ADDRESSES AND ORIGINAL ARTICLES

FATAL INFECTIONS BY HÆMOLYTIC STREPTOCOCCUS GROUP B

Streptococcus agalactiae (group B Streptococcus, GBS) is an important perinatal pathogen and an emerging etiology of disease in nonpregnant adults. Despite decades of control efforts, GBS remains a major cause of sepsis and meningitis on a global scale. Conjugate polysaccharide vaccines targeting the GBS capsule are in development and may provide protection against invasive disease in pregnant women and infants.

Streptococcus agalactiae is well known to be a potential etiology of bacterial meningitis in neonates. Invasive S. agalactiae has been also reported in nonpregnant adults. Among adults, the incidence of invasive group B Streptococcus (GBS) has been increasing 2–4 times in the past 2 decades. Chronic medical disease was suspected to increase the susceptibility for invasive GBS, especially diabetes mellitus. There was only one case reported to have GBS meningitis from acute otitis media infection in otherwise healthy individual. Hereby, we are reporting the second invasive GBS meningitis from acute otitis media infection with mastoiditis.

Group B streptococcus (GBS) or Streptococcus agalactiae is a β-hemolytic, Gram-positive bacterium that is a leading cause of neonatal infections. GBS commonly colonizes the lower gastrointestinal and genital tracts and, during pregnancy, neonates are at risk of infection. Although intrapartum antibiotic prophylaxis during labor and delivery has decreased the incidence of early-onset neonatal infection, these measures do not prevent ascending infection that can occur earlier in pregnancy leading to preterm births, stillbirths, or late-onset neonatal infections. Prevention of GBS infection in pregnancy is complex and is likely influenced by multiple factors, including pathogenicity, host factors, vaginal microbiome, false-negative screening, and/or changes in antibiotic resistance. A deeper understanding of the mechanisms of GBS infections during pregnancy will facilitate the development of novel therapeutics and vaccines. Here, we summarize and discuss important advancements in our understanding of GBS vaginal colonization, ascending infection, and preterm birth.