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Alzayer M, Alkhulaifi MM, Alyami A, Aldosary MS, Alageel A, Garaween G, Alsalloum N, Shibl A, Al-Hamad AM, Doumith M. Molecular Basis of Antimicrobial Resistance in Group B Streptococcus Clinical Isolates from Saudi Arabia. Infect Drug Resist 2024; 17:3715-3722. [PMID: 39221186 PMCID: PMC11365519 DOI: 10.2147/idr.s466726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024] Open
Abstract
Published data on the molecular mechanisms underlying antimicrobial resistance in Group B Streptococcus (GBS) isolates from Saudi Arabia are lacking. Here, we aimed to determine the genetic basis of resistance to relevant antibiotics in a collection of GBS clinical isolates (n = 204) recovered from colonized adults or infected patients and expressing serotypes Ia, Ib, II, III, V, and VI. Initial susceptibility testing revealed resistance to tetracycline (76.47%, n = 156/204), erythromycin (36.76%, n = 75/204), clindamycin (25.49%, n = 52/204), levofloxacin (6.37%, n = 13/204), and gentamicin (2.45%, n = 5/204). Primers designed for the detection of known resistance determinants in GBS identified the presence of erm(A), erm(B), mef(A), and/or lsa(C) genes at the origin of resistance to macrolides and/or clindamycin. Of these, erm(B) and erm(A) were associated with the cMLSB (n = 46) and iMLSB (n = 28) phenotypes, respectively, while mef(A) was linked to the M phenotype (n = 1) and lsa(C) was present in isolates with the L phenotype (n = 8). Resistance to tetracycline was mainly mediated by tet(M) alone (n = 112) or in combination with tet(O) (n = 10); the remaining isolates carried tet(O) (n = 29), tet(L) (n = 2), or both (n = 3). Isolates resistant to gentamicin (n = 5) carried aac(6')-Ie-aph(2')-Ia, and those exhibiting resistance to levofloxacin (n = 13) had alterations in GyrA and/or ParC. Most isolates with the erm gene (93.24%, n = 69/74) also had the tet gene and were therefore resistant to erythromycin, clindamycin, and tetracycline. Overall, there were no clear associations between serotypes and resistance genotypes except for the presence of erm(B) in serotype Ib isolates. Dissemination of antibiotic resistance genes across different serotypes represents a public health concern that requires further surveillance and appropriate antibiotic use in clinical practice.
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Affiliation(s)
- Maha Alzayer
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Manal M Alkhulaifi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Alyami
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed S Aldosary
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Alageel
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ghada Garaween
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Nada Alsalloum
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Atef Shibl
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Arif M Al-Hamad
- Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Michel Doumith
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Alzayer M, Alkhulaifi MM, Alyami A, Aldosary M, Alageel A, Garaween G, Shibl A, Al-Hamad AM, Doumith M. Genomic insights into the diversity, virulence, and antimicrobial resistance of group B Streptococcus clinical isolates from Saudi Arabia. Front Cell Infect Microbiol 2024; 14:1377993. [PMID: 38711928 PMCID: PMC11070470 DOI: 10.3389/fcimb.2024.1377993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/04/2024] [Indexed: 05/08/2024] Open
Abstract
Introduction Detailed assessment of the population structure of group B Streptococcus (GBS) among adults is still lacking in Saudi Arabia. Here we characterized a representative collection of isolates from colonized and infected adults. Methods GBS isolates (n=89) were sequenced by Illumina and screened for virulence and antimicrobial resistance determinants. Genetic diversity was assessed by single nucleotide polymorphisms and core-genome MLST analyses. Results Genome sequences revealed 28 sequence types (STs) and nine distinct serotypes, including uncommon serotypes VII and VIII. Majority of these STs (n=76) belonged to the human-associated clonal complexes (CCs) CC1 (33.71%), CC19 (25.84%), CC17 (11.24%), CC10/CC12 (7.87%), and CC452 (6.74%). Major CCs exhibited intra-lineage serotype diversity, except for the hypervirulent CC17, which exclusively expressed serotype III. Virulence profiling revealed that nearly all isolates (94.38%) carried at least one of the four alpha family protein genes (i.e., alphaC, alp1, alp2/3, and rib), and 92.13% expressed one of the two serine-rich repeat surface proteins Srr1 or Srr2. In addition, most isolates harbored the pilus island (PI)-2a alone (15.73%) or in combination with PI-1 (62.92%), and those carrying PI-2b alone (10.11%) belonged to CC17. Phylogenetic analysis grouped the sequenced isolates according to CCs and further subdivided them along with their serotypes. Overall, isolates across all CC1 phylogenetic clusters expressed Srr1 and carried the PI-1 and PI-2a loci, but differed in genes encoding the alpha-like proteins. CC19 clusters were dominated by the III/rib/srr1/PI-1+PI-2a (43.48%, 10/23) and V/alp1/srr1/PI-1+PI-2a (34.78%, 8/23) lineages, whereas most CC17 isolates (90%, 9/10) had the same III/rib/srr2/P1-2b genetic background. Interestingly, genes encoding the CC17-specific adhesins HvgA and Srr2 were detected in phylogenetically distant isolates belonging to ST1212, suggesting that other highly virulent strains might be circulating within the species. Resistance to macrolides and/or lincosamides across all major CCs (n=48) was associated with the acquisition of erm(B) (62.5%, 30/48), erm(A) (27.1%, 13/48), lsa(C) (8.3%, 4/48), and mef(A) (2.1%, 1/48) genes, whereas resistance to tetracycline was mainly mediated by presence of tet(M) (64.18%, 43/67) and tet(O) (20.9%, 14/67) alone or in combination (13.43%, 9/67). Discussion These findings underscore the necessity for more rigorous characterization of GBS isolates causing infections.
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Affiliation(s)
- Maha Alzayer
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Manal M. Alkhulaifi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Alyami
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Aldosary
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Alageel
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ghada Garaween
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Atef Shibl
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Arif M. Al-Hamad
- Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Michel Doumith
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Leal CAG, Silva BA, Colombo SA. Susceptibility Profile and Epidemiological Cut-Off Values Are Influenced by Serotype in Fish Pathogenic Streptococcus agalactiae. Antibiotics (Basel) 2023; 12:1726. [PMID: 38136760 PMCID: PMC10741021 DOI: 10.3390/antibiotics12121726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Streptococcus agalactiae is a major health concern in tilapia farming worldwide. In contrast to the availability of susceptibility profile results, interpretative criteria for disk diffusion assays and the influence of serotypes on resistance profiles are not available. To address this, sixty isolates (thirty of each serotype, Ib and III) were evaluated using the disk diffusion assay against six antibiotics, and the epidemiological cut-off value (ECV) was calculated. All the isolates were classified as non-wild type (NWT) for sulfamethoxazole (SUT) and norfloxacin (NOR). The inhibition zones for oxytetracycline (OXY) and doxycycline (DOX) were largely distinct; all serotype Ib and III isolates were classified as wild-type (WT) and NWT, respectively. The results for serotype III of fish group B Streptococcus (GBS) were comparable to the NWT tetracycline profile of human GBS available in EUCAST, suggesting the presence of resistance mechanisms in these fish isolates. The calculation of the cut-off wild type (COWT) values for OXY and DOX was appropriate for both serotypes. Differences between the distribution of florfenicol (FLO) and amoxicillin (AMO) were found, and we attribute this to the faster growth rate of serotype III, which promotes smaller inhibition zones. Therefore, using separate COWT for each serotype is necessary. In conclusion, the serotype of fish GBS affects its susceptibility profile, and it is recommended to use serotype-specific COWT values as interpretative criteria for disk diffusion assays against FLO and AMO.
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Affiliation(s)
- Carlos Augusto Gomes Leal
- Department of Preventive Veterinary Medicine, Veterinary School, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil; (B.A.S.); (S.A.C.)
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Alzayer M, Alkhulaifi MM, Alyami A, Aldosary M, Alageel A, Garaween G, Shibl A, Al-Hamad AM, Doumith M. Molecular typing and antimicrobial resistance of group B Streptococcus clinical isolates in Saudi Arabia. J Glob Antimicrob Resist 2023; 35:244-251. [PMID: 37844802 DOI: 10.1016/j.jgar.2023.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES Group B Streptococcus (GBS) has emerged as an important cause of severe infections in adults. However, limited data are available regarding the epidemiology of GBS in Saudi Arabia. METHODS Isolates were collected over a period of eight months from colonized (n = 104) and infected adults (n = 95). Serotypes and virulence determinants were detected by polymerase chain reactions (PCRs). Genetic relatedness was assessed using Multiple Locus Variable Number Tandem Repeat Analysis (MLVA). Antimicrobial susceptibilities were determined by disk diffusion. RESULTS Serotypes III and V (25% each) were the most prevalent, followed by serotypes II (16.18%), Ia (13.24%), VI (9.31%), and Ib (8.82%), while five isolates remained non-typeable (2.45%). Hypervirulent serotype III/CC17 clone (n = 21) accounted for 41.18% of the serotype III isolates. Most isolates (53.92%) harboured pilus island (PI) 1 and 2a types, while PI-2b was predominantly detected in the hypervirulent clone. Isolates were variably resistant to tetracycline (76.47%), erythromycin (36.76%), clindamycin (25.49%), and levofloxacin (6.37%), but remained susceptible to penicillin. Macrolide resistant isolates exhibited constitutive (55.42%) and inducible macrolide-lincosamide-streptogramin B resistance phenotypes (33.74%), while a few had L (9.64%) or M (1.2%) phenotypes. MLVA patterns of dominant serotypes III and V revealed 40 different types divided into 12 clusters and 28 singletons. Interestingly, macrolide resistance was significantly associated with two major MLVA types. CONCLUSIONS GBS isolates belonged predominantly to serotypes III and V, but there were no clear associations between serotypes and patient groups. The studied isolates exhibited high levels of resistance to erythromycin and clindamycin that need further surveillance.
