1887

Abstract

Group B (GBS) is a human commensal bacterium that is also associated with infection in pregnant and non-pregnant adults, neonates and elderly people.

The authors hypothesize that knowledge of regional GBS genetic patterns may allow the use of prevention and treatment measures to reduce the burden of streptococcal disease.

The aim was to report the genotypic diversity and antimicrobial sensitivity profiles of invasive, noninvasive urinary and colonizing GBS strains, and evaluate the relationships between these findings.

The study included consecutive and non-duplicated GBS isolates recovered in southern Brazil from 2015 to 2017. We performed multiple-locus variable-number tandem repeat analysis (MLVA) and PCR analyses to determine capsular serotypes and identify the presence of the resistance genes A/E, B and A/TR, and also antibiotic susceptibility testing.

The sample consisted of 348 GBS strains, 42 MLVA types were identified, and 4 of them represented 64 % of isolates. Serotype Ia was the most prevalent (42.2 %) and was found in a higher percentage associated with colonization, followed by serotypes V (24.4 %), II (17.8 %) and III (7.8 %). Serotype V was associated with invasive isolates and serotypes II and III with noninvasive isolates, without significant differences. All isolates were susceptible to penicillin. GBS 2018/ A was observed in 17 isolates, with 11 belonging to serogroup III. The Hunter–Gaston diversity index was calculated as 0.879. The genes A/E, /B and /A/TR were found in 45, 19 and 46 isolates.

This report suggests that the circulating GBS belong to a limited number of genetic lineages. The most common genotypes were Ia/MT12 and V/MT18, which are associated with high resistance to macrolides and the presence of the genes A/E and A/TR. Penicillin remains the antibiotic of choice. Implementation of continuous surveillance of GBS infections will be essential to assess GBS epidemiology and develop accurate GBS prevention, especially strategies associated with vaccination.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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2022-06-01
2022-06-25
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References

