Serotype Distribution of Invasive Group B Streptococcal Isolates in Maryland: Implications for Vaccine Formulation

Harrison, Lee H.; Elliott, John A.; Dwyer, Diane M.; Libonati, Joseph P.; Ferrieri, Patricia; Billmann, Lillian; Schuchat, Anne

doi:10.1086/515260

Cited by 187 publications

(172 citation statements)

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“…French reports indicate that serotype V accounted for about 15% of isolates recovered from neonates (1,16). Similar proportions (14 and 12%) of serotype V strains causing invasive infections were observed in neonates from Atlanta (6) and Maryland (13).…”

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confidence: 62%

“…Recently, serotype V GBS have emerged as a new cause of GBS infection or colonization in children and adults (13,18,19). Indeed, population-based surveillance of GBS in the 1990s indicated that serotype V was responsible for 10 to 15% of neonatal GBS infections in the United States (7,13,17) and was the most common serotype isolated from nonpregnant adults with invasive disease (13). Moreover, data from the Centers for Disease Control and Prevention (Atlanta, Ga.) have shown the emergence of a serotype V clonal type (8).…”

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Clonal Relationship between U.S. and French Serotype V Group B Streptococcus Isolates

et al. 2001

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We examined the genetic diversity of serotype V group B streptococcus (GBS) isolates in the Paris area and compared them with the predominant American serotype V clone. Pulsed-field gel electrophoresis yielded 11 patterns for 64 French GBS. One pattern was obtained with 60% of the isolates tested and was indistinguishable from that of the predominant American clone.Group B streptococci (GBS) are the main cause of severe infection in both infants and adults (2,20,21). GBS are serotyped on the basis of their capsular polysaccharide, of which nine different serotypes have been described (10, 15). The classical serotypes Ia, Ib, II, and III are the predominant cause of disease in neonates. Recently, serotype V GBS have emerged as a new cause of GBS infection or colonization in children and adults (13,18,19). Indeed, population-based surveillance of GBS in the 1990s indicated that serotype V was responsible for 10 to 15% of neonatal GBS infections in the United States (7,13,17) and was the most common serotype isolated from nonpregnant adults with invasive disease (13). Moreover, data from the Centers for Disease Control and Prevention (Atlanta, Ga.) have shown the emergence of a serotype V clonal type (8).In France, too, recent studies point to a significant shift in the distribution of GBS serotypes, with serotype V emerging as one of the major serotypes recovered from neonates (1,11,16).We examined the genetic diversity of French serotype V GBS clinical isolates in the Paris area and compared them with the predominant American clone.We studied a collection of 64 serotype V GBS isolates recovered between January 1998 and January 2000 in the Paris area. The isolates were obtained from genital specimens from pregnant women (n ϭ 30) or from gastric fluid or ear specimens from colonized or infected newborns (n ϭ 34). GBS isolates were confirmed at the species level by standard laboratory methods and were serotyped with a commercial latex agglutination kit (Streptex; Murex Diagnostics UK). The isolates were stored in Todd-Hewitt broth with 20% glycerol at Ϫ80°C until further analysis was done.Pulsed-field gel electrophoresis (PFGE) of serotype V GBS strains was performed as previously described (12). SmaI restriction enzyme chromosomal digests were separated with a Bio-Rad contour-clamped homogenous electric field mapper with a switch time of 0.85 to 35.38 s for 22 h and 35 min at a 120°angle with a voltage gradient of 6 V/cm at 14°C. The DNA size standard was a lambda DNA ladder (Bio-Rad). The gels were stained with ethidium bromide and photographed under UV light. PFGE banding patterns were compared visually. Strains were considered genetically distinguishable if their restriction patterns differed by three or more bands (24). Banding patterns were also compared using a computer system (Biocapt; Vilber-Lourmat) and whole-band analyzer software (Biogène; Vilber-Lourmat). Cluster analysis (unweighted pair group average) was used to calculate similarity and dissimilarity among GBS isolates. A difference was considered si...

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confidence: 62%

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confidence: 99%

Clonal Relationship between U.S. and French Serotype V Group B Streptococcus Isolates

et al. 2001

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“…Several serotypes of GBS exist (9), but only a few (serotypes Ia, Ib, Ic, II, and III) are common causes of human disease. Over the past decade, several investigators reported an increasing proportion of GBS disease to be due to serotype V (GBS-V) (1,2,8,11,21).…”

Section: Pulsed-field Gel Electrophoresis (Pfge) Was Performed On 122mentioning

confidence: 99%

Molecular Epidemiology of Macrolide Resistance in Neonatal Bloodstream Isolates of Group B Streptococci

