia, focal infections, bacteremia, and meningitis, which leads to a serious death rate (Lawn et al, 2017; Madrid et al, 2017)
A total of 21 invasive GBS diseases have been reported, including 16 isolates recovered from blood and five from cerebrospinal fluid (Figure 1)
A total of five sequence types (STs) that were clustered into five clonal complexes (CCs) were identified (Table 2 and Figure 1)
Summary
Group B streptococcus (GBS) is a leading cause of serious infection in young infants, commonly resulting in sepsis, pneumonia, focal infections, bacteremia, and meningitis, which leads to a serious death rate (Lawn et al, 2017; Madrid et al, 2017). The current gold standard for preventing the transfer of GBS from mother to neonate in many countries is the use of intrapartum antibiotic prophylaxis during delivery (Lawn et al, 2017; Li et al, 2017; Furfaro et al, 2018). This precaution has reduced the incidence of GBS-associated EOD, the rates of LOD with GBS infections remain unchanged. We aimed to understand the clinical and microbiological characteristics of this GBS strain
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