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Group B streptococcus neonatal invasive infections, France 2007-2012

C Joubrel1, A Tazi1, A Six2

  • 1Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', France; CNRS UMR 8104, France.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|June 10, 2015
PubMed

Insights

Late-onset disease (LOD) now accounts for most invasive group B Streptococcus (GBS) infections in newborns, despite intrapartum antibioprophylaxis. New prevention strategies are needed, particularly targeting the hypervirulent CC17 strain responsible for GBS meningitis.

Area of Science:

  • Neonatal infectious diseases
  • Bacteriology
  • Epidemiology

Background:

  • Group B Streptococcus (GBS) causes invasive neonatal infections, presenting as early-onset disease (EOD) or late-onset disease (LOD).
  • Intrapartum antibioprophylaxis (IAP) has reduced EOD incidence, but LOD rates remain unchanged.
  • LOD constitutes a significant proportion of GBS neonatal infections in industrialized nations.

Purpose of the Study:

  • To analyze the clinical and bacteriological characteristics of 438 GBS neonatal invasive infections in France (2007-2012).
  • To identify risk factors and prevalent strains associated with EOD and LOD.
  • To inform the development of novel prevention strategies for GBS neonatal infections.

Main Methods:

  • Retrospective analysis of GBS isolates from neonatal invasive infections reported to the French National Reference Centre for Streptococci.
  • Clinical data collected from hospitalization reports and questionnaires.
  • Characterization of isolates included capsular type, clonal complex (CC17) assignment, and antibiotic susceptibility.

Main Results:

  • LOD accounted for 60.3% of cases, while EOD represented 39.7%.
  • LOD was predominantly associated with meningitis (55%), and EOD with bacteremia (61%).
  • Capsular polysaccharide (CPS) III and CC17 were significantly associated with LOD, particularly GBS meningitis.

Conclusions:

  • LOD is the predominant form of GBS neonatal disease in France, even with IAP.
  • The hypervirulent CC17 strain, especially CPS III, is a key target for new prevention strategies.
  • Low gestational age and low birthweight are critical risk factors for adverse outcomes in neonatal GBS infections.

Keywords:
Capsular serotypeStreptococcus agalactiaegroup B streptococcushypervirulent CC17meningitisneonatal infectionsrisk factors

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