Epidemiology and Trends of Infective Meningitis in Neonates and Infants Less than 3 Months Old in Hong Kong

Wong, Chi Hang; Duque, Jaime S. Rosa; Wong, Joshua Sung Chih; Chan, Victor C.M.; Lam, Cheuk San Ivan; Fu, Yu Ming; Cheong, Kai-Ning; Chua, Gilbert T.; Lee, Pamela; Ip, Patrick; Ho, Marco H. K.; Wong, Ian Chi Kei; Chan, Godfrey Chi Fung; Leung, Wing; Lee, So Lun; Lee, Kwok Piu; Shek, Chi Chiu; Wong, Ming Sum Rosanna; Wong, Mabel Siu Chun; Lau, Yu Lung; Kwan, Mike Yat Wah

doi:10.1016/j.ijid.2021.06.025

Cited by 6 publications

(3 citation statements)

References 25 publications

(33 reference statements)

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“…Streptococcus agalactiae (also termed as group B Streptococcus , GBS) is a leading cause of invasive disease in neonatal and young infant patients, although intrapartum antimicrobial prophylaxis (IAP) has significantly reduced the incidence of early onset GBS infection ( Tan et al, 2021 ; Vatne et al, 2021 ; Wong et al, 2021 ). A recent survey revealed that families with a baby with GBS infection suffered significant financial and psychological difficulties ( Raybould et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Emerging Fatal Ib/CC12 Hypervirulent Multiresistant Streptococcus agalactiae in Young Infants With Bloodstream Infection in China

et al. 2021

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Streptococcus agalactiae [also known as group B Streptococcus (GBS)] is a tremendous threat to young infants. Eighty pediatric GBS infection cases were enrolled from a teaching hospital in Shanghai between 2009 and 2020; among them, 72.5% (58/80) were diagnosed with bloodstream infection (BSI). Sequence types (STs) and serotypes of associated GBS strains were identified, and most of the Ib/clonal complex (CC)12 (86.7%, 13/15) strains caused BSIs, which was significantly higher than that of the genetically related clone Ib/CC10 (20%, 2/10; p < 0.05). Ib/CC12 BSI (30.8%) mortality was significantly higher than that of non-Ib/CC12 BSI (2.2%; p < 0.05). Virulence genes associated with adhesion, invasion, and immune evasion were detected using polymerase chain reaction. The fbsA and gbsPC1 positive rates of Ib/CC12 strains was higher than that of non-Ib/CC12 strains, whereas cpsIaJ, cpsJ, cpsI, and cpsG positive rates were lower than those of non-Ib/CC12 (p < 0.05). In in vitro studies, the Ib/CC12 strains had strong invasiveness in RAW264.7 cells, but less invasiveness in human umbilical vein endothelial cells, human brain microvascular endothelial cells, and human mammary epithelial cells when compared to other two clones. In the in vivo model, the Ib/CC12 GBS invaded the circulation system more rapidly after intraperitoneal injection, was more difficult to eradicate by phagocytes, and caused significantly higher mortality than Ib/CC10 and III/ST17 (p < 0.05). Genome analysis showed that the Ib/CC12 strains had two clustered regularly interspaced short palindromic repeat-Cas systems and carried more antibiotic resistant genes, which conferred resistance to macrolides, clindamycin, aminoglycosides, and tetracycline. The Ib/CC12 strains had 45 unique annotated genes compared to that of Ib/CC10, including the pathogen-related toxin/antitoxin system, PezA/T. In conclusion, Ib/CC12 is an emerging hypervirulent multiresistant GBS clone that causes invasive and fatal infections in pediatric patients. The prevention and control of Ib/CC12 GBS infection should be emphasized.