Diekema¹,

Andrews

Huynh³

et al. 2003

J Clin Microbiol

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Pulsed-field gel electrophoresis (PFGE) was performed on 122 neonatal bloodstream isolates of group B streptococci (GBS) to further examine the relationship between macrolide resistance and serotype V GBS (GBS-V).Over one-third (35%) of macrolide-resistant GBS belonged to a single PFGE subtype of GBS-V, which was also the most common GBS-V subtype noted in previous Centers for Disease Control and Prevention surveillance studies. Erm methylase (ermA and ermB) was the most common resistance mechanism detected, present in 12 of 20 macrolide-resistant GBS.Group B streptococci (GBS) cause significant morbidity and mortality in neonates and can also cause serious infections in adults (20,21). Several serotypes of GBS exist (9), but only a few (serotypes Ia, Ib, Ic, II, and III) are common causes of human disease. Over the past decade, several investigators reported an increasing proportion of GBS disease to be due to serotype V (GBS-V) (1,2,8,11,21). During the same period, several investigators also reported an increase in macrolide (erythromycin) and clindamycin resistance among GBS isolates from U.S. hospitals (1,13,15,17). In addition, several groups (including ours) have recently reported an association between macrolide resistance and GBS-V (1, 10, 12). It was found that, though GBS-V accounted for only ϳ10% of neonatal GBS bloodstream isolates, 40% of erythromycin-resistant and 83% of clindamycin-resistant strains were GBS-V (1).To further investigate the association between macrolidelincosamide resistance and the emergence of GBS-V, we performed pulsed-field gel electrophoresis (PFGE) analysis of the SmaI chromosomal DNA digests of 122 neonatal bloodstream isolates of GBS for which antimicrobial susceptibilities and serotype distribution had previously been described (1). To determine if macrolide-resistant GBS-V represented a new subtype, we included a strain previously characterized by Elliott and colleagues (6) at the Centers for Disease Control and Prevention (CDC) and found to be the most common GBS-V PFGE pattern detected in the United States (representing 56% of isolates collected between 1986 and 1996).The GBS bloodstream isolates in this study were collected as part of the SENTRY antimicrobial surveillance program (1). This report focuses on all neonatal bloodstream isolates of GBS obtained between January 1997 and December 1999 from 35 medical centers throughout the Western Hemisphere.Upon receipt at the University of Iowa, GBS isolates were subcultured onto blood agar to ensure viability and purity. Confirmation of species identification was performed by conventional methods: all GBS in our study were confirmed by the Christie-Atkins-Munch-Petersen test. Antimicrobial susceptibility testing was performed by reference broth microdilution methods as described by the National Committee for Clinical Laboratory Standards (NCCLS) (14).Serotyping was performed by an agglutination test with rabbit antisera to serotypes Ia, Ib, II, III, IV, and V, as described previously (1). For PFGE analysis, genomic DNA w...

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“…There are major differences between countries in the distribution of GBS serotypes. In the USA, Germany and Sweden, the most common serotypes isolated from infants and colonized mothers have been types Ia, III, and V (Persson et al, 2004;Brimil et al, 2006;Harrison et al, 1998). Serotype V strains emerged in the 1990s as a frequent cause of neonatal sepsis and adult diseases in the USA.…”

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Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

Boswihi

Udo

Al‐Sweih

2012

Journal of Medical Microbiology

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A total of 143 group B streptococcus (GBS) isolates collected from mothers at the Maternity Hospital in Kuwait were investigated for their serotypes and antibiotic resistance, and screened by PCR for the carriage of genes for resistance to tetracycline (tetk, tetM, tetL, tetO), erythromycin (ermA, ermB, ermC, ermTR, ermM, mefA, mefE, msrA) and aminoglycosides (aph3, ant4, ant6). All isolates were serotyped using a latex agglutination test. Most of the isolates belonged to serotypes V (38.5 %), III (20.9 %), Ia (7.7 %) and II (11.2 %). Sixteen isolates (11.2 %) were nontypable. All isolates were susceptible to penicillin, ampicillin and cefotaxime (MICs 0.016-0.094 mg ml "1 ) but were resistant to trimethoprim (92.3 %), tetracycline (89.5 %), minocycline (89.5 %), high-level kanamycin (76.9 %), chloramphenicol (30.0 %), erythromycin (12.6 %), clindamycin (7.0 %), high-level streptomycin (3.5 %) and ciprofloxacin (0.7 %). The tetracycline-resistant isolates contained tetM (94.5 %), tetO (3.9 %), tetL (1.6 %) and tetK (0.8 %). The erythromycin-resistant isolates contained ermB (61.1 %), ermTR (38.9 %), ermA (5.5 %), mefA (5.5 %) and mefE (11 %). All high-level kanamycin-resistant isolates contained aph3. One of the high-level streptomycin-resistant isolates contained ant6. Partial DNA sequencing of aph3 revealed sequences with 99 % similarity to aph3 found in Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis, suggesting that the GBS isolates could have acquired aph3 from other Gram-positive cocci. The high proportion of isolates with resistance to tetracycline, high-level kanamycin and trimethoprim, and the increase in the prevalence of erythromycin resistance, represents an emerging public health concern that needs further surveillance. INTRODUCTIONGroup B streptococcus (GBS), also known as Streptococcus agalactiae, is a leading cause of serious infections in neonates and immunocompromised adults (Truog et al., 1976;Baker, 1979;High et al., 2005).GBS are encapsulated and have been classified into ten serotypes (Ia, Ib, II, III, IV, V, VI, VII, VIII and IX) on the basis of the capsular polysaccharide components of their cell wall (Victor & Rubens, 2000;Slotved et al., 2007). The capsular polysaccharide, as a virulence factor, assists GBS survival in vivo by avoiding recognition by the host defence system (Rubens et al., 1987). There are major differences between countries in the distribution of GBS serotypes. In the USA, Germany and Sweden, the most common serotypes isolated from infants and colonized mothers have been types Ia, III, and V (Persson et al., 2004;Brimil et al., 2006;Harrison et al., 1998). Serotype V strains emerged in the 1990s as a frequent cause of neonatal sepsis and adult diseases in the USA. On the other hand, serotypes VI and VIII represented 35.6 % and 24.7 %, respectively, of GBS isolated from pregnant women in Japan (Lachenauer et al., 1999).Penicillin G is the drug of choice for the intrapartum prophylaxis of GBS infections (Figueira-Coelho e...

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Serotype Distribution of Invasive Group B Streptococcal Isolates in Maryland: Implications for Vaccine Formulation

Cited by 187 publications

References 14 publications

Clonal Relationship between U.S. and French Serotype V Group B Streptococcus Isolates

Clonal Relationship between U.S. and French Serotype V Group B Streptococcus Isolates

Molecular Epidemiology of Macrolide Resistance in Neonatal Bloodstream Isolates of Group B Streptococci

Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

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