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Updated: Oct 24, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Clinical and bacterial features of Group B streptococci with reduced penicillin susceptibility from respiratory
Naoya Nishiyama1, Takeshi Kinjo2, Kohei Uechi3,4
1Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
Abstract:
Streptococcus agalactiae (Group B Streptococcus, GBS) is an invasive pathogen that causes sepsis and meningitis among infants, elderly adults, and immunosuppressed patients. Generally, GBS is susceptible to penicillin; however, GBS with reduced penicillin susceptibility (PRGBS) has been reported. PRGBS are commonly isolated from respiratory specimens, but clinical features of patients with PRGBS remain unclear. In this case-control study, clinical features of patients with PRGBS and bacterial characteristics of these isolates from respiratory specimens were investigated. Patients with GBS at the University of the Ryukyus Hospital between January 2017 and June 2018 were retrospectively investigated. GBS were further classified into penicillin-susceptible GBS (PSGBS) and PRGBS using a drug susceptibility test. Moreover, serotypes, genotypes, and drug resistance genes of PRGBS isolates were determined. In total, 362 GBS were isolated, of which 46 were collected from respiratory specimens, which had the highest rate of PRGBS (24%). Compared to patients with PSGBS, those with PRGBS were more likely to have neuromuscular disease, poor performance status, risk of multidrug-resistant pathogen infection, prior pneumonia history within 1 year, and prior penicillin use within 1 year. Among eight PRGBS isolates, multilocus sequence typing revealed that five isolates were sequence type (ST) 358, two were ST3 and ST10, respectively, and one isolate was ST1404. All PRGBS isolates belonged to the ST1/ST19/ST10 group. This study reveals clinical characteristics of patients with PRGBS from respiratory specimens. Because invasive GBS infection cases are increasing, especially in the elderly, more attention should be paid to this infection.
Insights
Penicillin-resistant Streptococcus agalactiae (GBS) infections are increasing, particularly in the elderly. Patients with PRGBS respiratory infections often have underlying conditions and prior penicillin use, requiring increased clinical attention.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Streptococcus agalactiae (Group B Streptococcus, GBS) is a significant cause of invasive infections like sepsis and meningitis.
- While generally penicillin-susceptible, penicillin-reduced susceptibility GBS (PRGBS) has emerged, particularly in respiratory samples.
- Clinical characteristics of patients with PRGBS remain poorly understood.
Purpose of the Study:
- To investigate the clinical features of patients with PRGBS isolated from respiratory specimens.
- To characterize the bacterial properties of PRGBS isolates.
Main Methods:
- A retrospective case-control study was conducted at the University of the Ryukyus Hospital.
- GBS isolates from January 2017 to June 2018 were classified as penicillin-susceptible (PSGBS) or PRGBS via drug susceptibility testing.
- PRGBS isolates underwent serotyping, genotyping, and drug resistance gene analysis.
Main Results:
- Of 362 GBS isolates, 46 were from respiratory specimens, showing the highest PRGBS rate (24%).
- Patients with PRGBS were more likely to have neuromuscular disease, poor performance status, risk of multidrug-resistant pathogen infection, recent pneumonia, and prior penicillin use compared to PSGBS patients.
- Multilocus sequence typing of eight PRGBS isolates identified ST358 as predominant, with all belonging to the ST1/ST19/ST10 group.
Conclusions:
- This study highlights distinct clinical characteristics associated with PRGBS respiratory infections.
- The increasing incidence of invasive GBS infections, especially in the elderly, necessitates greater awareness and attention to PRGBS.
- Understanding PRGBS patient profiles and bacterial traits is crucial for effective management.
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