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Recurrent Group B Streptococcus Neonatal Invasive Infections, France, 2007-2021

Ghalia Sbaa1, Nicolas Delettre2, Cécile Guyonnet1,2,3

  • 1Service de Bactériologie, Centre National de Référence des Streptocoques, Assistance Publique-Hôpitaux de Paris Centre, Paris, France.

The Journal of Infectious Diseases
|June 6, 2024
PubMed

Insights

Recurrent group B Streptococcus (GBS) infections are rare in newborns, primarily affecting premature infants and linked to the hypervirulent CC17 strain. Further research is needed for optimal management strategies.

Area of Science:

  • Neonatal infectious diseases
  • Bacterial pathogenesis
  • Epidemiology

Background:

  • Group B Streptococcus (GBS) is a leading cause of neonatal infections.
  • Recurrence of GBS neonatal infections is a rare but serious complication.
  • Understanding risk factors for GBS recurrence is crucial for prevention and management.

Purpose of the Study:

  • To investigate the incidence and characteristics of recurrent GBS neonatal invasive infections.
  • To identify risk factors associated with GBS infection recurrence in neonates.
  • To explore potential microbiological features contributing to GBS recurrence.

Main Methods:

  • Retrospective observational study of GBS neonatal invasive infections in France (2007-2021).
  • Analysis of 1527 reported cases to identify recurrent infections.
  • Association analysis with infant characteristics (preterm, low birth weight) and bacterial factors (clonal complex, whole-genome sequencing).

Main Results:

  • 36 out of 1527 (2.36%) GBS neonatal infections were recurrent.
  • Recurrent cases predominantly involved preterm (68%) and low-birth-weight (72%) infants.
  • Recurrence was significantly associated with the hypervirulent GBS clonal complex 17 (83%; OR, 2.86).
  • No β-lactam-tolerant strains were detected, and whole-genome sequencing did not reveal specific recurrence-associated features.

Conclusions:

  • Recurrent GBS neonatal infections are rare, associated with prematurity, low birth weight, and the CC17 GBS strain.
  • Current microbiological analyses do not explain the mechanism of recurrence.
  • Large-cohort studies are recommended to determine optimal management for these uncommon GBS infections.
Keywords:
Streptococcus agalactiaegroup B Streptococcuslate-onset sepsisrecurrent neonatal infectionswhole-genome sequencing

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