1887

Abstract

(group B , GBS) has recently emerged as an important pathogen among adults. However, it is overlooked in this population, with all global efforts being directed towards its containment among pregnant women and neonates. This systematic review assessed the molecular epidemiology and compared how the lineages circulating among non-pregnant populations relate to those of pregnant and neonatal populations worldwide. A systematic search was performed across nine databases from 1 January 2000 up to and including 20 September 2021, with no language restrictions. The Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Tool (PCAT) was used to assess the quality of included studies. The global population structure of GBS from the non-pregnant population was analysed using typing and phylogenetic reconstruction tools. Twenty-four articles out of 13 509 retrieved across 9 databases were eligible. Most studies were conducted in the World Health Organization European region (12/24, 50 %), followed by the Western Pacific region (6/24, 25 %) and the Americas region (6/24, 25 %). Serotype V (23%, 2310/10240) and clonal complex (CC) 1 (29 %, 2157/7470) were the most frequent serotype and CC, respectively. The pilus island PI1 : PI2A combination (29 %, 3931/13751) was the most prevalent surface protein gene, while the tetracycline resistance M (55 %, 5892/10624) was the leading antibiotic resistance gene. This study highlights that, given the common serotype distribution identified among non-pregnant populations (V, III, Ia, Ib, II and IV), vaccines including these six serotypes will provide broad coverage. The study indicates advanced molecular epidemiology studies, especially in resource-constrained settings for evidence-based decisions. Finally, the study shows that considering all at-risk populations in an inclusive approach is essential to ensure the sustainable containment of GBS.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Loading

Article metrics loading...

/content/journal/mgen/10.1099/mgen.0.001140
2023-11-29
2024-04-28
Loading full text...

Full text loading...

/deliver/fulltext/mgen/9/11/mgen001140.html?itemId=/content/journal/mgen/10.1099/mgen.0.001140&mimeType=html&fmt=ahah

