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The Influence of Maternal Staphylococcus aureus Anti-Hla Neutralizing Antibody on Infant Skin and Soft Tissue
Carol M Kao1, Kristine M Wylie1, Mary G Boyle1
1Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States.
Insights
Maternal antibodies against Staphylococcus aureus, specifically anti-alpha-toxin (Hla) neutralizing antibodies (NAb), protect infants from skin and soft tissue infections (SSTI). Early infant S. aureus colonization is common, highlighting the need for early life interventions.
Area of Science:
- Immunology
- Neonatal Health
- Infectious Diseases
Background:
- Staphylococcus aureus is a leading cause of infection-related mortality.
- Prior immune responses may hinder vaccine efficacy, suggesting early-life vaccination.
- Understanding maternal immunity's role in infant protection is crucial.
Purpose of the Study:
- To correlate maternal anti-S. aureus serologic response with infant risk of skin and soft tissue infection (SSTI).
- To assess infant S. aureus colonization and SSTI incidence in the first year of life.
- To investigate the protective role of maternal antibodies against S. aureus.
Main Methods:
- Pilot study involving pregnant women and their infants over 12 months.
- Measurement of maternal and cord blood anti-S. aureus IgG and anti-alpha-toxin (Hla) neutralizing antibody (NAb) titers.
- Longitudinal tracking of infant S. aureus colonization and SSTI incidence via surveys and skin swabs.
Main Results:
- Early infant S. aureus colonization was observed in 23% at birth and 43% by 1 month.
- Maternal S. aureus colonization increased infant colonization odds by 7.4 times.
- Higher cord blood anti-Hla NAb titers correlated with significantly reduced infant SSTI risk.
Conclusions:
- S. aureus colonization is prevalent in early infancy.
- Transplacental transfer of anti-Hla NAb is associated with protection against infant SSTI.
- Alpha-toxin (Hla) is a promising target for early-life S. aureus vaccines.
Background:
Staphylococcus aureus is the leading cause of infectious-related deaths. Vaccine development has been hampered by the recall of nonprotective immune responses from prior exposure, suggesting an effective vaccine may need to be given early in life. The goal of this pilot study was to correlate the maternal serologic response against S. aureus to an infant's risk for skin and soft tissue infection (SSTI) and colonization in the first year of life.
Methods:
Pregnant women were enrolled and maternal-infant dyads followed for 12 months. Maternal third trimester and cord blood were obtained to determine the anti-S. aureus IgG and anti-α-toxin (Hla) neutralizing antibody (NAb) titers. Serial surveys and skin swabs were obtained from mothers at enrollment and from infants longitudinally to ascertain S. aureus colonization status and the incidence of SSTI.
Results:
Sixty-three pregnant women were enrolled, 54% with history of SSTI or asymptomatic S. aureus colonization at enrollment. Within 48-h of delivery, 23% of infants had S. aureus colonization and 43% at 1-month. Maternal S. aureus colonization resulted in 7.4 increased odds of infant colonization at delivery. Higher cord blood anti-Hla Nab titer was associated with significantly lower risk for infant SSTI in the first year of life.
Conclusions:
S. aureus colonization occurs early in life, with over 40% of infants colonized by 1-month. These results are the first to demonstrate an association between higher transplacental anti-Hla NAb and protection against infant SSTI in the first year of life. Overall, these findings support Hla as a promising vaccine target.
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