Incidence and Severity of Invasive Streptococcus pneumoniae, Group A Streptococcus, and Group B Streptococcus Infections Among Pregnant and Postpartum Women

Deutscher, Meredith; Lewis, Melissa Glenda; Zell, Elizabeth R.; Taylor, Thomas H.; Beneden, Chris Van; Schrag, Stephanie J.

doi:10.1093/cid/cir325

Cited by 129 publications

(118 citation statements)

References 36 publications

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“…Group B streptococcus (GBS), a highly prevalent human pathogen (4,5), has been used widely as a model organism to investigate innate immunity responses against extracellular bacteria (6). GBS is capable of potently inducing a wide array of responses, including the production of proinflammatory cytokines, type I interferon (IFN), and antimicrobial factors (7).…”

mentioning

confidence: 99%

Role of Toll-Like Receptor 13 in Innate Immune Recognition of Group B Streptococci

et al. 2014

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c Murine Toll-like receptor 13 (TLR13), an endosomal receptor that is not present in humans, is activated by an unmethylated motif present in the large ribosomal subunit of bacterial RNA (23S rRNA). Little is known, however, of the impact of TLR13 on antibacterial host defenses. Here we examined the role of this receptor in the context of infection induced by the model pathogen group B streptococcus (GBS). To this end, we used bacterial strains masked from TLR13 recognition by virtue of constitutive expression of the ErmC methyltransferase, which results in dimethylation of the 23S rRNA motif at a critical adenine residue. We found that TLR13-mediated rRNA recognition was required for optimal induction of tumor necrosis factor alpha and nitrous oxide in dendritic cell and macrophage cultures stimulated with heat-killed bacteria or purified bacterial RNA. However, TLR13-dependent recognition was redundant when live bacteria were used as a stimulus. Moreover, masking bacterial rRNA from TLR13 recognition did not increase the ability of GBS to avoid host defenses and replicate in vivo. In contrast, increased susceptibility to infection was observed under conditions in which signaling by all endosomal TLRs was abolished, i.e., in mice with a loss-of-function mutation in the chaperone protein UNC93B1. Our data lend support to the conclusion that TLR13 participates in GBS recognition, although blockade of the function of this receptor can be compensated for by other endosomal TLRs. Lack of selective pressure by bacterial infections might explain the evolutionary loss of TLR13 in humans. However, further studies using different bacterial species are needed to prove this hypothesis.

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confidence: 99%

Role of Toll-Like Receptor 13 in Innate Immune Recognition of Group B Streptococci

et al. 2014

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“…In this case both GAS and Bacteroides were presented. Regardless of delivery type, postpartum patients have a 20-fold increased incidence of GAS-induced postpartum infection compared to non-pregnant women [16]. Lamagni et al founded that S. pyogenes causes 3% of all puerperal sepsis cases [17].…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis and Sepsis from Group A Streptococcus Following Cesarean Section

Bartkevičienė¹,

Kurtinaitiene²,

Šilkūnas³

et al. 2017

Gynecol Obstet Case Rep

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“…More than 10 million noninvasive GAS infections (primarily throat and superficial skin infections) occur annually. 11,12 Streptococcal skin infections occur most frequently during the summer (or year round in warm climates), within skin abrasions and insect bites. By contrast invasive GAS infection is much less common than noninvasive infection.…”

Section: Epidemiologymentioning

confidence: 99%

“…1 However, postpartum women have a 20-fold increased incidence of invasive GAS infection compared with nonpregnant women. 12 GAS primarily spreads by personto-person transmission. Neither spread of organisms by fomites nor transmission from animals (eg, family pets) seems to play a significant role in GAS infection.…”

Section: Epidemiologymentioning

confidence: 99%

“…Invasive GAS infection is uncommon in neonates perhaps because of protective, transplacentally acquired antibody from the mother. 12 From 15% to 25% of asymptomatic household contacts of an index patient with invasive GAS infection has GAS in their upper respiratory tract. Routine screening for and treatment of GAS in asymptomatic household contacts are generally not recommended because the attack rate of another invasive GAS infection from an asymptomatic carrier appears rare.…”

Section: Epidemiologymentioning

confidence: 99%

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Group A Streptococcal Infections in Obstetrics and Gynecology

Rimawi

Soper

Eschenbach

2012

Clinical Obstetrics &Amp; Gynecology

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Group A streptococcal (GAS) infections continue to be an infrequent, but potentially lethal infections in women despite the victory over childbed fever in the 1800s. Invasive group A streptococcal infection still causes 40% of septic deaths among patients with postpartum endometritis, necrotizing fasciitis, and toxic shock syndrome. Many times symptoms and signs of this infection are nonspecific, but laboratory evaluation can suggest serious infection. The prudent combination of antibiotic and surgical therapy can be lifesaving.

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Incidence and Severity of Invasive Streptococcus pneumoniae, Group A Streptococcus, and Group B Streptococcus Infections Among Pregnant and Postpartum Women

Abstract: Although invasive streptococcal infections do not appear to be more severe in pregnant or postpartum women, postpartum women have a 20-fold increased incidence of GAS and GBS, compared with nonpregnant women.

Cited by 129 publications

References 36 publications

Role of Toll-Like Receptor 13 in Innate Immune Recognition of Group B Streptococci

Role of Toll-Like Receptor 13 in Innate Immune Recognition of Group B Streptococci

Necrotizing Fasciitis and Sepsis from Group A Streptococcus Following Cesarean Section

Group A Streptococcal Infections in Obstetrics and Gynecology

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