  1. Lancefield RC, Hare R. The serological differentiation of pathogenic and non-pathogenic strains of hemolytic streptococci from parturient women. J Exp Med 1935; 61:335–349 [View Article] [PubMed]
    [Google Scholar]
  2. Da Cunha V, Davies MR, Douarre P-E, Rosinski-Chupin I, Margarit I et al. Streptococcus agalactiae clones infecting humans were selected and fixed through the extensive use of tetracycline. Nat Commun 2014; 5:4544 [View Article] [PubMed]
    [Google Scholar]
  3. Le Doare K, Heath PT. An overview of global GBS epidemiology. Vaccine 2013; 31 Suppl 4:D7–12 [View Article] [PubMed]
    [Google Scholar]
  4. Seale AC, Bianchi-Jassir F, Russell NJ, Kohli-Lynch M, Tann CJ et al. Estimates of the burden of group B streptococcal disease worldwide for pregnant women, stillbirths, and children. Clin Infect Dis 2017; 65:S200–S219 [View Article] [PubMed]
    [Google Scholar]
  5. Francois Watkins LK, McGee L, Schrag SJ, Beall B, Jain JH et al. Epidemiology of invasive group B streptococcal infections among nonpregnant adults in the United States, 2008-2016. JAMA Intern Med 2019; 179:479–488 [View Article] [PubMed]
    [Google Scholar]
  6. Barkham T, Zadoks RN, Azmai MNA, Baker S, Bich VTN et al. One hypervirulent clone, sequence type 283, accounts for a large proportion of invasive Streptococcus agalactiae isolated from humans and diseased tilapia in Southeast Asia. PLoS Negl Trop Dis 2019; 13:e0007421 [View Article] [PubMed]
    [Google Scholar]
  7. Raabe VN, Shane AL. Group B streptococcus (Streptococcus agalactiae). Microbiol Spectr 2019; 7: [View Article]
    [Google Scholar]
  8. Yao K, Poulsen K, Maione D, Rinaudo CD, Baldassarri L et al. Capsular gene typing of Streptococcus agalactiae compared to serotyping by latex agglutination. J Clin Microbiol 2013; 51:503–507 [View Article] [PubMed]
    [Google Scholar]
  9. Brigtsen AK, Dedi L, Melby KK, Holberg-Petersen M, Radtke A et al. Comparison of PCR and serotyping of Group B Streptococcus in pregnant women: the Oslo GBS-study. J Microbiol Methods 2015; 108:31–35 [View Article] [PubMed]
    [Google Scholar]
  10. Haguenoer E, Baty G, Pourcel C, Lartigue M-F, Domelier A-S et al. A multi locus variable number of tandem repeat analysis (MLVA) scheme for Streptococcus agalactiae genotyping. BMC Microbiol 2011; 11:1–13 [View Article] [PubMed]
    [Google Scholar]
  11. Sabat AJ, Budimir A, Nashev D, Sá-Leão R, van Dijl J m et al. Overview of molecular typing methods for outbreak detection and epidemiological surveillance. Euro Surveill 2013; 18:20380 [View Article] [PubMed]
    [Google Scholar]
  12. Lee K, Izumiya H, Iyoda S, Ohnishi M. Effective surveillance using multilocus variable-number tandem-repeat analysis and whole-genome sequencing for enterohemorrhagic Escherichia coli O157. Appl Environ Microbiol 2019; 85:e00728-19 [View Article] [PubMed]
    [Google Scholar]
  13. Radtke A, Lindstedt B-A, Afset JE, Bergh K. Rapid multiple-locus variant-repeat assay (MLVA) for genotyping of Streptococcus agalactiae. J Clin Microbiol 2010; 48:2502–2508 [View Article] [PubMed]
    [Google Scholar]
  14. Verani JR, McGee L, Schrag SJ. Division of bacterial diseases, national center for immunization and respiratory diseases, centers for disease control and prevention (CDC). prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59:1–36
    [Google Scholar]
  15. Clinical and Laboratory Standard Institute Performance standards for antimicrobial susceptibility testing. Informational supplement M100-S26 Wayne, PA: 2016
    [Google Scholar]
  16. Imperi M, Pataracchia M, Alfarone G, Baldassarri L, Orefici G et al. A multiplex PCR assay for the direct identification of the capsular type (Ia to IX) of Streptococcus agalactiae. J Microbiol Methods 2010; 80:212–214 [View Article] [PubMed]
    [Google Scholar]