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Affiliation(s)
- Maha Alzayer
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia; Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Manal M Alkhulaifi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Alyami
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Aldosary
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Alageel
- Pathology and Clinical Laboratory, Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ghada Garaween
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Atef Shibl
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Arif M Al-Hamad
- Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Michel Doumith
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Wen Z, Wang C, Bai B, Cao X, Fan K, Hu C, Li P, Deng Q, Yu Z. In Vitro, In Vivo, and In Silico Activities of Ginkgolic Acid C15:1 against Streptococcus agalactiae Clinical Isolates. ACS Infect Dis 2023; 9:1867-1877. [PMID: 37696007 DOI: 10.1021/acsinfecdis.3c00188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Streptococcus agalactiae is the major cause of invasive neonatal infections and is a recognized pathogen associated with various diseases in nonpregnant adults. The emergence and spread of antibiotic-resistant S. agalactiae necessitate the development of a novel antibacterial agent. Here, the potential antibacterial activities and mechanisms of ginkgolic acid C15:1 (GA (15:1)) from Ginkgo biloba against clinical S. agalactiae are characterized. The MIC50 and MIC90 values for GA (15:1) against 72 clinical S. agalactiae isolates were 6.25 and 12.5 μM, respectively. GA (15:1) showed a strong bactericidal effect against both planktonic bacteria and bacteria embedded in biofilms as well as significant effectiveness in suppressing the growth of S. agalactiae biofilms. Moreover, GA (15:1) possesses intracellular antibacterial activity and could significantly decrease the bacterial burden in the intraperitoneal infection model of S. agalactiae. Mechanistic studies showed that GA (15:1) triggers membrane damage of S. agalactiae through a unique dual-targeting mechanism of action (MoA). First, GA (15:1) targets phospholipids in the bacterial cytoplasmic membrane. Second, by using mass-spectrometry-based drug affinity responsive target stability (DARTS) and molecular docking, lipoprotein signaling peptidase II (lspA) was identified as a target protein of GA (15:1), whose role is crucial for maintaining bacterial membrane depolarization and permeabilization. Our findings suggest a potential therapeutic strategy for developing GA (15:1) to combat S. agalactiae infections.
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Affiliation(s)
- Zewen Wen
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
| | - Cong Wang
- Department of Microbiology, The First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Bing Bai
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
| | - Xinyi Cao
- Department of Microbiology, The First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Kewei Fan
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
| | - Chunyou Hu
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
| | - Peiyu Li
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
| | - Qiwen Deng
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
| | - Zhijian Yu
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Huazhong University of Science and Technology Union Shenzhen Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China
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Le Gallou B, Pastuszka A, Lemaire C, Perrotin F, Mitanchez D, Lanotte P, Mereghetti L. Long-term surveillance of group B Streptococcus strains isolated from infection and colonization in pregnant women and newborns. J Med Microbiol 2023; 72. [PMID: 37335614 DOI: 10.1099/jmm.0.001717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Introduction. Group B Streptococcus (GBS) remains the leading cause of bacterial neonatal infections worldwide, despite the spread of recommendations on vaginal screening and antibiotic prophylaxis.Hypothesis/Gap Statement. There is a need to evaluate the potential changes in GBS epidemiology over time following the introduction of such guidelines.Aim. Our aim was to perform a descriptive analysis of the epidemiological characteristics of GBS by conducting a long-term surveillance of strains isolated between 2000 and 2018, using molecular typing methods.Methodology. A total of 121 invasive strains, responsible for maternal infections (20 strains), fetal infections (8 strains) and neonatal infections (93 strains), were included in the study, representing all the invasive isolates during the period; in addition, 384 colonization strains isolated from vaginal or newborn samples were randomly selected. The 505 strains were characterized by capsular polysaccharide (CPS) type multiplex PCR assay and the clonal complex (CC) was assigned using a single nucleotide polymorphism PCR assay. Antibiotic susceptibility was also determined.Results. CPS types III (32.1 % of the strains), Ia (24.6 %) and V (19 %) were the most prevalent. The five main CCs observed were CC1 (26.3 % of the strains), CC17 (22.2 %), CC19 (16.2 %), CC23 (15.8 %) and CC10 (13.9 %). Neonatal invasive GBS diseases were predominantly due to CC17 isolates (46.3 % of the strains), which mainly express CPS type III (87.5 %), with a very high prevalence in late-onset diseases (76.2 %).Conclusion. Between 2000 and 2018, we observed a decrease in the proportion of CC1 strains, which mainly express CPS type V, and an increase in the proportion of CC23 strains, mainly expressing CPS type Ia. Conversely, there was no significant change in the proportion of strains resistant to macrolides, lincosamides or tetracyclines. The two molecular techniques used in our study provide almost as much information as classical serotyping and multilocus sequence typing, but are quicker, easy to perform, and avoid long sequencing and analysis steps.
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Affiliation(s)
- Brice Le Gallou
- UMR1282 ISP, INRAE, Université de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Adeline Pastuszka
- UMR1282 ISP, INRAE, Université de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Coralie Lemaire
- UMR1282 ISP, INRAE, Université de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Franck Perrotin
- Service d'Obstétrique, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Delphine Mitanchez
- Service de Néonatologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Philippe Lanotte
- UMR1282 ISP, INRAE, Université de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Laurent Mereghetti
- UMR1282 ISP, INRAE, Université de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire de Tours, Tours, France
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Schindler Y, Rahav G, Nissan I, Treygerman O, Prajgrod G, Attia BZ, Raz R, Valenci GZ, Tekes-Manova D, Maor Y. Group B streptococcus virulence factors associated with different clinical syndromes: Asymptomatic carriage in pregnant women and early-onset disease in the newborn. Front Microbiol 2023; 14:1093288. [PMID: 36860481 PMCID: PMC9968972 DOI: 10.3389/fmicb.2023.1093288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
Background Group B streptococcus (GBS) harbors many virulence factors but there is limited data regarding their importance in colonization in pregnancy and early-onset disease (EOD) in the newborn. We hypothesized that colonization and EOD are associated with different distribution and expression of virulence factors. Methods We studied 36 GBS EOD and 234 GBS isolates collected during routine screening. Virulence genes (pilus-like structures-PI-1, PI-2a, PI-2b; rib and hvgA) presence and expression were identified by PCR and qRT-PCR. Whole genome sequencing (WGS) and comparative genomic analyses were used to compare coding sequences (CDSs) of colonizing and EOD isolates. Results Serotype III (ST17) was significantly associated with EOD and serotype VI (ST1) with colonization. hvgA and rib genes were more prevalent among EOD isolates (58.3 and 77.8%, respectively; p < 0.01). The pilus loci PI-2b and PI-2a were more prevalent among EOD isolates (61.1%, p < 0.01), while the pilus loci PI-2a and PI-1 among colonizing isolates (89.7 and 93.1% vs. 55.6 and 69.4%, p < 0.01). qRT PCR analysis revealed that hvgA was barely expressed in colonizing isolates, even though the gene was detected. Expression of the rib gene and PI-2b was two-fold higher in EOD isolates compared to colonizing isolates. Transcription of PI-2a was three-fold higher in colonizing isolates compared to EOD isolates. ST17 isolates (associated with EOD) had a smaller genome size compared ST1 and the genome was more conserved relative to the reference strain and ST17 isolates. In a multivariate logistic regression analysis virulence factors independently associated with EOD were serotype 3, and PI-1 and PI-2a was protective. Conclusion There was a significant difference in the distribution of hvg A, rib, and PI genes among EOD (serotype III/ST17) and colonizing (serotype VI/ST1) isolates suggesting an association between invasive disease and these virulence factors. Further study is needed to understand the contribution of these genes to GBS virulence.
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Affiliation(s)
- Yulia Schindler
- Laboratory of Microbiology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Rahav
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel,Infectious Disease Unit, Sheba Medical Center, Tel HaShomer, Israel
| | - Israel Nissan
- Infectious Disease Unit, Sheba Medical Center, Tel HaShomer, Israel,National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - Orit Treygerman
- Laboratory of Microbiology, Meuhedet Health Maintenance Organization, Lod, Israel
| | - George Prajgrod
- Laboratory of Microbiology, Meuhedet Health Maintenance Organization, Lod, Israel
| | | | - Ronit Raz
- Laboratory of Microbiology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel
| | | | - Dorit Tekes-Manova
- Laboratory of Microbiology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel
| | - Yasmin Maor
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel,Infectious Disease Unit, Wolfson Medical Center, Holon, Israel,*Correspondence: Yasmin Maor, ,
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Molecular Epidemiology of Group B Streptococcus Colonization in Egyptian Women. Microorganisms 2022; 11:microorganisms11010038. [PMID: 36677330 PMCID: PMC9861799 DOI: 10.3390/microorganisms11010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Streptococcus agalactiae or Group B Streptococcus (GBS) causes severe neonatal infections with a high burden of disease, especially in Africa. Maternal vaginal colonization and perinatal transmissions represent the common mode of acquiring the infection. Development of an effective maternal vaccine against GBS relies on molecular surveillance of the maternal GBS population to better understand the global distribution of GBS clones and serotypes. (2) Methods: Here, we present genomic data from a collection of colonizing GBS strains from Ismailia, Egypt that were sequenced and characterized within the global JUNO project. (3) Results: A large proportion of serotype VI, ST14 strains was discovered, a serotype which is rarely found in strain collections from the US and Europe and typically not included in the current vaccine formulations. (4) Conclusions: The molecular epidemiology of these strains clearly points to the African origin with the detection of several sequence types (STs) that have only been observed in Africa. Our data underline the importance of continuous molecular surveillance of the GBS population for future vaccine implementations.
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Antimicrobial Resistance and Virulence Genes of Streptococcus Agalactiae Isolated from Mastitis Milk Samples in China. J Vet Res 2022; 66:581-590. [PMID: 36846045 PMCID: PMC9944998 DOI: 10.2478/jvetres-2022-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Streptococcus agalactiae is an important zoonotic pathogen that affects milk production and quality and poses a threat to public health. Treatment of infections with this bacterium exploits antimicrobials, to which the resistance of S. agalactiae is a growing problem. Addressing the possibility of a correlation between this pathogen's genetic factors for antimicrobial resistance and virulence, this study attempted to identify the relevant genes. Material and Methods Antimicrobial resistance of S. agalactiae isolated from 497 Chinese bovine mastitic milk samples was detected by the broth microdilution method. Eight drug resistance genes and eleven virulence genes were detected using PCR. Results Streptococcus agalactiae was 100% susceptible to rifampicin and vancomycin, 93.33% susceptible to sulfisoxazole and sulfamethoxazole, but 100% resistant to ≥3 of the 16 antimicrobial agents, thereby being multidrug resistant, with resistance to oxacillin, tetracycline, erythromycin, clindamycin, and gentamicin being common. The ermB, ermA and lnuA genes were carried by 73.33%, 66.67% and 60.00% of the strains, respectively. The carriage rates of the glnA, clyE, hylB, bibA, iagA, and fbsA virulence genes were greater than 40%, lmb and bac were not observed in any strain, and glnA+hylB+bibA+iagA+fbsA+clyE combined virulence gene patterns were the most commonly detected. Conclusion Antimicrobial resistance of S. agalactiae is still a great concern for cattle health in China, and multidrug resistance coupled with the high positive rates of this bacterium's strains for virulence genes indicates the importance of S. agalactiae surveillance and susceptibility tests.
