Invasive Group B Streptococcus Disease With Recurrence and in Multiples: Towards a Better Understanding of GBS...

Area of Science:

• Neonatal Medicine
• Infectious Diseases
• Microbiology

Background:

• Group B Streptococcus (GBS) commonly colonizes the gut in newborns.
• While often asymptomatic, GBS can lead to late-onset invasive GBS disease (iGBS), including sepsis or meningitis, in a small percentage of infants.
• The transmission routes and specific risk factors for iGBS, particularly in recurrent cases and multiple births, remain incompletely understood.

Purpose of the Study:

• To investigate shared and fixed risk factors for invasive Group B Streptococcus disease (iGBS).
• To analyze cases of recurrent iGBS and iGBS occurring in twins/triplets to understand disease dynamics and contributing factors.

Main Methods:

• Analysis of iGBS cases with recurrence (n=25) and in twins/triplets (n=32).
• Data sourced from a UK/Ireland national surveillance study (2014/15) and a retrospective case collection from Germany and Switzerland.
• Statistical analysis to identify risk factors and disease onset intervals.

Main Results:

• Infants from multiple births faced a high risk (17%) of iGBS if a sibling was already affected.
• The onset interval for iGBS between siblings was 4.5 days, and for recurrent cases, it was 12.5 days.
• Increased risk of recurrence was associated with short-term antibiotic use (aOR 4.2, P=0.02), suggesting microbiome disruption.

Conclusions:

• High iGBS risk in multiples and recurrent cases points to disturbed individual microbiomes and potential failures in GBS strain integration.
• Identical GBS serotypes in recurrent/multiple infections suggest a common source or failed colonization resistance.
• Fluctuations in host immunity and individual exposure patterns likely contribute to the failure of natural niche occupation by GBS.