Factors Associated with Intrapartum Transmission of Group B Streptococcus

Berardi, Alberto; Rossi, Cecilia; Guidotti, Isotta; Vellani, Giulia; Lugli, Licia; Reggiani, Maria Letizia Bacchi; Ferrari, Filippo; Facchinetti, Fabio; Ferrari, Fabrizio

doi:10.1097/inf.0000000000000439

Cited by 37 publications

(30 citation statements)

References 13 publications

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“…Rates of neonatal colonisation did not differ among neonates exposed to IAP for less than 1 to 12 hours prior to delivery 11. However, the interpretation of current data requires some caution.…”

Section: Discussionmentioning

confidence: 63%

Are postnatal ampicillin levels actually related to the duration of intrapartum antibiotic prophylaxis prior to delivery? A pharmacokinetic study in 120 neonates

Berardi

Pietrangiolillo

Reggiani

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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Section: Discussionmentioning

confidence: 63%

Are postnatal ampicillin levels actually related to the duration of intrapartum antibiotic prophylaxis prior to delivery? A pharmacokinetic study in 120 neonates

Berardi

Pietrangiolillo

Reggiani

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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“…It has been associated with severe neonatal infections, and there have been few changes in mortality rates since 1990 [5]. Maternal colonization is a necessary condition for ascending fetal infection, stillbirth, and early onset of the disease in neonates, constituting a risk factor for late-onset disease [43,44]. Currently, there is no licensed vaccine for GBS that can prevent bacterial infection [45,46].…”

Section: Discussionmentioning

confidence: 99%

Mucosal Vaccination with Lactococcus lactis-Secreting Surface Immunological Protein Induces Humoral and Cellular Immune Protection against Group B Streptococcus in a Murine Model

et al. 2020

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Group B Streptococcus (GBS) is the primary etiological agent of sepsis and meningitis in newborns and is associated with premature birth and stillbirth. The development of a licensed vaccine is one of the pending challenges for the World Health Organization. Previously, we showed that oral immunization with surface immune protein (SIP) decreases vaginal colonization of GBS and generates functional opsonizing antibodies, which was determined by opsonophagocytic assays (OPA) in vitro. We also showed that the protein has an adjuvant vaccine profile. Therefore, an oral vaccine based on SIP may be an attractive alternative to employ in the development of new vaccines against GBS. Lactococcus lactis is a highlighted oral vaccine probiotic inducer of the mucosal immune response. This bacterium could serve as an antigen-delivering vehicle for the development of an edible vaccine and has been used in clinical trials. In this study, we showed that an oral vaccine with a recombinant L. lactis strain secreting SIP from GBS (rL. lactis-SIP) can induce protective humoral and cellular immunity in an experimental model of GBS vaginal colonization in C57BL/6 mice. Mice immunized with rL. lactis-SIP were protected against clinical symptoms and bacterial colonization after GBS vaginal colonization. Our rL. lactis-SIP vaccine also induces an increase of immunoglobulin G (IgG) and immunoglobulin A (IgA) specifically against SIP. The adoptive transfer of serum from vaccinated mice to naïve mice generated protection against GBS vaginal colonization. Moreover, the rL. lactis-SIP strain induces the activation of SIP-specific T cells, which could decrease GBS vaginal colonization and generate protective antibodies when transferred to other mice. Our experimental observations strongly support the notion that rL. lactis-SIP induces protective humoral and cellular immunity and could be considered as a novel alternative in the development of vaccines for GBS.

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“…There are mixed conclusions regarding the efficacy of the timing and duration of intrapartum antibiotic use in preventing the vertical transmission of GBS. 41,42 There may be differences in the infant gut microbiota among GBS+ women due to differences in the prophylaxis strategy employed that we were unable to account for in the current study. A major strength of the current study was the use of sequencing to measure the infants' gut microbiota.…”

Section: Strengths and Limitationsmentioning

confidence: 93%

Maternal group B Streptococcus and the infant gut microbiota

Cassidy‐Bushrow

Sitarik

Levin

et al. 2015

J Dev Orig Health Dis

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Early patterns of gut colonization may predispose children to adult disease. Exposures in utero and during delivery are associated with the infant gut microbiome. Although ~35% of women carry group B strep (GBS; Streptococcus agalactiae) during pregnancy, it is unknown if GBS presence influences the infant gut microbiome. As part of a population-based, general risk birth cohort, stool specimens were collected from infant’s diapers at research visits conducted at approximately 1 and 6 months of age. Using the Illumina MiSeq (San Diego, CA) platform, the V4 region of the bacterial 16S rRNA gene was sequenced. Infant gut bacterial community compositional differences by maternal GBS status were evaluated using permutational multivariate analysis of variance. Individual operational taxonomic units (OTUs) were tested using a zero-inflated negative binomial model. Data on maternal GBS and infant gut microbiota from either 1 (n=112) or 6 month (n=150) old samples was available on 262 maternal-child pairs. Eighty women (30.5%) were GBS+, of who 58 (72.5%) were given intrapartum antibiotics. After adjusting for maternal race, prenatal antifungal use and intrapartum antibiotics, maternal GBS status was statistically significantly associated with gut bacterial composition in the 6 month visit sample (Canberra R2=0.008, P=0.008; Unweighted UniFrac R2=0.010, P=0.011). Individual OTU tests revealed that infants of GBS+ mothers were significantly enriched for specific members of the Clostridiaceae, Ruminococcoceae, and Enterococcaceae in the 6 month samples compared to infants of GBS- mothers. Whether these taxonomic differences in infant gut microbiota at 6 months lead to differential predisposition for adult disease requires additional study.

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Factors Associated with Intrapartum Transmission of Group B Streptococcus

Abstract: Heavy maternal colonization, intrapartum fever, African ethnicity and lack of IAP exposure were associated with GBS transmission in neonates born to women who were tested positive on admission. Low rates of NC were found among IAP-exposed neonates irrespective of IAP duration.

Cited by 37 publications

References 13 publications

Are postnatal ampicillin levels actually related to the duration of intrapartum antibiotic prophylaxis prior to delivery? A pharmacokinetic study in 120 neonates

Are postnatal ampicillin levels actually related to the duration of intrapartum antibiotic prophylaxis prior to delivery? A pharmacokinetic study in 120 neonates

Mucosal Vaccination with Lactococcus lactis-Secreting Surface Immunological Protein Induces Humoral and Cellular Immune Protection against Group B Streptococcus in a Murine Model

Maternal group B Streptococcus and the infant gut microbiota

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