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Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121848. [PMID: 36553292 PMCID: PMC9776505 DOI: 10.3390/children9121848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/14/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Maternal rectovaginal colonization with Group B Streptococcus (GBS) during labor is a prerequisite for neonatal early-onset GBS disease. Intrapartum antibiotic prophylaxis (IAP) has been proven to prevent GBS perinatal infection, while there are few studies on the evaluation of the effectiveness of different antibiotic prophylaxis regimens. This study aimed to assess the maternal rectovaginal GBS colonization status after IAP, antimicrobial susceptibility and maternal and neonatal outcomes among women administered different antibiotic prophylaxis regimens. A prospective study was conducted between June 2018 and June 2022. GBS carriers identified at 35-37 weeks of gestation were provided IAP (penicillin, cefazolin or clindamycin) at delivery based on the local protocol for GBS prevention. Rectovaginal samples were obtained from participants again after delivery. Antimicrobial susceptibility testing in GBS isolates was performed using the broth microdilution method. A total of 295 cases were included in this study. In the postpartum re-examination for GBS, the overall negative rectovaginal culture rate was 90.8% (268/295). Women who received cefazolin prophylaxis had the highest negative culture rate (95.2%, 197/207), which was followed by those who received penicillin (80.7%, 67/83) and clindamycin (80.0%, 4/5) (p = 0.001). All GBS isolates achieved sensitivity to penicillin and cefazolin, whereas resistance to clindamycin was shown in 21.4% of the strains. There were no significant differences in maternal and neonatal outcomes among the IAP groups. The use of IAP is highly effective in reducing the maternal rectovaginal GBS colonization. Cefazolin may offer equivalent efficacy and safety compared to standard penicillin prophylaxis.
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Virulence Profiles and Antimicrobial Resistance of Streptococcus agalactiae Infective and Colonizing Strains from Argentina. Curr Microbiol 2022; 79:392. [DOI: 10.1007/s00284-022-03050-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 11/05/2022]
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12
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Feuerschuette OHM, Alves EV, Scheffer MC, Vilela APP, Barazzetti FH, Feuerschuette HM, Cancelier ACL, Bazzo ML. Genetic diversity and antimicrobial resistance of invasive, noninvasive and colonizing group B Streptococcus isolates in southern Brazil. Access Microbiol 2022; 4:acmi000370. [PMID: 36004365 PMCID: PMC9394672 DOI: 10.1099/acmi.0.000370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/12/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction. Group B
Streptococcus
(GBS) is a human commensal bacterium that is also associated with infection in pregnant and non-pregnant adults, neonates and elderly people.
Gap Statement. 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.
Aim. 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.
Methodology. 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 mefA/E, ermB and ermA/TR, and also antibiotic susceptibility testing.
Results. 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/ hvgA was observed in 17 isolates, with 11 belonging to serogroup III. The Hunter–Gaston diversity index was calculated as 0.879. The genes mefA/E, erm/B and erm/A/TR were found in 45, 19 and 46 isolates.
Conclusion. 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 mefA/E and ermA/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.
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Affiliation(s)
- Otto Henrique May Feuerschuette
- Universidade do Sul de Santa Catarina – UNISUL, Tubarão, Brazil
- Hospital Universitário Professor Polydoro Ernani de São Thiago, HU/UFSC, Florianópolis, Brazil
| | - Eduardo Venâncio Alves
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
| | - Mara Cristina Scheffer
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
- Hospital Universitário Professor Polydoro Ernani de São Thiago, HU/UFSC, Florianópolis, Brazil
| | - Ana Paula Pessoa Vilela
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
| | | | | | | | - Maria Luiza Bazzo
- Laboratório de Biologia Molecular, Microbiologia e Sorologias, HU/UFSC, Florianópolis, Brazil
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Yazdanizad M, Montazeri M, Saboor Yaraghi AA, Nezhad Fard RM. Isolation of bacteriophages from wastewaters on clinical Streptococcus species. Future Virol 2022. [DOI: 10.2217/fvl-2021-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Excessive use of antimicrobials has resulted in broad antimicrobial resistances in bacteria as well as problems in their infection treatments, which lead to increased case mortalities and medical costs. One of the alternative treatments includes use of bacteriophages. Therefore, the major aim of the current study was to isolate bacteriophages from sewages on bacteria from biological samples to potentially use in infections. Materials & methods: Urban wastewater samples were used to isolate bacteriophages on streptococcal isolates. Bacteriophages were characterized using phenotypic and genotypic methods. Results: Five bacteriophages were isolated on Streptococcus agalactiae, mostly belonging to Caudovirales order. Conclusion: As emergence of antimicrobial-resistant bacteria has created medical problems, identification of novel bacteriophages for use in infection treatments seems an appropriate solution.
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Affiliation(s)
- Maryam Yazdanizad
- Department of Medical Biotechnology, Faculty of Advanced Science & Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, 1949635881, Iran
| | - Maryam Montazeri
- Department of Medical Biotechnology, Faculty of Advanced Science & Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, 1949635881, Iran
| | - Ali Akbar Saboor Yaraghi
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, 1417613151, Iran
| | - Ramin Mazaheri Nezhad Fard
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, 1417613151, Iran
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, 1417613151, Iran
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14
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Shabayek S, Ferrieri P, Spellerberg B. Group B Streptococcal Colonization in African Countries: Prevalence, Capsular Serotypes, and Molecular Sequence Types. Pathogens 2021; 10:pathogens10121606. [PMID: 34959562 PMCID: PMC8706430 DOI: 10.3390/pathogens10121606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022] Open
Abstract
Streptococcus agalactiae or group B streptococcus (GBS) is a commensal of the gastrointestinal and genitourinary tracts of healthy women and an important cause of neonatal invasive infections worldwide. Transmission of bacteria to the newborn occurs at birth and can be prevented by intrapartum antibiotic prophylaxis. However, this not available in resource limited settings in Africa, which carries a particular high burden of disease. Serotype based vaccines are in development and present a suitable alternative to prevent neonatal infections. To be able to assess vaccine efficacy, knowledge and surveillance of GBS epidemiological data are required. This review summarizes investigations about the serotype distribution and the multi-locus sequence types (MLST) found in different African countries. While most serotypes and MLST data are comparable to findings from other continents, some specific differences exist. Serotype V is predominant among colonizing maternal strains in many different African countries. Serotypes that are rarely detected in western industrialized nations, such as serotypes VI, VII and IX, are prevalent in studies from Ghana and Egypt. Moreover, some specific MLST sequence types that seem to be more or less unique to Africa have been detected. However, overall, the data confirm that a hexavalent vaccine can provide broad coverage for the African continent and that a protein vaccine could represent a promising alternative.
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Affiliation(s)
- Sarah Shabayek
- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt;
| | - Patricia Ferrieri
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Barbara Spellerberg
- Institute of Medical Microbiology and Hygiene, University Hospital Ulm, 89081 Ulm, Germany
- Correspondence:
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Motallebirad T, Fazeli H, Azadi D, Shokri D, Moghim S, Esfahani BN. Determination of Capsular Serotypes, Antibiotic Susceptibility Pattern, and Molecular Mechanism of Erythromycin Resistance among Clinical Isolates of Group B Streptococcus in Isfahan, Iran. Adv Biomed Res 2021; 10:27. [PMID: 34760809 PMCID: PMC8531737 DOI: 10.4103/abr.abr_269_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/12/2021] [Accepted: 01/25/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Documented streptococcal resistance to erythromycin has recently been raised. The aim of this study is to identify the molecular mechanism of erythromycin resistance among group B Streptococcus (GBS) strains and to correlate with the clinical origin of strains. Materials and Methods: A total number of 134 colonizing (n = 36), invasive (n = 36), noninvasive (n = 46), and asymptomatic (n = 16) GBS isolates were characterized by the detection of dltS gene, capsular serotyping, antibiotic susceptibility profiles using disc diffusion method, and screening of the ermB, ermTR, and mefA resistance genes. Results: The distribution of capsular serotypes was as follow: serotype III (24.6%), Ia (21.6%), V (17.9%), Ib (14.9%), II (8.9%), IV (8.9%), VI (1.5%), and VII (1.5%). From 134 GBS isolates, 51 (38%) isolates were resistant to erythromycin. The constitutive macrolide lincosamide streptogrmin B (MLSB) was the most common resistance phenotype (62.7%), followed by inducible MLSB (27.4%) and M phenotype (9.8%). Erythromycin resistance rate was higher among asymptomatic GBS strains (13/16, 81.2%). Serotype III was the most prevalent type among resistant isolates (41.1%). The ermB gene highly distributed among resistant strains (64.7%), followed by ermTR (21.5%) and mefA (9.8%). The ermB gene was related to constitutive MLSB phenotype (84.3%, P < 0.05) and serotypes III (61.9%), Ib (87.5%), and V (83.3%). All M phenotype strains harbored mefA gene and were in association with serotype Ia (90%). Conclusion: The current study suggests that ribosomal modification with erm genes is the main mechanism of erythromycin resistance. Because of relatively high prevalence of erythromycin resistance, double disc test highly recommended for GBS disease treatment and intrapartum prophylaxis among penicillin intolerant patients in our region.
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Affiliation(s)
- Tahereh Motallebirad
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Fazeli
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Azadi
- Department of Basic and Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Dariush Shokri
- Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sharareh Moghim
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Nasr Esfahani
- Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Bob-Manuel M, McGee L, Igunma JA, Alex-Wele MA, Obunge OK, Wariso KT. Whole genome sequence based capsular typing and antimicrobial resistance prediction of Group B streptococcal isolates from colonized pregnant women in Nigeria. BMC Genomics 2021; 22:627. [PMID: 34425756 PMCID: PMC8382210 DOI: 10.1186/s12864-021-07929-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/05/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Streptococcus agalactiae (Group B Streptococcus, GBS) is one of the major bacterial pathogens responsible for neonatal sepsis. Whole genome sequencing has, in recent years, emerged as a reliable tool for capsular typing and antimicrobial resistance prediction. This study characterized vaginal and rectal isolates of Group B Streptococcus obtained from pregnant women in Port Harcourt, Nigeria using a whole-genome sequence-based approach. RESULTS Capsular types Ia, Ib, II, III, IV and V were detected among the 43 isolates sequenced. Twelve sequence types (STs) were identified, with ST19 (n = 9, 27.3 %) and ST486 (n = 5, 15.2 %) the most frequent among non-duplicated isolates. Of the alpha-like proteins (alp) identified, Alp1 was the most prevalent in 11 (33.3 %) isolates. Macrolide and lincosamide resistance determinants were present in 15 (45.5 %) isolates; ermB was detected in 1 (3 %), ermTR in 7 (21.2 %) isolates, lnu gene was detected in 6 (18.2 %) and mef was identified in 3 (9.1 %) isolates. Resistance of GBS to erythromycin and clindamycin (predicted from presence of erm or mef genes) was found to be 30.3 % and 24.2 %, respectively. All isolates were predicted resistant to tetracycline with only the tetM gene identified. Fluoroquinolone-resistance conferring substitutions in gyrA + parC were detected in 9 (27.3 %) isolates and chloramphenicol resistance was predicted from presence of aac6'-aph2 gene in 11 (33.3 %). CONCLUSIONS The data available from the whole genome sequencing of these isolates offers a small but insightful description of common serotypes and resistance features within colonizing GBS in Nigeria.