References

  1. 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]
  2. World Health Organization (WHO) WHO Preferred Product Characteristics for Group B Streptococcus Vaccines Geneva: World Health Organization; 2017
    [Google Scholar]
  3. van Kassel MN, Janssen S, Kofman S, Brouwer MC, van de Beek D et al. Prevalence of group B streptococcal colonization in the healthy non-pregnant population: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27:968–980 [View Article] [PubMed]
    [Google Scholar]
  4. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372:71 [View Article] [PubMed]
    [Google Scholar]
  5. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016; 5:210 [View Article] [PubMed]
    [Google Scholar]
  6. Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc 2015; 13:147–153 [View Article] [PubMed]
    [Google Scholar]
  7. Flores AR, Galloway-Peña J, Sahasrabhojane P, Saldaña M, Yao H et al. Sequence type 1 group B Streptococcus, an emerging cause of invasive disease in adults, evolves by small genetic changes. Proc Natl Acad Sci U S A 2015; 112:6431–6436 [View Article] [PubMed]
    [Google Scholar]
  8. Teatero S, Athey TBT, Van Caeseele P, Horsman G, Alexander DC et al. Emergence of serotype IV group B Streptococcus adult invasive disease in Manitoba and Saskatchewan, Canada, is driven by clonal sequence type 459 strains. J Clin Microbiol 2015; 53:2919–2926 [View Article] [PubMed]
    [Google Scholar]
  9. 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]
  10. Teatero S, McGeer A, Low DE, Li A, Demczuk W et al. Characterization of invasive group B Streptococcus strains from the greater Toronto area, Canada. J Clin Microbiol 2014; 52:1441–1447 [View Article] [PubMed]
    [Google Scholar]
  11. 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]
  12. Page AJ, Taylor B, Delaney AJ, Soares J, Seemann T et al. SNP-sites: rapid efficient extraction of SNPs from multi-FASTA alignments. Microb Genom 2016; 2:e000056 [View Article] [PubMed]
    [Google Scholar]
  13. van Kassel MN, de Boer G, Teeri SAF, Jamrozy D, Bentley SD et al. Molecular epidemiology and mortality of group B Streptococcal meningitis and infant sepsis in the Netherlands: a 30-year nationwide surveillance study. Lancet Microbe 2021; 2:E32–E40 [View Article] [PubMed]
    [Google Scholar]
  14. van Kassel MN, Bijlsma MW, Brouwer MC, van der Ende A, van de Beek D. Community-acquired group B Streptococcal meningitis in adults: 33 cases from prospective cohort studies. J Infect 2019; 78:54–57 [View Article] [PubMed]
    [Google Scholar]
  15. Lambertsen L, Ekelund K, Skovsted IC, Liboriussen A, Slotved HC. Characterisation of invasive group B Streptococci from adults in Denmark 1999 to 2004. Eur J Clin Microbiol Infect Dis 2010; 29:1071–1077 [View Article] [PubMed]
    [Google Scholar]
  16. Slotved HC, Fuursted K, Kavalari ID, Hoffmann S. Molecular identification of invasive non-typeable group B Streptococcus isolates from Denmark (2015 to 2017). Front Cell Infect Microbiol 2021; 11:571901 [View Article] [PubMed]
    [Google Scholar]
  17. Persson E, Berg S, Bevanger L, Bergh K, Valsö-Lyng R et al. Characterisation of invasive group B Streptococci based on investigation of surface proteins and genes encoding surface proteins. Clin Microbiol Infect 2008; 14:66–73 [View Article] [PubMed]
    [Google Scholar]
  18. Gudjónsdóttir MJ, Hentz E, Berg S, Backhaus E, Elfvin A et al. Serotypes of group B Streptococci in Western Sweden and comparison with serotypes in two previous studies starting from 1988. BMC Infect Dis 2015; 2015:507
    [Google Scholar]
  19. Wang Y-H, Chen H-M, Yang Y-H, Yang T-H, Teng C-H et al. Clinical and microbiological characteristics of recurrent group B Streptococcal infection among non-pregnant adults. Int J Infect Dis 2014; 26:140–145 [View Article] [PubMed]
    [Google Scholar]
  20. Lo C-W, Liu H-C, Lee C-C, Lin C-L, Chen C-L et al. Serotype distribution and clinical correlation of Streptococcus agalactiae causing invasive disease in infants and children in Taiwan. J Microbiol Immunol Infect 2019; 52:578–584 [View Article] [PubMed]
    [Google Scholar]
  21. Tan S, Lin Y, Foo K, Koh HF, Tow C et al. Group B Streptococcus serotype III sequence type 283 bacteremia associated with consumption of raw fish, Singapore. Emerg Infect Dis 2016; 22:1970–1973 [View Article] [PubMed]
    [Google Scholar]
  22. Nagano N, Koide S, Hayashi W, Taniguchi Y, Tanaka H et al. Population-level transition of capsular polysaccharide types among sequence type 1 group B Streptococcus isolates with reduced penicillin susceptibility during a long-term hospital epidemic. Int J Antimicrob Agents 2019; 53:203–210 [View Article] [PubMed]
    [Google Scholar]