  17. Lamy M-C, Dramsi S, Billoët A, Réglier-Poupet H, Tazi A et al. Rapid detection of the “highly virulent” group B Streptococcus ST-17 clone. Microbes Infect 2006; 8:1714–1722 [View Article] [PubMed]
    [Google Scholar]
  18. Sutcliffe J, Grebe T, Tait-Kamradt A, Wondrack L. Detection of erythromycin-resistant determinants by PCR. Antimicrob Agents Chemother 1996; 40:2562–2566 [View Article] [PubMed]
    [Google Scholar]
  19. Feil EJ, Li BC, Aanensen DM, Hanage WP, Spratt BG. eBURST: inferring patterns of evolutionary descent among clusters of related bacterial genotypes from multilocus sequence typing data. J Bacteriol 2004; 186:1518–1530 [View Article] [PubMed]
    [Google Scholar]
  20. Hunter PR, Gaston MA. Numerical index of the discriminatory ability of typing systems: an application of Simpson’s index of diversity. J Clin Microbiol 1988; 26:2465–2466 [View Article] [PubMed]
    [Google Scholar]
  21. Russell NJ, Seale AC, O’Driscoll M, O’Sullivan C, Bianchi-Jassir F et al. Maternal colonization with group B Streptococcus and serotype distribution worldwide: systematic review and meta-analyses. Clin Infect Dis 2017; 65:S100–S111 [View Article] [PubMed]
    [Google Scholar]
  22. Hall J, Adams NH, Bartlett L, Seale AC, Lamagni T et al. Maternal disease with group B Streptococcus and serotype distribution worldwide: systematic review and meta-analyses. Clin Infect Dis 2017; 65:S112–S124 [View Article] [PubMed]
    [Google Scholar]
  23. Francois Watkins LK, McGee L, Schrag SJ, Beall B, Jain JH et al. Epidemiology of invasive group B streptococcal infections among nonpregnant adults in the United States, 2008-2016. JAMA Intern Med 2019; 179:479–488 [View Article] [PubMed]
    [Google Scholar]
  24. Gizachew M, Tiruneh M, Moges F, Tessema B. Streptococcus agalactiae maternal colonization, antibiotic resistance and serotype profiles in Africa: a meta-analysis. Ann Clin Microbiol Antimicrob 2019; 18:14 [View Article] [PubMed]
    [Google Scholar]
  25. Slotved HC, Hoffmann S. The epidemiology of invasive group B Streptococcus in Denmark From 2005 to 2018. Front Public Health 2020; 8:40 [View Article] [PubMed]
    [Google Scholar]
  26. Teatero S, McGeer A, Li A, Gomes J, Seah C et al. Population structure and antimicrobial resistance of invasive serotype IV group B Streptococcus, Toronto, Ontario, Canada. Emerg Infect Dis 2015; 21:585–591 [View Article] [PubMed]
    [Google Scholar]
  27. Bellais S, Six A, Fouet A, Longo M, Dmytruk N et al. Capsular switching in group B Streptococcus CC17 hypervirulent clone: a future challenge for polysaccharide vaccine development. J Infect Dis 2012; 206:1745–1752 [View Article] [PubMed]
    [Google Scholar]
  28. Absalon J, Segall N, Block SL, Center KJ KJ, Scully IL et al. Safety and immunogenicity of a novel hexavalent group B Streptococcus conjugate vaccine in healthy, non-pregnant adults: a phase 1/2, randomised, placebo-controlled, observer-blinded, dose-escalation trial. Lancet Infect Dis 2020; 3:0478–3
    [Google Scholar]
  29. Alhhazmi A, Hurteau D, Tyrrell GJ. Epidemiology of invasive group B streptococcal disease in Alberta, Canada, from 2003 to 2013. J Clin Microbiol 2016; 54:1774–1781 [View Article] [PubMed]
    [Google Scholar]
  30. Chen SL. Genomic insights into the distribution and evolution of group B Streptococcus. Front Microbiol 2019; 10:1447 [View Article] [PubMed]
    [Google Scholar]
  31. Kong F, Lambertsen LM, Slotved H-C, Ko D, Wang H et al. Use of phenotypic and molecular serotype identification methods to characterize previously nonserotypeable group B streptococci. J Clin Microbiol 2008; 46:2745–2750 [View Article] [PubMed]
    [Google Scholar]
  32. Otaguiri ES, Morguette AEB, Tavares ER, dos Santos PMC, Morey AT et al. Commensal Streptococcus agalactiae isolated from patients seen at University Hospital of Londrina, Paraná, Brazil: capsular types, genotyping, antimicrobial susceptibility and virulence determinants. BMC Microbiol 2013; 13:297 [View Article] [PubMed]