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Affiliation(s)
- Mienye Bob-Manuel
- Department of Medical Microbiology and Parasitology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
| | - Lesley McGee
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, GA, 30329, Atlanta, USA.
| | - Jeremiah A Igunma
- Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Mary A Alex-Wele
- Department of Medical Microbiology and Parasitology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Orikomaba K Obunge
- Department of Medical Microbiology and Parasitology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Kennedy T Wariso
- Department of Medical Microbiology and Parasitology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
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Carra E, Russo S, Micheli A, Garbarino C, Ricchi M, Bergamini F, Bassi P, Prosperi A, Piva S, Cricca M, Schiavo R, Merialdi G, Serraino A, Arrigoni N. Evidence of Common Isolates of Streptococcus agalactiae in Bovines and Humans in Emilia Romagna Region (Northern Italy). Front Microbiol 2021; 12:673126. [PMID: 34177854 PMCID: PMC8226232 DOI: 10.3389/fmicb.2021.673126] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Streptococcus agalactiae (group B Streptococcus, GBS) is one of the most important agents of bovine mastitis and causes remarkable direct and indirect economic losses to the livestock sector. Moreover, this species can cause severe human diseases in susceptible individuals. To investigate the zoonotic potential of S. agalactiae, 203 sympatric isolates from both humans and cattle, isolated in the same time frame (2018) and in the same geographic area (Emilia Romagna region, Northern Italy), were characterized by molecular capsular typing (MCT), pilus island typing (PI), and multi-locus sequence typing (MLST). In addition, antibiotic-resistant phenotypes were investigated. The distribution of the allelic profiles obtained by combining the three genotyping methods (MCT-PI-MLST) resulted in 64 possible genotypes, with greater genetic variability among the human compared to the bovine isolates. Although the combined methods had a high discriminatory power (>96,2%), five genotypes were observed in both species (20,9% of the total isolates). Furthermore, some of these strains shared the same antibiotic resistance profiles. The finding of human and bovine isolates with common genotypes and antibiotic resistance profiles supports the hypothesis of interspecies transmission of S. agalactiae between bovines and humans.
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Affiliation(s)
- Elena Carra
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Simone Russo
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Alessia Micheli
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Chiara Garbarino
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Matteo Ricchi
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Federica Bergamini
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Patrizia Bassi
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Alice Prosperi
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Silvia Piva
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Monica Cricca
- Microbiology, DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Roberta Schiavo
- Microbiology, Department of Clinical Pathology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Giuseppe Merialdi
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
| | - Andrea Serraino
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Norma Arrigoni
- Experimental Zooprophylactic Institute in Lombardy and Emilia Romagna, Brescia, Italy
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Motallebirad T, Fazeli H, Ghahiri A, Shokri D, Jalalifar S, Moghim S, Esfahani BN. Prevalence, population structure, distribution of serotypes, pilus islands and resistance genes among erythromycin-resistant colonizing and invasive Streptococcus agalactiae isolates recovered from pregnant and non-pregnant women in Isfahan, Iran. BMC Microbiol 2021; 21:139. [PMID: 33947330 PMCID: PMC8096152 DOI: 10.1186/s12866-021-02186-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/06/2021] [Indexed: 01/31/2023] Open
Abstract
Background The information on antibiotic resistance and molecular features of Group B Streptococcus (GBS) are essential for epidemiological purposes as well as vaccine development. Therefore, we aimed to assess the antimicrobial resistance profiles and molecular characteristics of GBS isolates in Isfahan, Iran. A total number of 72 colonizing and invasive GBS were collected from pregnant and non-pregnant women. The GBS isolates were analyzed for resistance profiles, capsular genotyping, and detection of PI-1, PI-2a, PI-2b, hvgA, ermB, ermTR, lnuB and, mefA genes. Besides, erythromycin-resistant strains were subjected to multilocus sequence typing (MLST). Results The prevalence of colonizing and invasive GBS were 11 and 0.05%, respectively. The frequency of capsular serotypes was as follows: III (26.3%), Ia (20.83%), Ib and V (each 15.2%), IV (9.7%), II (8.3%), VII (2.7%), and VI (1.3%). Overall frequencies of PIs were as follows: PI-1, 37.5%, PI-1 + PI-2a, 30.5%, PI-1 + PI-2b, 29.1% and PI-2b, 2.7%. Two maternal colonizing GBS (2.6%) were hvgA positive and were belonged to ST-17/CPS-III/PI-1 + PI-2b lineage. Among 30(41.6%) erythromycin resistant GBS, 21 isolates (70%) harbored ermB gene, followed by ermTR (23.3%) and mefA (10%). One clindamycin-resistant isolate harbored the lnuB gene. MLST analysis revealed the following five clonal complexes (CCs) and nine STs: (CC-19/ST-335, ST-19, and ST-197), (CC-12/ST-43, ST-12), (CC-23/ST-163, ST-23), (CC-17/ST-17) and (CC-4/ST-16). Conclusion The study shows an alarmingly high prevalence of erythromycin-resistant GBS in Iran. In addition, we report dissemination of ST-335/CPS-III clone associated with tetracycline and erythromycin resistance in our region. The distribution of capsular and pilus genotypes varies between invasive and colonizing GBS that could be helpful for vaccine development.
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Affiliation(s)
- Tahereh Motallebirad
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Hezar-Jerib Street, Isfahan, Iran
| | - Hossein Fazeli
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Hezar-Jerib Street, Isfahan, Iran
| | - Ataollah Ghahiri
- Department of Gynecology and Obstetrics, Al-Zahra university Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Dariush Shokri
- Infectious disease and tropical medicine research center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saba Jalalifar
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Hezar-Jerib Street, Isfahan, Iran
| | - Sharareh Moghim
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Hezar-Jerib Street, Isfahan, Iran
| | - Bahram Nasr Esfahani
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Hezar-Jerib Street, Isfahan, Iran.
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Schindler Y, Rahav G, Nissan I, Madar-Shapiro L, Abtibol J, Ravid M, Maor Y. Group B Streptococcus serotypes associated with different clinical syndromes: Asymptomatic carriage in pregnant women, intrauterine fetal death, and early onset disease in the newborn. PLoS One 2020; 15:e0244450. [PMID: 33382792 PMCID: PMC7774942 DOI: 10.1371/journal.pone.0244450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 12/09/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To study Group B Streptococcus (GBS) isolates associated with different clinical syndromes: asymptomatic carriage in pregnant women, intrauterine fetal death (IUFD), and early onset disease (EOD) in the newborn. METHODS GBS isolates were collected from asymptomatic pregnant women admitted for labor, IUFD cases, and neonates with EOD. Serotypes and antibiotic susceptibilities were determined. Multilocus sequence typing (MLST) was performed to assess genetic epidemiology. RESULTS GBS carriage rate was 26.1% (280/1074). The dominant serotype among asymptomatic pregnant women was VI [98/240 women (40.8%)], followed by serotypes III, V and IV in 42/240 (17.5%), 30/240 (12.5%) and 28/240 (11.7%) women, respectively. The dominant serotype in IUFD cases was serotype VI [10/13 (76.9%)]. In contrast the prevalent serotype among EOD cases was III [16/19 (84.2%)]. ST-1 was associated with IUFD [7/13 (53.8%)], ST-17 was associated with serotype III and EOD in the newborn 14/19 (73.7%)]. Erythromycin and clindamycin resistance reached 36.8%, 7.7% and 20.0%among EOD, vaginal carriage and IUFD, respectively. CONCLUSIONS Serotypes VI and ST-1 were dominant among asymptomatic pregnant women and in IUFD cases while EOD was associated with serotype III and ST-17. Invasive mechanisms thus may differ between IUFD and EOD in the newborn and virulence may be related to capsule serotype. Resistance rates to erythromycin and clindamycin were high in EOD cases.
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Affiliation(s)
- Yulia Schindler
- Microbiology laboratory, Maayaney Hayeshua, Bney Brak, Israel
- The Sackler School of medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Rahav
- The Sackler School of medicine, Tel Aviv University, Tel Aviv, Israel
- Infectious Disease Unit, Sheba Medical Center, Tel Hahomer, Israel
| | - Israel Nissan
- Infectious Disease Unit, Sheba Medical Center, Tel Hahomer, Israel
- Infectious Disease Unit, Wolfson Medical Center, Holon, Israel
| | | | - Julia Abtibol
- Microbiology laboratory, Maayaney Hayeshua, Bney Brak, Israel
| | - Moti Ravid
- Microbiology laboratory, Maayaney Hayeshua, Bney Brak, Israel
- The Sackler School of medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yasmin Maor
- The Sackler School of medicine, Tel Aviv University, Tel Aviv, Israel
- National Public Health Laboratory, Ministry of Health (Israel), Tel-Aviv, Israel
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20
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Capraro GA, Lala S, Khaled K, Gosciniak E, Saadat B, Alvarez SM, Kumar S, Calhoun T, Landry E, Caldito G, Bocchini JA, Vanchiere JA. Association of sexually-transmitted infection and African-American race with Streptococcus agalactiae colonization in pregnancy. Antimicrob Resist Infect Control 2020; 9:174. [PMID: 33148312 PMCID: PMC7640462 DOI: 10.1186/s13756-020-00827-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/15/2020] [Indexed: 01/30/2023] Open
Abstract
Background Group B Streptococcus (GBS) remains a significant cause of neonatal infection, but the maternal risk factors for GBS colonization remain poorly defined. We hypothesized that there may be an association between antibiotic exposure during pregnancy and GBS colonization and/or the presence of inducible clindamycin resistance (iCLI-R) in GBS isolates from GBS-colonized pregnant women.