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Section: Introductionmentioning

confidence: 99%

Emerging Fatal Ib/CC12 Hypervirulent Multiresistant Streptococcus agalactiae in Young Infants With Bloodstream Infection in China

et al. 2021

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“…In our institute, we have applied the policies of routine GBS screening for pregnant women and intrapartum antibiotic prophylaxis (IAP) since 2004. A change in policy was associated with the predominance of serotype III/ST-17 GBS isolates since 2010 and the increasing prevalence of antibiotic-resistant GBS isolates [12,13,20,25]. More infection control strategies have been carried out in Taiwan in recent decades, which has ultimately led to decreased cases of GBS sepsis and meningitis in neonates since 2018 [6,[26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…The high rates of neuropsychiatric and developmental sequelae among GBS meningitis survivors highlight the importance of understanding the pathophysiology and genetic mechanisms, which may help clinicians to develop new therapeutic and/or neuroprotective strategies for the developing brain [15][16][17]. The serotype III GBS hypervirulent clonal complex 17 (CC17) isolates have become a predominant cause of meningitis and GBS LOD in recent years, which may be related to their higher penetration ability to cross the blood-brain barrier (BBB) [18][19][20]. However, the relevant molecular and genetic characteristics of specific GBS strains that are likely to cause meningitis remain unidentified.…”

Section: Introductionmentioning

confidence: 99%

The Clinical and Genetic Characteristics of Streptococcus agalactiae Meningitis in Neonates

Hsu,

Lu,

Chu

et al. 2023

IJMS

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Streptococcus agalactiae (Group B Streptococcus, GBS) is an important pathogen of bacterial meningitis in neonates. We aimed to investigate the clinical and genetic characteristics of neonatal GBS meningitis. All neonates with GBS meningitis at a tertiary level medical center in Taiwan between 2003 and 2020 were analyzed. Capsule serotyping, multilocus sequence typing, antimicrobial resistance, and whole-genome sequencing (WGS) were performed on the GBS isolates. We identified 48 neonates with GBS meningitis and 140 neonates with GBS sepsis. Neonates with GBS meningitis had significantly more severe clinical symptoms; thirty-seven neonates (77.8%) had neurological complications; seven (14.6%) neonates died; and 17 (41.5%) survivors had neurological sequelae at discharge. The most common serotypes that caused meningitis in neonates were type III (68.8%), Ia (20.8%), and Ib (8.3%). Sequence type (ST) is highly correlated with serotypes, and ST17/III GBS accounted for more than half of GBS meningitis cases (56.3%, n = 27), followed by ST19/Ia, ST23/Ia, and ST12/Ib. All GBS isolates were sensitive to ampicillin, but a high resistance rates of 72.3% and 70.7% to erythromycin and clindamycin, respectively, were noted in the cohort. The virulence and pilus genes varied greatly between different GBS serotypes. WGS analyses showed that the presence of PezT; BspC; and ICESag37 was likely associated with the occurrence of meningitis and was documented in 60.4%, 77.1%, and 52.1% of the GBS isolates that caused neonatal meningitis. We concluded that GBS meningitis can cause serious morbidity in neonates. Further experimental models are warranted to investigate the clinical and genetic relevance of GBS meningitis. Specific GBS strains that likely cause meningitis requires further investigation and clinical attention.

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Citrobacter Infections in Children and Hearing Loss

Emiroğlu,

Turgut,

Tenenbaum

2023

Hearing Loss in Congenital, Neonatal and Childhood Infections

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Epidemiology and Trends of Infective Meningitis in Neonates and Infants Less than 3 Months Old in Hong Kong

Cited by 6 publications

References 25 publications

Emerging Fatal Ib/CC12 Hypervirulent Multiresistant Streptococcus agalactiae in Young Infants With Bloodstream Infection in China

Emerging Fatal Ib/CC12 Hypervirulent Multiresistant Streptococcus agalactiae in Young Infants With Bloodstream Infection in China

The Clinical and Genetic Characteristics of Streptococcus agalactiae Meningitis in Neonates

Citrobacter Infections in Children and Hearing Loss

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