Group B Streptococcus early-onset disease and observation of well-appearing newborns

Berardi, Alberto; Spada, C.; Reggiani, Maria Letizia Bacchi; Creti, Roberta; Baroni, Lorenza; Capretti, Maria Grazia; Ciccia, Matilde; Fiorini, Valentina; Gambini, Lucia; Gargano, Giancarlo; Papa, Irene; Piccinini, Gema Conte; Rizzo, Vittoria; Sandri, Fabrizio; Lucaccioni, Laura

doi:10.1371/journal.pone.0212784

Cited by 23 publications

(17 citation statements)

References 19 publications

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“…GBS is a leading cause of neonatal sepsis, pneumonia, and meningitis (9)(10)(11)(12)(13)(14). Recent data also suggest that GBS is a frequent cause of chorioamnionitis, endometritis, pneumonia, and urosepsis in adults with underlying medical conditions (i.e., diabetes mellitus or immunosuppression) (15)(16)(17)(18)(19). As these patterns of pathogenesis suggest, GBS is considered a saprophytic organism, i.e., invasive GBS disease is most commonly observed in weakened hosts.…”

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confidence: 99%

A Solution to Antifolate Resistance in Group B Streptococcus : Untargeted Metabolomics Identifies Human Milk Oligosaccharide-Induced Perturbations That Result in Potentiation of Trimethoprim

Chambers

Moore

Craft

et al. 2020

mBio

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Adjuvants can be used to potentiate the function of antibiotics whose efficacy has been reduced by acquired or intrinsic resistance. In the present study, we discovered that human milk oligosaccharides (HMOs) sensitize strains of group B Streptococcus (GBS) to trimethoprim (TMP), an antibiotic to which GBS is intrinsically resistant. Reductions in the MIC of TMP reached as high as 512-fold across a diverse panel of isolates. To better understand HMOs’ mechanism of action, we characterized the metabolic response of GBS to HMO treatment using ultrahigh-performance liquid chromatography–high-resolution tandem mass spectrometry (UPLC-HRMS/MS) analysis. These data showed that when challenged by HMOs, GBS undergoes significant perturbations in metabolic pathways related to the biosynthesis and incorporation of macromolecules involved in membrane construction. This study represents reports the metabolic characterization of a cell that is perturbed by HMOs. IMPORTANCE Group B Streptococcus is an important human pathogen that causes serious infections during pregnancy which can lead to chorioamnionitis, funisitis, premature rupture of gestational membranes, preterm birth, neonatal sepsis, and death. GBS is evolving antimicrobial resistance mechanisms, and the work presented in this paper provides evidence that prebiotics such as human milk oligosaccharides can act as adjuvants to restore the utility of antibiotics.

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confidence: 99%

A Solution to Antifolate Resistance in Group B Streptococcus : Untargeted Metabolomics Identifies Human Milk Oligosaccharide-Induced Perturbations That Result in Potentiation of Trimethoprim

Chambers

Moore

Craft

et al. 2020

mBio

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“…Moreover, several studies showed that asymptomatic term newborn at risk for infection can be monitored with clinical criteria. In those studies, no infection was found in asymptomatic newborn [13][14][15]. Antibiotics early in life have long term side effects that are well described.…”

Section: Discussionmentioning

confidence: 94%

Term newborns at risk for early-onset neonatal sepsis: Clinical surveillance versus systematic paraclinical test

Schmitt¹,

Novy²,

Hascoët

2021

Archives de Pédiatrie

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IntroductionEarly onset neonatal sepsis is a rare but potentially lethal affection which is very often suspected. Previous national guidelines recommended the use of systematic paraclinic tests for healthy newborns with suspected infection. These guidelines have been updated in 2017 by the French Haute Autorité de Santé, and promote initial clinical monitoring taking into account the infectious risk level for term and near term born infants.Objectives: To assess the impact of the new recommendations on antibiotic therapy prescription and on the outcomes of infants born from 36 weeks gestation. Materials and methodsThis study compared the management and the outcome of neonates born from 36 weeks gestation in the level III University Hospital of Nancy, according to their infectious risk level during two periods, before and after the update of national recommendations: from July 1 st to December 31 st 2017, versus July 1 st to December 31 st 2018. Data were retrospectively first period, there were 18 newborns (1.4%) hospitalized for suspicion of infection versus 9 (0.8%) in the second (p = 0.13). The duration of hospitalization was 5.7+/-1.7 days in the first period versus 5.2 +/-3 days in the second (p = 0.33). ConclusionThe application of the new guidelines enables a reduction of antibiotic exposure without additional risk.

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“… 5 However, another study, conducted in 2015, reported that India ranked first with estimated numbers of 31,000 infant GBS cases and 13,000 deaths. 26 Another study, by the WHO in 2017, estimated highest GBS colonization in pregnant women in India (2.5 million), 49 which is a major source of transmission in early-onset GBS in neonates, 50 which are the primary target group. Hence, this review was conducted to identify the disease burden of GBS in newborns as well as the presence of GBS colonization in pregnant women to identify the risk of neonatal GBS in the Indian population.…”

Section: Discussionmentioning

confidence: 99%

Disease burden due to Group B Streptococcus in the Indian population and the need for a vaccine – a narrative review

Ghia

Rambhad

2021

Therapeutic Advances in Infection

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Streptococcus agalactiae, a Gram-positive bacterium, causes invasive infection known as Group B streptococcal disease (GBS). It is a leading cause of neonatal death and complications prior to delivery. The burden of GBS is unknown in India despite the high incidence of preterm and stillbirths. In this study, we performed a narrative review of the available literature (published in the last 10 years) on the epidemiology of GBS, using PubMed and Google Scholar, to understand its impact in India and evaluate potential strategies to prevent the disease in the high-risk population, that is, neonates. The review showed that the incidence of early- and late-onset GBS in neonates (per 1000 live births) was in the ranges of 0.090–0.68 and 0.0–0.07 respectively. The overall case fatality rate reported in only one study was 0.63. In pregnant women, the prevalence of GBS colonization was 2–62% and its transmission to their newborns varied from 6.7% to 11.1%. The serotype distribution of GBS is unclear, but some studies reported the distribution of types Ia, Ib, II, III, V, VII among pregnant women in India. The associated risk factors for GBS colonization in pregnant women are unclear but a few studies suggest the role of age and multigravida, while the risk factors in neonates include preterm birth, prolonged rupture of membrane (⩾18 h), maternal fever, obstetric complications, and prolonged labor >18 h. Screening of GBS is not a routine practice in India and intrapartum antibiotics prophylaxis is limited to only in risk conditions to prevent neonatal disease transmission. A few studies also suggest that high birth rate, poor detection methods, and financial constraints limit routine GBS screening in a developing country such as India. Hence, maternal vaccination is the most promising strategy to prevent neonatal GBS and Pfizer’s hexavalent GBS conjugate vaccine (GBS6) is being developed for GBS neonatal disease.

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Group B Streptococcus early-onset disease and observation of well-appearing newborns

Cited by 23 publications

References 19 publications

A Solution to Antifolate Resistance in Group B Streptococcus : Untargeted Metabolomics Identifies Human Milk Oligosaccharide-Induced Perturbations That Result in Potentiation of Trimethoprim

A Solution to Antifolate Resistance in Group B Streptococcus : Untargeted Metabolomics Identifies Human Milk Oligosaccharide-Induced Perturbations That Result in Potentiation of Trimethoprim

Term newborns at risk for early-onset neonatal sepsis: Clinical surveillance versus systematic paraclinical test

Disease burden due to Group B Streptococcus in the Indian population and the need for a vaccine – a narrative review

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