Methods A retrospective cohort study was performed at Louisiana State University Health Sciences Center – Shreveport including demographic and clinical data from 1513 pregnant women who were screened for GBS between July 1, 2009 and December 31, 2010. Results Among 526 (34.8%) women who screened positive for GBS, 124 (23.6%) carried GBS strains with iCLI-R (GBS-iCLI-R). While antibiotic exposure, race, sexually-transmitted infection (STI) in pregnancy, GBS colonization in prior pregnancy and BMI were identified as risk factors for GBS colonization in univariate analyses, the only independent risk factors for GBS colonization were African–American race (AOR = 2.142; 95% CI = 2.092–3.861) and STI during pregnancy (AOR = 1.309; 95% CI = 1.035–1.653). Independent risk factors for GBS-iCLI-R among women colonized with GBS were non-African–American race (AOR = 2.13; 95% CI = 1.20–3.78) and younger age (AOR = 0.94; 95% CI = 0.91–0.98). Among GBS-colonized women with an STI in the current pregnancy, the only independent risk factor for iCLI-R was Chlamydia trachomatis infection (AOR = 4.31; 95% CI = 1.78–10.41). Conclusions This study identified novel associations for GBS colonization and colonization with GBS-iCLI-R. Prospective studies will improve our understanding of the epidemiology of GBS colonization during pregnancy and the role of antibiotic exposure in alterations of the maternal microbiome.
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Affiliation(s)
- Gerald A Capraro
- Department of Pediatrics, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway, #5-303, Shreveport, LA, 71130, USA.,Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Sajel Lala
- Department of Pediatrics, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway, #5-303, Shreveport, LA, 71130, USA
| | - Khaldia Khaled
- School of Medicine, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Elizabeth Gosciniak
- School of Medicine, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Brianna Saadat
- School of Medicine, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Sarah M Alvarez
- Department of Pediatrics, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway, #5-303, Shreveport, LA, 71130, USA
| | - Seema Kumar
- School of Medicine, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Tara Calhoun
- School of Medicine, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Edward Landry
- School of Medicine, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Gloria Caldito
- Department of Neurology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Joseph A Bocchini
- Department of Pediatrics, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway, #5-303, Shreveport, LA, 71130, USA
| | - John A Vanchiere
- Department of Pediatrics, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway, #5-303, Shreveport, LA, 71130, USA.
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21
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Mitsuboshi S, Date J, Tsuruma N, Yamaga H, Watanabe K, Kijima H, Nakashita M, Hosokawa H, Tsugita M. Does Quinolone- or Macrolide-Resistant Streptococcus agalactiae Bacteremia Affect Patient Outcome? A Multicenter Cohort Study. Jpn J Infect Dis 2020; 74:240-244. [PMID: 33132300 DOI: 10.7883/yoken.jjid.2020.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of quinolone- and macrolide-resistant Group B Streptococcus (GBS) is increasing worldwide, but the relationship between the resistance of GBS to these antibiotics and patient outcome remains unclear. Therefore, we evaluated whether blood stream infection caused by quinolone- or macrolide-resistant GBS is associated with high mortality. Our findings in 77 patients with GBS bacteremia demonstrate that quinolone and macrolide resistance may not be risk factors for 30-day mortality.
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Affiliation(s)
| | | | - Naoki Tsuruma
- Department of Pharmacy, Sado General Hospital, Japan
| | | | - Kazuya Watanabe
- Department of Pharmacy, Nagaoka Chuo General Hospital, Japan
| | | | | | | | - Masami Tsugita
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Sciences, Japan
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22
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Plainvert C, Anselem O, Joubrel C, Marcou V, Falloukh A, Frigo A, Magdoud El Alaoui F, Ancel PY, Jarreau PH, Mandelbrot L, Goffinet F, Poyart C, Tazi A. Persistence of group B Streptococcus vaginal colonization and prevalence of hypervirulent CC-17 clone correlate with the country of birth: a prospective 3-month follow-up cohort study. Eur J Clin Microbiol Infect Dis 2020; 40:133-140. [PMID: 32812077 DOI: 10.1007/s10096-020-04011-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/11/2020] [Indexed: 01/10/2023]
Abstract
To identify factors associated with vaginal colonization and persistence by group B Streptococcus (GBS) and by the hypervirulent neonatal CC-17 clone in late pregnancy and after delivery, a multicentre prospective observational cohort with 3-month follow-up was established in two university hospitals, Paris area, France. Pregnant women were recruited when antenatal screening for GBS vaginal colonization at 34-38 weeks of gestational age was positive. Vaginal samples were analysed by conventional culture methods at antenatal screening, delivery, and 21 and 60 days following delivery. Identification of the hypervirulent neonatal GBS CC-17 was performed. Colonization was defined as persistent when all vaginal samples were positive for GBS. A total of 754 women were included. GBS vaginal colonization was persistent in 63% of the cases (95% CI 59%-67%). Persistent colonization was more likely in women born in Sub-Saharan Africa compared with women born in France (OR = 1.88, 95% CI 1.05-3.52), and GBS CC-17 was overrepresented in women born in Sub-Saharan Africa (OR = 2.09, 95% CI 1.20-3.57). Women born in Sub-Saharan Africa are at higher risk for GBS vaginal persistence than women born in France. This observation correlates with an increased prevalence of the hypervirulent GBS CC-17 in the former group, which likely reflect variations linked to ethnicity and vaginal community-state types and might account for the increased susceptibility of black neonates to GBS infections.
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Affiliation(s)
- Céline Plainvert
- Department of Bacteriology, University Hospitals Paris Centre Cochin Port Royal, French National Reference Centre for Streptococci, AP-HP, Paris, France
- FHU Prema, Paris, France
| | - Olivia Anselem
- FHU Prema, Paris, France
- Department of Obstetrics and Gynaecology, Port-Royal Maternity, University Hospitals Paris Centre Cochin Port Royal, AP-HP, Paris, France
| | - Caroline Joubrel
- Department of Bacteriology, University Hospitals Paris Centre Cochin Port Royal, French National Reference Centre for Streptococci, AP-HP, Paris, France
- FHU Prema, Paris, France
| | - Valérie Marcou
- FHU Prema, Paris, France
- Department of Neonatal Medicine, University Hospitals Paris Centre Cochin Port Royal, AP-HP, Paris, France
| | - Amiel Falloukh
- Department of Neonatal Medicine, Louis Mourier Hospital, AP-HP, Colombes, France
| | - Amandine Frigo
- Department of Bacteriology, University Hospitals Paris Centre Cochin Port Royal, French National Reference Centre for Streptococci, AP-HP, Paris, France
- FHU Prema, Paris, France
| | - Fatma Magdoud El Alaoui
- Department of Microbiology, Louis Mourier Hospital, AP-HP, Colombes, France
- Université de Paris, Paris, France
| | - Pierre-Yves Ancel
- Université de Paris, Paris, France
- Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), INSERM UMR 1153, Paris, France
- URC-CIC P1419, University Hospitals Paris Centre Cochin Port Royal, AP-HP, Paris, France
| | - Pierre Henri Jarreau
- FHU Prema, Paris, France
- Department of Neonatal Medicine, University Hospitals Paris Centre Cochin Port Royal, AP-HP, Paris, France
- Université de Paris, Paris, France
| | - Laurent Mandelbrot
- FHU Prema, Paris, France
- Université de Paris, Paris, France
- Department of Obstetrics and Gynaecology, Louis Mourier Hospital, AP-HP, Colombes, France
| | - François Goffinet
- Department of Obstetrics and Gynaecology, Port-Royal Maternity, University Hospitals Paris Centre Cochin Port Royal, AP-HP, Paris, France
- Université de Paris, Paris, France
- Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), INSERM UMR 1153, Paris, France
| | - Claire Poyart
- Department of Bacteriology, University Hospitals Paris Centre Cochin Port Royal, French National Reference Centre for Streptococci, AP-HP, Paris, France
- FHU Prema, Paris, France
- Université de Paris, Paris, France
| | - Asmaa Tazi
- Department of Bacteriology, University Hospitals Paris Centre Cochin Port Royal, French National Reference Centre for Streptococci, AP-HP, Paris, France.
- FHU Prema, Paris, France.
- Université de Paris, Paris, France.
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23
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Antibiotic Resistance and Molecular Epidemiological Characteristics of Streptococcus agalactiae Isolated from Pregnant Women in Guangzhou, South China. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2020; 2020:1368942. [PMID: 32399123 PMCID: PMC7210523 DOI: 10.1155/2020/1368942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/16/2020] [Accepted: 03/07/2020] [Indexed: 11/17/2022]
Abstract
Streptococcus agalactiae colonization in pregnant women can cause postpartum intrauterine infections and life-threatening neonatal infections. To formulate strategies for the prevention and treatment of S. agalactiae infections, we performed a comprehensive analysis of antibiotic resistance and a molecular-based epidemiological investigation of S. agalactiae in this study. Seventy-two S. agalactiae strains, collected from pregnant women, were subjected to antibiotic susceptibility tests; then, the screened erythromycin and clindamycin nonsusceptible isolates were used for macrolides and clindamycin resistance genes detection, respectively. Detection of resistance genes, serotyping, and determination of virulence genes were performed by polymerase chain reaction. The clonal relationships among the colonized strains were evaluated by multilocus sequence typing. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) mass peak analysis was performed to discriminate the specific sequence types (STs). In our study, 69.4% and 47.2% of the strains were nonsusceptible to erythromycin and clindamycin, respectively; the multidrug resistance rate was 66.7%. All erythromycin nonsusceptible strains harbored resistance genes, whereas only 52.9% of the clindamycin nonsusceptible strains possessed the linB gene. Erythromycin resistance was mainly mediated by the ermB or mefA/E genes. Four serotypes were identified, and the most common serotype was serotype III (52.8%), followed by Ib (22.2%), Ia (18.0%), and II (4.2%). All the strains were divided into 18 STs that were assigned to nine clonal complexes. Most of the major STs were distributed into specific serotypes, including ST19/serotype III, ST17/serotype III, ST485/serotype Ia, ST862/serotype III, and ST651/serotype III. Analysis of virulence genes yielded seven clusters, of which bca-cfb-scpB-lmb (61.6%) was the predominant virulence gene cluster. Among all ST strains distributed in this region, only the ST17 strains had a mass peak at 7620 Da. The outcomes of this study are beneficial for the epidemiological comparison of colonized S. agalactiae in different regions and may be helpful for developing the strategies for the prevention of S. agalactiae infection in Guangzhou. Furthermore, our results show that MALDI-TOF MS can be used for the rapid identification of the ST17 strains.