  23. Zhao Z, Kong F, Zeng X, Gidding HF, Morgan J et al. Distribution of genotypes and antibiotic resistance genes among invasive Streptococcus agalactiae (group B Streptococcus) isolates from Australasian patients belonging to different age groups. Clin Microbiol Infect 2008; 14:260–267 [View Article] [PubMed]
    [Google Scholar]
  24. N. Zhang ZF, Donghui Y, Jianong S, Yanyan Z. Molecular characteristics and antibiotic susceptibility of clinical strains of Streptococcus agalactiae. Disease Surveillance 2019; 34:12
    [Google Scholar]
  25. Otaguiri ES, Morguette AEB, Tavares ER, Santos PMC, Morey AT et al. Commensal Streptococcus agalactiae isolated from patients seen at University Hospital of Londrina, Parana, Brazil: capsular types, genotyping, antimicrobial susceptibility and virulence determinants. BMC Microbiol 2013; 13: [View Article]
    [Google Scholar]
  26. Lopardo HA, Vidal P, Jeric P, Centron D, Paganini H et al. Six-month multicenter study on invasive infections due to group B Streptococci in Argentina. J Clin Microbiol 2003; 41:4688–4694 [View Article] [PubMed]
    [Google Scholar]
  27. Usein C-R, Militaru M, Cristea V, Străuţ M. Genetic diversity and antimicrobial resistance in Streptococcus agalactiae strains recovered from female carriers in the Bucharest area. Mem Inst Oswaldo Cruz 2014; 109:189–196 [View Article] [PubMed]
    [Google Scholar]
  28. Kernéis S, Plainvert C, Barnier J-P, Tazi A, Dmytruk N et al. Clinical and microbiological features associated with group B Streptococcus bone and joint infections, France 2004-2014. Eur J Clin Microbiol Infect Dis 2017; 36:1679–1684 [View Article] [PubMed]
    [Google Scholar]
  29. Lopes E, Fernandes T, Machado MP, Carriço JA, Melo-Cristino J et al. Increasing macrolide resistance among Streptococcus agalactiae causing invasive disease in non-pregnant adults was driven by a single capsular-transformed lineage, Portugal, 2009 to 2015. Euro Surveill 2018; 23:1700473 [View Article] [PubMed]
    [Google Scholar]
  30. Baldan R, Droz S, Casanova C, Knabben L, Huang DJ et al. Group B streptococcal colonization in elderly women. BMC Infect Dis 2021; 21:408 [View Article] [PubMed]
    [Google Scholar]
  31. Meehan M, Cunney R, Cafferkey M. Molecular epidemiology of group B Streptococci in Ireland reveals a diverse population with evidence of capsular switching. Eur J Clin Microbiol Infect Dis 2014; 33:1155–1162 [View Article] [PubMed]
    [Google Scholar]
  32. Nan Z, Zhou F, Yan D, Su J, Zhou Y. Molecular characteristics and antibiotic susceptibility of clinical strains of Streptococcus agalactiae. Dis Surveillance 2019; 34:1117–1121
    [Google Scholar]
  33. Kekic D, Gajic I, Opavski N, Kojic M, Vukotic G et al. Trends in molecular characteristics and antimicrobial resistance of group B Streptococci: a multicenter study in Serbia, 2015-2020. Sci Rep 2021; 11:540 [View Article] [PubMed]
    [Google Scholar]
  34. Lopes E, Fernandes T, Machado MP, Carrico J, Cristino JM et al. Increase of macrolide resistance among group B Streptococcus invasive disease in non-pregnant adults in Portugal (2009-2015) was driven by a Capsular variant of a single clone. Int J Antimicrob Agents 2017; 50:S116
    [Google Scholar]
  35. 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]
  36. Bianchi-Jassir F, Paul P, To K-N, Carreras-Abad C, Seale AC et al. Systematic review of group B Streptococcal capsular types, sequence types and surface proteins as potential vaccine candidates. Vaccine 2020; 38:6682–6694 [View Article] [PubMed]
    [Google Scholar]
  37. CDC Antibiotic Resistance Threats in the United States Atlanta, GA: U.S: Department of Health and Human Services; 2019
    [Google Scholar]
  38. Mudzana R, Mavenyengwa RT, Gudza-Mugabe M. Analysis of virulence factors and antibiotic resistance genes in group B Streptococcus from clinical samples. BMC Infect Dis 2021; 21:125 [View Article] [PubMed]
    [Google Scholar]
  39. Pawlowski A, Lannergård J, Gonzalez-Miro M, Cao D, Larsson S et al. A group B Streptococcus alpha-like protein subunit vaccine induces functionally active antibodies in humans targeting homotypic and heterotypic strains. Cell Rep Med 2022; 3:100511 [View Article] [PubMed]
    [Google Scholar]
  40. United Nations General Assembly Transforming Our World: The 2030 Agenda for Sustainable Development New-York: UN General Assembly; 2015
    [Google Scholar]
  41. Pinto TCA, Costa NS, Corrêa A de A, de Oliveira ICM, de Mattos MC et al. Conjugative transfer of resistance determinants among human and bovine Streptococcus agalactiae. Braz J Microbiol 2014; 45:785–789 [View Article] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/mgen/10.1099/mgen.0.001140
Loading
/content/journal/mgen/10.1099/mgen.0.001140
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error