    [Google Scholar]
  33. van der Linden M, Mamede R, Levina N, Helwig P, Vila-Cerqueira P et al. Heterogeneity of penicillin-non-susceptible group B streptococci isolated from a single patient in Germany. J Antimicrob Chemother 2020; 75:296–299 [View Article] [PubMed]
    [Google Scholar]
  34. McGee L, Chochua S, Li Z, Mathis S, Rivers J et al. Multistate, population-based distributions of candidate vaccine targets, clonal complexes, and resistance features of invasive group B streptococci within the United States, 2015-2017. Clin Infect Dis 2021; 72:1004–1013 [View Article] [PubMed]
    [Google Scholar]
  35. do Nascimento CS, Dos Santos NFB, Ferreira RCC, Taddei CR. Streptococcus agalactiae in pregnant women in Brazil: prevalence, serotypes, and antibiotic resistance. Braz J Microbiol 2019; 50:943–952 [View Article] [PubMed]
    [Google Scholar]
  36. Dutra VG, Alves VMN, Olendzki AN, Dias CAG, de Bastos AFA et al. Streptococcus agalactiae in Brazil: serotype distribution, virulence determinants and antimicrobial susceptibility. BMC Infect Dis 2014; 14:323 [View Article] [PubMed]
    [Google Scholar]
  37. Palmeiro JK, Dalla-Costa LM, Fracalanzza SEL, Botelho ACN, da Silva Nogueira K et al. Phenotypic and genotypic characterization of group B streptococcal isolates in southern Brazil. J Clin Microbiol 2010; 48:4397–4403 [View Article] [PubMed]
    [Google Scholar]
  38. Bergal A, Loucif L, Benouareth DE, Bentorki AA, Abat C et al. Molecular epidemiology and distribution of serotypes, genotypes, and antibiotic resistance genes of Streptococcus agalactiae clinical isolates from Guelma, Algeria and Marseille, France. Eur J Clin Microbiol Infect Dis 2015; 34:2339–2348 [View Article] [PubMed]
    [Google Scholar]
  39. Lin FY, Azimi PH, Weisman LE, Philips JB 3rd, Regan J et al. Antibiotic susceptibility profiles for group B streptococci isolated from neonates, 1995-1998. Clin Infect Dis 2000; 31:76–79 [View Article] [PubMed]
    [Google Scholar]
  40. Diekema DJ, Andrews JI, Huynh H, Rhomberg PR, Doktor SR et al. Molecular epidemiology of macrolide resistance in neonatal bloodstream isolates of group B streptococci. J Clin Microbiol 2003; 41:2659–2661 [View Article] [PubMed]
    [Google Scholar]
  41. von Both U, Ruess M, Mueller U, Fluegge K, Sander A et al. A serotype V clone is predominant among erythromycin-resistant Streptococcus agalactiae isolates in A southwestern region of Germany. J Clin Microbiol 2003; 41:2166–2169 [View Article] [PubMed]
    [Google Scholar]
  42. Dogan B, Schukken YH, Santisteban C, Boor KJ. Distribution of serotypes and antimicrobial resistance genes among Streptococcus agalactiae isolates from bovine and human hosts. J Clin Microbiol 2005; 43:5899–5906 [View Article] [PubMed]
    [Google Scholar]
  43. Gajic I, Plainvert C, Kekic D, Dmytruk N, Mijac V et al. Molecular epidemiology of invasive and non-invasive group B Streptococcus circulating in Serbia. Int J Med Microbiol 2019; 309:19–25 [View Article] [PubMed]
    [Google Scholar]
  44. Gherardi G, Imperi M, Baldassarri L, Pataracchia M, Alfarone G et al. Molecular epidemiology and distribution of serotypes, surface proteins, and antibiotic resistance among group B streptococci in Italy. J Clin Microbiol 2007; 45:2909–2916 [View Article] [PubMed]
    [Google Scholar]
  45. Furfaro LL, Chang BJ, Payne MS. Perinatal Streptococcus agalactiae epidemiology and surveillance targets. Clin Microbiol Rev 2018; 31:e00049-18 [View Article] [PubMed]
    [Google Scholar]
  46. Corrêa AB de A, Oliveira ICM de, Pinto T de CA, Mattos MC de, Benchetrit LC. Pulsed-field gel electrophoresis, virulence determinants and antimicrobial susceptibility profiles of type Ia group B streptococci isolated from humans in Brazil. Mem Inst Oswaldo Cruz 2009; 104:599–603 [View Article] [PubMed]
    [Google Scholar]
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