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Hayes K, O'Halloran F, Cotter L. A review of antibiotic resistance in Group B Streptococcus: the story so far. Crit Rev Microbiol 2020; 46:253-269. [PMID: 32363979 DOI: 10.1080/1040841x.2020.1758626] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Group B Streptococcus (GBS) is the leading cause of neonatal disease worldwide, and invasive disease in adults is becoming more prevalent. Currently, some countries adopt an intrapartum antibiotic prophylaxis regime to help prevent the transmission of GBS from mother to neonate during delivery. This precaution has reduced the incidence of GBS-associated early-onset disease; however, rates of late-onset disease and stillbirths associated with GBS infections remain unchanged. GBS is still recognized as being universally susceptible to beta-lactam antibiotics; however, there have been reports of reduced susceptibility to beta-lactams, including penicillin, in some countries. Resistance to second-line antibiotics, such as erythromycin and clindamycin, remains high amongst GBS, with several countries noting increased resistance rates in recent years. Moreover, resistance to other antibiotic classes, such as fluoroquinolones and aminoglycosides, also continues to rise. In instances where patients are allergic to penicillin and second-line antibiotics are ineffective, vancomycin is administered. While vancomycin, a last resort antibiotic, still remains largely effective, there have been two documented cases of vancomycin resistance in GBS. This review provides a comprehensive analysis of the prevalence of antibiotic resistance in GBS and outlines the specific resistance mechanisms identified in GBS isolates to date.
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25
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Osei Sekyere J, Mensah E. Molecular epidemiology and mechanisms of antibiotic resistance in Enterococcus spp., Staphylococcus spp., and Streptococcus spp. in Africa: a systematic review from a One Health perspective. Ann N Y Acad Sci 2020; 1465:29-58. [PMID: 31647583 DOI: 10.1111/nyas.14254] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/04/2019] [Accepted: 09/17/2019] [Indexed: 12/19/2022]
Abstract
A systematic review of antibiotic-resistant Gram-positive bacteria in Africa from a One Health perspective is lacking. Here, we report result from a search for English-language articles on the resistance mechanisms and clonality of Gram-positive bacteria in Africa between 2007 and 2019 reported in PubMed, Web of Science, ScienceDirect, and African Journals OnLine; 172 studies from 22 different African countries were identified. Resistance genes, such as mecA, erm(B), erm(C), tet(M), tet(K), tet(L), vanB, vanA, vanC, and tet(O), were found to be common. Staphylococcus spp., Enterococcus spp., and Streptococcus spp. were the main species reported by the studies, with clones such as Staphylococcus aureus ST5 (n = 218 isolates), ST8 (n = 127 isolates), ST80 (n = 133 isolates), and ST88 (n = 117 isolates), and mobile genetic elements such as IS16 (n = 28 isolates), IS256 (n = 96), Tn916 (n = 107 isolates), and SCCmec (n = 4437 isolates) identified. SCCmec IV (n = 747 isolates) was predominant, followed by SCCmec III (n = 305 isolates), SCCmec II (n = 163 isolates), SCCmec V (n = 135 isolates), and SCCmec I (n = 79 isolates). Resistance to penicillin (n = 5926 isolates), tetracycline (n = 5300 isolates), erythromycin (n = 5151 isolates), rifampicin (n = 3823 isolates), gentamycin (n = 3494 isolates), sulfamethoxazole/trimethoprim (n = 3089 isolates), and ciprofloxacin (n = 2746 isolates) was common in most reports from 22 countries. Clonal dissemination of resistance across countries and between humans, animals, and the environment was observed. Resistance rates ranged from 1.4% to 100% for 15 of the studies; 10 were One Health-related studies. Strict infection control measures, antimicrobial stewardship, and periodic One Health epidemiological surveillance studies are needed to monitor and contain the threat of increasing antibiotic resistance in Africa.
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Affiliation(s)
- John Osei Sekyere
- Department of Medical Microbiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Eric Mensah
- Kumasi Centre for Collaborative Research in Tropical Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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26
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Marziali G, Foschi C, Parolin C, Vitali B, Marangoni A. In-vitro effect of vaginal lactobacilli against group B Streptococcus. Microb Pathog 2019; 136:103692. [PMID: 31445119 DOI: 10.1016/j.micpath.2019.103692] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/29/2019] [Accepted: 08/21/2019] [Indexed: 01/31/2023]
Abstract
Streptococcus agalactiae(GBS) is a leading cause of infection during pregnancy, preterm birth and neonatal infection, with a significant clinical and socio-economic impact. To prevent maternal GBS vaginal colonization, new antibiotic-free approaches, based on lactobacilli probiotics, are advisable. The aim of this study was to assess the anti-GBS activity of 14 vaginal Lactobacillus strains, belonging to different species (L. crispatus, L. gasseri, L. vaginalis), isolated from healthy pre-menopausal women. In particular, we performed 'inhibition' experiments, evaluating the ability of both Lactobacillus cells and culture supernatants in reducing Streptococcus viability, after 60 min contact time. First, we demonstrated that the acidic milieu, produced by vaginal lactobacilli metabolism, is crucial in counteracting GBS growth in a pH-dependent manner. Experiments with organic/inorganic acid solutions confirmed the strict correlation between pH levels and the anti-GBS activity. GBS was more sensitive to lactic acid than to hydrochloric acid, indicating that the presence of H+ ions is necessary but not sufficient for the inhibitory activity. Moreover, experiments with Lactobacillus pH-adjusted supernatants led to exclude a direct role in the anti-GBS activity by other bioactive molecules. Second, we found that only a few Lactobacillus strains were able to reduce Streptococcus viability by means of cell pellets. The anti-GBS effect displayed by Lactobacillus cells was related to the their ability to interact and aggregate with Streptococcus cells. We found that the anti-GBS activity was retained after methanol/proteinase K treatment, but lost after lysozyme exposure of Lactobacillus cells. Therefore, we supposed that non-proteinaceous components of Lactobacillus cell wall could be responsible for the anti-GBS activity. In conclusion, we identified specific Lactobacillus strains able to interfere with GBS viability by multiple strategies and we elucidated some of the mechanisms of action. These strains could serve as probiotic formulations for the prevention of GBS vaginal colonization.
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Affiliation(s)
- Giacomo Marziali
- Microbiology, DIMES, University of Bologna, Via Massarenti 9, Bologna, Italy
| | - Claudio Foschi
- Microbiology, DIMES, University of Bologna, Via Massarenti 9, Bologna, Italy.
| | - Carola Parolin
- Department of Pharmacy and Biotechnology, University of Bologna, Via San Donato 19/2, Bologna, Italy
| | - Beatrice Vitali
- Department of Pharmacy and Biotechnology, University of Bologna, Via San Donato 19/2, Bologna, Italy
| | - Antonella Marangoni
- Microbiology, DIMES, University of Bologna, Via Massarenti 9, Bologna, Italy
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Hayes K, Cotter L, O'Halloran F. In vitro synergistic activity of erythromycin and nisin against clinical Group B Streptococcus isolates. J Appl Microbiol 2019; 127:1381-1390. [PMID: 31342602 DOI: 10.1111/jam.14400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/04/2019] [Accepted: 07/18/2019] [Indexed: 12/12/2022]
Abstract
AIMS This study investigated the potential synergy between erythromycin and nisin against clinical Group B Streptococcus (GBS) strains. METHODS AND RESULTS The combination of erythromycin and nisin was examined for synergistic activity using checkerboard and time-kill assays against invasive and colonizing GBS strains. Additionally, the immunological effect of the antibiotic combination was investigated in vitro using human U937 cells and ELISA analysis. Checkerboard assays confirmed an additive effect when the antimicrobials were combined, while time-kill assays demonstrated a synergistic effect when antimicrobials were combined for invasive GBS isolates. Furthermore, a significantly lower TNF-alpha response (P < 0·05) was observed in U937 cells challenged with GBS when erythromycin and nisin were used in combination. CONCLUSIONS The results suggest that erythromycin and nisin can act synergistically to inhibit the growth of GBS. SIGNIFICANCE AND IMPACT OF THE STUDY Group B Streptococcus is the leading cause of invasive neonatal disease worldwide and is becoming increasingly more prevalent in adults. Resistance to some conventionally used antibiotics, such as erythromycin and clindamycin, continue to rise among GBS, indicating a need for alternative treatments. This study demonstrates the potential of an erythromycin-nisin combination for treatment of GBS infections and encourages further investigation of this treatment option.
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Affiliation(s)
- K Hayes
- Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland
| | - L Cotter
- Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland
| | - F O'Halloran
- Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland
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28
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Chen SL. Genomic Insights Into the Distribution and Evolution of Group B Streptococcus. Front Microbiol 2019; 10:1447. [PMID: 31316488 PMCID: PMC6611187 DOI: 10.3389/fmicb.2019.01447] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/11/2019] [Indexed: 01/31/2023] Open
Abstract
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a bacteria with truly protean biology. It infects a variety of hosts, among which the most commonly studied are humans, cattle, and fish. GBS holds a singular position in the history of bacterial genomics, as it was the substrate used to describe one of the first major conceptual advances of comparative genomics, the idea of the pan-genome. In this review, I describe a brief history of GBS and the major contributions of genomics to understanding its genome plasticity and evolution as well as its molecular epidemiology, focusing on the three hosts mentioned above. I also discuss one of the major recent paradigm shifts in our understanding of GBS evolution and disease burden: foodborne GBS can cause invasive infections in humans.
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Affiliation(s)
- Swaine L Chen
- Division of Infectious Diseases, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Infectious Diseases Group, Genome Institute of Singapore, Singapore, Singapore
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29
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Tavares GC, Pereira FL, Barony GM, Rezende CP, da Silva WM, de Souza GHMF, Verano-Braga T, de Carvalho Azevedo VA, Leal CAG, Figueiredo HCP. Delineation of the pan-proteome of fish-pathogenic Streptococcus agalactiae strains using a label-free shotgun approach. BMC Genomics 2019; 20:11. [PMID: 30616502 PMCID: PMC6323687 DOI: 10.1186/s12864-018-5423-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 12/27/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Streptococcus agalactiae (GBS) is a major pathogen of Nile tilapia, a global commodity of the aquaculture sector. The aims of this study were to evaluate protein expression in the main genotypes of GBS isolated from diseased fishes in Brazil using a label-free shotgun nano-liquid chromatography-ultra definition mass spectrometry (nanoLC-UDMSE) approach and to compare the differential abundance of proteins identified in strains isolated from GBS-infected fishes and humans. RESULTS A total of 1070 protein clusters were identified by nanoLC-UDMSE in 5 fish-adapted GBS strains belonging to sequence types ST-260 and ST-927 and the non-typeable (NT) lineage and 1 human GBS strain (ST-23). A total of 1065 protein clusters corresponded to the pan-proteome of fish-adapted GBS strains; 989 of these were identified in all fish-adapted GBS strains (core proteome), and 62 were shared by at least two strains (accessory proteome). Proteins involved in the stress response and in the regulation of gene expression, metabolism and virulence were detected, reflecting the adaptive ability of fish-adapted GBS strains in response to stressor factors that affect bacterial survival in the aquatic environment and bacterial survival and multiplication inside the host cell. Measurement of protein abundance among different hosts showed that 5 and 26 proteins were exclusively found in the human- and fish-adapted GBS strains, respectively; the proteins exclusively identified in fish isolates were mainly related to virulence factors. Furthermore, 215 and 269 proteins were up- and down-regulated, respectively, in the fish-adapted GBS strains in comparison to the human isolate. CONCLUSIONS Our study showed that the core proteome of fish-adapted GBS strains is conserved and demonstrated high similarity of the proteins expressed by fish-adapted strains to the proteome of the human GBS strain. This high degree of proteome conservation of different STs suggests that, a monovalent vaccine may be effective against these variants.
