The online version of this article (https://doi.org/10.1186/s12879-017-2811-0) contains supplementary material, which is available to authorized users.
Group B Streptococcus (GBS) is a leading cause of morbidity and mortality in infants in both developed and developing countries. To our knowledge, only a few studies have been reported the clinical features, treatment and outcomes of the GBS disease in China. The severity of neonatal GBS disease in China remains unclear. Population-based surveillance in China is therefore required.
We retrospectively collected data of <3 months old infants with culture-positive GBS in sterile samples from three large urban tertiary hospitals in South China from Jan 2011 to Dec 2014. The GBS isolates and their antibiotic susceptibility were routinely identified in clinical laboratories in participating hospitals. Serotyping and multi-locus sequence typing (MLST) were also conducted for further analysis of the neonatal GBS disease.
Total 70 cases of culture-confirmed invasive GBS infection were identified from 127,206 live births born in studying hospitals, giving an overall incidence of 0.55 per 1000 live births (95% confidence interval [CI] 0.44–0.69). They consisted of 49 with early-onset disease (EOD, 0.39 per 1000 live births (95% CI 0.29–0.51)) and 21 with late-onset disease (LOD, 0.17 per 1000 live births (95% CI 0.11–0.25)). The incidence of EOD increased significantly over the studying period. Five infants (4 EOD and 1 LOD) died before discharge giving a mortality rate of 7.1% and five infants (7.1%, 2 EOD and 3 LOD) had neurological sequelae. Within 68 GBS isolates from GBS cases who born in the studying hospitals or elsewhere, serotype III accounted for 77.9%, followed by Ib (14.7%), V (4.4%), and Ia (2.9%). MLST analysis revealed the presence of 13 different sequence types among the 68 GBS isolates and ST-17 was the most frequent sequence type (63.2%). All isolates were susceptible to penicillin, ceftriaxone, vancomycin and linezolid, while 57.4% and 51.5% were resistant to erythromycin and clindamycin, respectively.
This study gains the insight into the spectrum of GBS infection in south China which will facilitate the development of the guidance for reasonable antibiotics usage and will provide evidence for the implementation of potential GBS vaccines in the future.
Additional file 1: Figure S1. Partial sequence diagram for seven house-keeping genes. adhP gene(A), pheS gene(B), atr gene(C), glnA gene(D), sdhA gene(E), glcK gene(F), tkt gene(G). (DOCX 849 kb)12879_2017_2811_MOESM1_ESM.docx
Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report: Group B Streptococcus, provisional-2014. ABCs [ https://www.cdc.gov/abcs/reports-findings/survreports/gbs14.html].
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing - twenty-fourth informational supplement (M100-S24), vol. 34. Wayne, PA: National Committee for Clinical Laboratory Standards; 2014.
Centers for Disease Control and Prevention. Prevention of Perinatal Group B Streptococcal Disease Revised Guidelines from CDC, 2010. MMWR Morb Mortal Wkly Rep. 2010;59:RR-10:1-32.
Wang H, Zhao C, He W, Zhang F, Zhang L, Cao B, Sun Z, Xu Y, Yang Q, Mei Y, et al. High prevalence of fluoroquinolone-resistant group B streptococci among clinical isolates in China and predominance of sequence type 19 with serotype III. Antimicrob Agents Chemother. 2013;57(3):1538–41. CrossRefPubMedPubMedCentral
Rivera L, Sáez-Llorens X, Feris-Iglesias J, Ip M, Saha S, Adrian PV, Madhi SA, Boudville IC, Cunnington MC, Casellas JM, et al. Incidence and serotype distribution of invasive group B streptococcal disease in young infants: a multi-country observational study. BMC Pediatr. 2015;15:143. CrossRefPubMedPubMedCentral
Fluegge K, Siedler A, Heinrich B, Schulte-Moenting J, Moennig M-J, Bartels DB, Dammann O, von Kries R, Berner R. German pediatric surveillance unit study G: incidence and clinical presentation of invasive neonatal group B streptococcal infections in Germany. Pediatrics. 2006;117(6):e1139–45. CrossRefPubMed
Morozumi M, Wajima T, Kuwata Y, Chiba N, Sunaoshi K, Sugita K, Sakata H, Iwata S, Ubukata K. Associations between capsular serotype, multilocus sequence type, and macrolide resistance in Streptococcus Agalactiae isolates from Japanese infants with invasive infections. Epidemiol Infect. 2014;142(4):812–9. CrossRefPubMed
Heath PT. An update on vaccination against group B streptococcus. Expert RevVaccines. 2011;10(5):685–94. CrossRef
Madhi SA, Cutland CL, Jose L, Koen A, Govender N, Wittke F, Olugbosi M, Meulen AS-T, Baker S, Dull PM, et al. Safety and immunogenicity of an investigational maternal trivalent group B streptococcus vaccine in healthy women and their infants: a randomised phase 1b/2 trial. Lancet Infect Dis. 2016;16(8):923–34. CrossRefPubMed
- Epidemiology of invasive group B streptococcal disease in infants from urban area of South China, 2011–2014
- BioMed Central
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