Abstract
BackgroundGroup B Streptococcus (GBS) is an important pathogen that causes high mortality and morbidity in young infants. However, data on clinical manifestations between different GBS serotypes and correlation with molecular epidemiology are largely incomplete. The aim of this study was to determine the serotype distribution, antimicrobial resistance, clinical features and molecular characteristics of invasive GBS isolates recovered from Taiwanese infants.MethodsFrom 2003 to 2017, 182 non-duplicate GBS isolates that caused invasive disease in infants less than one year of age underwent serotyping, multilocus sequence typing (MLST) and antibiotic susceptibility testing. The clinical features of these infants with GBS disease were also reviewed.ResultsOf the 182 patients with invasive GBS disease, 41 (22.5%) were early-onset disease, 121 (66.5%) were late-onset disease and 20 (11.0%) were late late-onset disease (> 90 days of age). All these patients were treated with effective antibiotics on time. Among them, 51 (28.0%) had meningitis, 29 (16.0%) had neurological complications, 12 (6.6%) died during hospitalization, and 15 (8.8%) out of 170 patients who survived had long-term neurological sequelae at discharge. Serotype III GBS strains accounted for 64.8%, followed by serotype Ia (18.1%) and Ib (8.2%). MLST analysis revealed 11 different sequence types among the 182 isolates and ST-17 was the most dominant sequence type (56.6%). The correlation between serotype III and ST17 was evident, as ST17 accounted for 87.3% of all serotype III isolates. There was an obvious increasing trend of type III/ST-17 GBS that caused invasive disease in infants. All isolates were susceptible to penicillin, cefotaxime, and vancomycin, while 68.1 and 65.9% were resistant to erythromycin and clindamycin, respectively.ConclusionsDespite timely and appropriate antibiotic treatment, a significant proportion of invasive GBS disease still inevitably causes adverse outcomes. Further study to explore preventive strategies and development of serotype-based vaccines will be necessary in the future.
Highlights
Group B Streptococcus (GBS) is an important pathogen that causes high mortality and morbidity in young infants
There were a total of 41 Early-onset disease (EOD) (22.5%), 121 late-onset disease (LOD) (66.5%), and 20 late LOD (LLOD) (11.0%) (Table 1)
Serotypes III predominated in these invasive GBS strains (n = 118, 64.8%), followed by serotype Ia (n = 33, 18.1%) and Ib (n = 15, 8.2%)
Summary
Group B Streptococcus (GBS) is an important pathogen that causes high mortality and morbidity in young infants. Data on clinical manifestations between different GBS serotypes and correlation with molecular epidemiology are largely incomplete. The aim of this study was to determine the serotype distribution, antimicrobial resistance, clinical features and molecular characteristics of invasive GBS isolates recovered from Taiwanese infants. In order to obtain more precise clinical, epidemiological and molecular characteristics of invasive GBS disease, we retrospectively collected data from infants aged less than 1 year with culture-proven invasive GBS disease from the largest medical center in Taiwan. The results of serotyping, clinical characteristics, multilocus sequence typing (MLST) analysis of these GBS isolates and antimicrobial susceptibility were reported in this study
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