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Affiliation(s)
- Guilherme Campos Tavares
- AQUACEN - National Reference Laboratory of Aquatic Animal Diseases, Ministry of Agriculture, Livestock and Food Supply, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Felipe Luiz Pereira
- AQUACEN - National Reference Laboratory of Aquatic Animal Diseases, Ministry of Agriculture, Livestock and Food Supply, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Gustavo Morais Barony
- AQUACEN - National Reference Laboratory of Aquatic Animal Diseases, Ministry of Agriculture, Livestock and Food Supply, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cristiana Perdigão Rezende
- AQUACEN - National Reference Laboratory of Aquatic Animal Diseases, Ministry of Agriculture, Livestock and Food Supply, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Wanderson Marques da Silva
- Laboratory of Cellular and Molecular Genetics, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Thiago Verano-Braga
- Department of Physiology and Biophysics, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Vasco Ariston de Carvalho Azevedo
- Laboratory of Cellular and Molecular Genetics, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Augusto Gomes Leal
- AQUACEN - National Reference Laboratory of Aquatic Animal Diseases, Ministry of Agriculture, Livestock and Food Supply, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Henrique César Pereira Figueiredo
- AQUACEN - National Reference Laboratory of Aquatic Animal Diseases, Ministry of Agriculture, Livestock and Food Supply, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. .,School of Veterinary, Department of Preventive Veterinary Medicine, Federal University of Minas Gerais, Av. Antônio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, 30161-970, Brazil.
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Peyclit L, Chanteloup A, Hadjadj L, Rolain JM. Role of Institut Hospitalo-Universitaire Méditerranée Infection in the surveillance of resistance to antibiotics and training of students in the Mediterranean basin and in African countries. New Microbes New Infect 2018; 26:S52-S64. [PMID: 30402244 PMCID: PMC6205572 DOI: 10.1016/j.nmni.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Surveillance of antibiotic resistance has become a public global concern after the rapid worldwide dissemination of several antibiotic resistance genes. Here we report the role of the Institut Hospitalo-Universitaire Méditerranée Infection created in 2011 in the identification and description of multidrug-resistant bacteria thanks to collaborations and training of students from the Mediterranean basin and from African countries. Since the creation of the institute, 95 students and researchers have come from 19 different countries from these areas to characterize 6359 bacterial isolates from 7280 samples from humans (64%), animals (28%) and the environment (8%). Most bacterial isolates studied were Gram-negative bacteria (n = 5588; 87.9%), mostly from Algeria (n = 4190), Lebanon (n = 946), Greece (n = 610), Saudi Arabia (n = 299) and Senegal (n = 278). Antibiotic resistance was diversified with the detection and characterization of extended-spectrum β-lactamases, carbapenemases and resistance to colistin, vancomycin and methicillin. All those studies led to 97 indexed international scientific papers. Over the last 6 years, our institute has created a huge network of collaborations by training students that plays a major role in the surveillance of resistance to antibiotics in these countries.
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Affiliation(s)
| | | | | | - J.-M. Rolain
- Aix-Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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Wu CJ, Lai JF, Huang IW, Hsieh LY, Wang HY, Shiau YR, Lauderdale TL. Multiclonal emergence of levofloxacin-resistant group B Streptococcus, Taiwan. J Antimicrob Chemother 2018; 72:3263-3271. [PMID: 28961888 DOI: 10.1093/jac/dkx297] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/24/2017] [Indexed: 01/16/2023] Open
Abstract
Objectives This study investigated the trend in antimicrobial resistance among group B Streptococcus (GBS) from a national surveillance programme in Taiwan and delineated characteristics of and factors associated with levofloxacin-resistant isolates. Methods Clinical isolates of all sample types and patient groups were collected from multiple hospitals biennially between 2002 and 2012. Susceptibilities to different antibiotics were determined by broth microdilution. Molecular studies of levofloxacin-resistant isolates included serotyping, PFGE, mutations in the QRDRs and MLST. Results A total of 1559 isolates were tested and all remained susceptible to penicillin, cephalosporins, meropenem and vancomycin. However, levofloxacin resistance increased from 2.2% (range 0%-3.3%) in 2002-06 to 6.2% (5.9%-7.5%) in 2008-12 (P = 0.016). Among the 88 levofloxacin-resistant isolates, the majority (79.5%) had the GyrA(S81L)+ParC(S79F/Y) double mutations and most (54.5%) were also resistant to clindamycin, erythromycin and tetracycline. The predominant genotype of the levofloxacin-resistant isolates was ST19/serotype III (43.2%). Four previously unreported genotypes, ST1 and its single-locus variants (ST920 and ST922)/serotype VI (28.4%) and ST1/serotype II (18.2%), were found to have circulated locally. Serotype III isolates were predominately from urine and female genital tract specimens and <65-year-old adult outpatients, while serotype II and VI isolates were mostly from respiratory and urine samples and >65-year-old inpatients. Multivariate analysis revealed that elderly age and respiratory samples were independent factors associated with levofloxacin resistance. Conclusions Multiclonal emergence and dissemination of levofloxacin-resistant GBS isolates occurred in healthcare and community settings in Taiwan. Continuous molecular-level surveillance is important to detect new epidemic trends.
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Affiliation(s)
- Chi-Jung Wu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Fen Lai
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - I-Wen Huang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Li-Yun Hsieh
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Hui-Ying Wang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Yih-Ru Shiau
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Tsai-Ling Lauderdale
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
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Guo D, Cao X, Li S, Ou Q, Lin D, Yao Z, Chen S, Wu C, Wen G, Ye X. Neonatal colonization of group B Streptococcus in China: Prevalence, antimicrobial resistance, serotypes, and molecular characterization. Am J Infect Control 2018; 46:e19-e24. [PMID: 29305279 DOI: 10.1016/j.ajic.2017.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/28/2017] [Accepted: 10/28/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Group B Streptococcus (GBS) remains a leading cause of neonatal mortality and morbidity. This study aimed to determine the prevalence, antimicrobial susceptibility, serotypes, and molecular characterization of GBS colonized in neonates. METHODS A cross-sectional study was conducted using a multistage sampling method. Swabs for GBS identification were taken from infants' ear, oral cavity, and umbilicus immediately after birth. All GBS isolates were tested for antimicrobial susceptibility, resistance genes, serotyping, multilocus sequence typing, and virulence genes. RESULTS Of the 1,814 neonates, 1.3% tested positive for GBS, with 66.7% tested as multidrug resistant. All GBS isolates were susceptible to penicillin, but rates of resistance to tetracycline and erythromycin were high (70.8%), with the predominant resistance genes being tetM and ermB. The predominant serotype was III, followed by Ia and Ib, and the most common genotypes were sequence type (ST) 19, ST10, and ST485. Notably, we found that ST19 and ST17 isolates were associated with serotype III, resistant to tetracycline, erythromycin, and clindamycin, and carrying ermB, tetM, and rib; ST10 and ST12 isolates were associated with serotype Ib, resistant to erythromycin and clindamycin, and carrying ermB and alphaC; and ST485 isolates were associated with serotype Ia and carrying mefA/E, tetM, and epsilon. CONCLUSIONS These findings indicate a high prevalence of multidrug-resistant GBS and specific phenotype-genotype combinations for GBS clones.
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Hu Y, Kan Y, Zhang Z, Lu Z, Li Y, Leng C, Ji J, Song S, Shi H. New Mutations of Penicillin-Binding Proteins in Streptococcus agalactiae Isolates from Cattle with Decreased Susceptibility to Penicillin. Microb Drug Resist 2018; 24:1236-1241. [PMID: 29473792 DOI: 10.1089/mdr.2017.0223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Streptococcus agalactiae is a causal agent of bovine mastitis and is treated by β-lactam antibiotics (BLAs). Compared to penicillin-resistant S. agalactiae from humans, resistant strains in bovine are rarely reported. In this study, we aimed to investigate BLA resistance and mutations in penicillin-binding proteins (PBPs) of S. agalactiae in central and northeast China. The minimum inhibitory concentrations (MICs) of 129 penicillin-resistant S. agalactiae isolates from cows with mastitis were determined, and the related PBP genes were detected and sequenced. All strains were unsusceptible to penicillin G and mostly resistant to ampicillin, cefalexin, and ceftiofur sodium. One hundred twenty-nine strains were divided into 4 clonal groups and 8 sequence types by multilocus sequence typing analysis. We found a set of new substitutions in PBP1B, PBP2B, and PBP2X from most strains isolated from three provinces. The strains with high PBP mutations showed a broader unsusceptible spectrum and higher MICs than those with few or single mutation. Our research indicates unpredicted mutations in the PBP genes of S. agalactiae isolated from cows with mastitis treated by BLAs. This screening is the first of S. agalactiae from cattle.
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Affiliation(s)
- Yun Hu
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Yunchao Kan
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Zhengtian Zhang
- 2 School of Life Science and Technology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Zhanning Lu
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Yanqiu Li
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Chaoliang Leng
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Jun Ji
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
| | - Shiyang Song
- 3 Animal Husbandry and Fishery Department, Heilongjiang State 853 Farm , Shuangyashan, People's Republic of China
| | - Hongfei Shi
- 1 Henan Key Laboratory of Insect Biology in Funiu Mountain, Henan Provincial Engineering Laboratory of Insects Bio-Reactor, China-UK-NYNU-RRes Joint Laboratory of Insect Biology, Nanyang Normal University , Nanyang, People's Republic of China
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Wang X, Cao X, Li S, Ou Q, Lin D, Yao Z, Chen S, Wu C, Wen G, Ye X. Phenotypic and molecular characterization of Streptococcus agalactiae colonized in Chinese pregnant women: predominance of ST19/III and ST17/III. Res Microbiol 2018; 169:101-107. [PMID: 29378338 DOI: 10.1016/j.resmic.2017.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/10/2017] [Accepted: 12/14/2017] [Indexed: 11/24/2022]
Abstract
Streptococcus agalactiae (GBS) remains a major cause of invasive infections in neonates and pregnant women. Our aim was to evaluate the phenotypic and molecular characteristics of GBS isolates in order to reveal potential relationships among molecular characteristics and differences in genotype-phenotype characteristics between ST17 and ST19. A total of 104 GBS isolates were collected from pregnant women. All isolates were tested for antibiotic susceptibility by disk diffusion method and molecular characteristics, including antibiotic-resistant genes, virulence genes, serotypes and STs. The prevalence of GBS colonization in pregnant women was 4.9%. All isolates were susceptible to penicillin, but a high prevalence of resistance was observed for tetracycline (76.9%) and erythromycin (72.1%), with the predominant resistant genes being tet(M), tet(O), erm(B) and mef (A/E). The most frequent serotypes were III, Ia and V, and the predominant STs were ST19, ST17, ST12, ST10 and ST651. A potential correlation existed between STs, serotypes and alp genes, with ST19/III/rib and ST17/III/rib as the most prevalent clones. Notably, we observed significant differences in phenotypic and genotypic characteristics between ST17 [levofloxacin-susceptible and tet(O)-positive] and ST19 [levofloxacin-resistant and tet(O)-negative]. Our findings reveal a high prevalence of ST19/III and ST17/III and significant characteristic differences between them.
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Affiliation(s)
- Xiaolin Wang
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xuelian Cao
- Women Health Care, Maternal and Child Healthcare Hospital of Longhua District, Shenzhen, China
| | - Shunming Li
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qianting Ou
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Dongxin Lin
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhenjiang Yao
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Sidong Chen
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chuan'an Wu
- Women Health Care, Maternal and Child Healthcare Hospital of Longhua District, Shenzhen, China
| | - Guoming Wen
- Women Health Care, Maternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
| | - Xiaohua Ye
- Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
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Abstract
Group B Streptococcal isolates (n = 235) from the South of Ireland were characterised by serotyping, antimicrobial susceptibility and determination of the phenotypic and genotypic mechanisms of resistance. Resistance to erythromycin and clindamycin was observed in 21·3% and 20·4% of the total population, respectively. The c-MLSB phenotype was the most common phenotype detected (62%), with ermB being the predominant genetic determinant, present in 84% of resistant isolates. The rare L phenotype was observed in 2·9% (n = 7) of isolates, four of which harboured the lsaC gene responsible for clindamycin resistance. Serotypes Ia, III and II were the most common amongst the entire study population (28·1%, 24·7% and 14%, respectively). Four of the seven L phenotype isolates were serotype III and two of these strains were confirmed as the hypervirulent clone, ST-17 and harboured the hvgA gene. This is the first documented case of the L phenotype in Ireland to date and the study findings emphasise the need for continued monitoring of antibiotic resistance and serotype distribution in GBS isolates from Ireland.
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Large-scale genomic analyses reveal the population structure and evolutionary trends of Streptococcus agalactiae strains in Brazilian fish farms. Sci Rep 2017; 7:13538. [PMID: 29051505 PMCID: PMC5648781 DOI: 10.1038/s41598-017-13228-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/20/2017] [Indexed: 12/19/2022] Open
Abstract
Streptococcus agalactiae is a major pathogen and a hindrance on tilapia farming worldwide. The aims of this work were to analyze the genomic evolution of Brazilian strains of S. agalactiae and to establish spatial and temporal relations between strains isolated from different outbreaks of streptococcosis. A total of 39 strains were obtained from outbreaks and their whole genomes were sequenced and annotated for comparative analysis of multilocus sequence typing, genomic similarity and whole genome multilocus sequence typing (wgMLST). The Brazilian strains presented two sequence types, including a newly described ST, and a non-typeable lineage. The use of wgMLST could differentiate each strain in a single clone and was used to establish temporal and geographical correlations among strains. Bayesian phylogenomic analysis suggests that the studied Brazilian population was co-introduced in the country with their host, approximately 60 years ago. Brazilian strains of S. agalactiae were shown to be heterogeneous in their genome sequences and were distributed in different regions of the country according to their genotype, which allowed the use of wgMLST analysis to track each outbreak event individually.
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López Y, Parra E, Cepas V, Sanfeliú I, Juncosa T, Andreu A, Xercavins M, Pérez J, Sanz S, Vergara A, Bosch J, Soto SM. Serotype, virulence profile, antimicrobial resistance and macrolide-resistance determinants in Streptococcus agalactiae isolates in pregnant women and neonates in Catalonia, Spain. Enferm Infecc Microbiol Clin 2017; 36:472-477. [PMID: 29029763 DOI: 10.1016/j.eimc.2017.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/14/2017] [Accepted: 08/02/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Streptococcus agalactiae, or group B streptococci (GBS), is the main aetiological agent of early neonatal sepsis in developed countries. This microorganism belongs to the gastrointestinal tract microbiota wherefrom it can colonize the vagina and be vertically transmitted to the child either before or at birth, and subsequently cause infection in the newborn. Approximately, 50% of newborns born to women with GBS become colonized, with 1-2% developing early neonatal infection if no preventive intervention is performed. The aim of this study was to characterize and compare serotypes, virulence factors and antimicrobial resistance of GBS isolates collected from pregnant women and newborns in several hospitals in Catalonia. METHODS 242 GBS strains were analyzed including 95 colonizers and 68 pathogenic strains isolated from pregnant women, and 79 strains isolated from neonates with sepsis in order to determine serotype, virulence and antimicrobial resistance. RESULTS Serotype distribution was different among the three groups, with serotypes Ia and II being significantly more frequent among colonizing strains (p=0.001 and 0.012, respectively). Virulence factors bca and scpB were significantly more frequent among neonatal strains than pathogenic or colonizing strains (p=0.0001 and 0.002, respectively). Pathogenic strains were significantly more resistant to erythromycin, clindamycin and azithromycin than their non-pathogenic counterparts. CONCLUSIONS Taking into account that neonatal sepsis represents a significant problem on a global scale, epidemiological surveillance, antimicrobial resistance and GBS virulence at the local level could provide important knowledge about these microorganisms as well as help to improve treatment and prevent invasive infection caused by this microorganism.
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Affiliation(s)
- Yuly López
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
| | - Elena Parra
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Virginio Cepas
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | | | | | | | | | - Josefa Pérez
- CatLab, Hospital Mutua de Terrassa, Barcelona, Spain
| | - Sergi Sanz
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Andrea Vergara
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Department of Microbiology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Jordi Bosch
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Department of Microbiology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Sara Maria Soto
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
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Simoni S, Vincenzi C, Brenciani A, Morroni G, Bagnarelli P, Giovanetti E, Varaldo PE, Mingoia M. Molecular Characterization of Italian Isolates of Fluoroquinolone-Resistant Streptococcus agalactiae and Relationships with Chloramphenicol Resistance. Microb Drug Resist 2017; 24:225-231. [PMID: 28783417 DOI: 10.1089/mdr.2017.0139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A total number of 368 clinical isolates of Streptococcus agalactiae (group B Streptococcus, GBS) were collected in 2010-2016 from three hospitals in a region of central Italy. Fluoroquinolone (FQ)-resistant isolates were selected using levofloxacin. Levofloxacin-resistant (LR) strains (11/368, 2.99%) were characterized for several features, and their FQ resistance was analyzed phenotypically and genotypically using seven additional FQs. Their gyrA and parC quinolone resistance-determining regions were sequenced. Of the 11 LR isolates, 10 showed high-level and 1 low-level resistance. The former isolates exhibited higher minimal inhibitory concentrations also of the other FQs and all shared one amino acid substitution in ParC (Ser79Phe) and one in GyrA (Ser81Leu); only Ser79Phe in ParC was detected in the low-level LR isolate. The 11 LR strains exhibited distinctive relationships between their susceptibilities to non-FQ antibiotics and typing data. Remarkably, despite the very rare occurrence of chloramphenicol resistance in S. agalactiae, no <4 of the 11 LR isolates were chloramphenicol-resistant. Studies of GBS resistance to FQs in Europe remain scarce, notwithstanding the emergence of multidrug-resistant isolates. The incidence of LR GBS isolates is still limited in Italy, consistent with the moderate (though growing) rates reported in Europe, and much lower than the very high rates reported in East Asia. The intriguing relationships between FQ and chloramphenicol resistance deserve further investigation.
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Affiliation(s)
- Serena Simoni
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy
| | - Chiara Vincenzi
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy .,2 Clinical Microbiology Laboratory, Torrette Regional Hospital , Ancona, Italy
| | - Andrea Brenciani
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy
| | - Gianluca Morroni
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy
| | - Patrizia Bagnarelli
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy
| | - Eleonora Giovanetti
- 3 Department of Life and Environmental Sciences, Polytechnic University of Marche , Ancona, Italy
| | - Pietro E Varaldo
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy
| | - Marina Mingoia
- 1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School , Ancona, Italy
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Fyfe C, Grossman TH, Kerstein K, Sutcliffe J. Resistance to Macrolide Antibiotics in Public Health Pathogens. Cold Spring Harb Perspect Med 2016; 6:a025395. [PMID: 27527699 PMCID: PMC5046686 DOI: 10.1101/cshperspect.a025395] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Macrolide resistance mechanisms can be target-based with a change in a 23S ribosomal RNA (rRNA) residue or a mutation in ribosomal protein L4 or L22 affecting the ribosome's interaction with the antibiotic. Alternatively, mono- or dimethylation of A2058 in domain V of the 23S rRNA by an acquired rRNA methyltransferase, the product of an erm (erythromycin ribosome methylation) gene, can interfere with antibiotic binding. Acquired genes encoding efflux pumps, most predominantly mef(A) + msr(D) in pneumococci/streptococci and msr(A/B) in staphylococci, also mediate resistance. Drug-inactivating mechanisms include phosphorylation of the 2'-hydroxyl of the amino sugar found at position C5 by phosphotransferases and hydrolysis of the macrocyclic lactone by esterases. These acquired genes are regulated by either translation or transcription attenuation, largely because cells are less fit when these genes, especially the rRNA methyltransferases, are highly induced or constitutively expressed. The induction of gene expression is cleverly tied to the mechanism of action of macrolides, relying on antibiotic-bound ribosomes stalled at specific sequences of nascent polypeptides to promote transcription or translation of downstream sequences.
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Affiliation(s)
- Corey Fyfe
- Tetraphase Pharmaceuticals, Watertown, Massachusetts 02472
| | | | - Kathy Kerstein
- Tetraphase Pharmaceuticals, Watertown, Massachusetts 02472
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