Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Department of Clinical Microbiology, Landspitali University Hospital, Reykjavik, Iceland.
J Med Microbiol. 2021 Sep;70(9). doi: 10.1099/jmm.0.001426.
Group B streptococcus (GBS) is a leading cause of invasive neonatal infections. These have been divided into early-onset disease (EOD; <7 days) and late-onset disease (LOD; 7-89 days), with different GBS clonal complexes (CCs) associated with different disease presentations. Different GBS CCs are associated with timing of infection (EOD or LOD) and clinical presentation (sepsis, meningitis or pneumonia). To study infant GBS infections in Iceland from 1975 to 2019. Are specific GBS CCs related to disease presentation? Is CC17 overrepresented in infant GBS infections in Iceland? All culture-confirmed invasive GBS infections in infants (<90 days) in Iceland from 1975 to 2019 were included. Clinical information was gathered from medical records. A total of 127 invasive GBS infections in infants were diagnosed, but 105 infants were included in the study. Of these, 56 had EOD and 49 had LOD. The incidence of GBS infections declined from 2000 onwards but increased again at the end of the study period. Furthermore, there was a significant increase in LOD over the study period (0.0001). The most common presenting symptoms were respiratory difficulties and fever and the most common presentation was sepsis alone. Approximately one-third of the cases were caused by GBS CC17 of serotype III with surface protein RIB and pili PI-1+PI-2b or PI-2b. CC17 was significantly associated with LOD (<0.001). CC17 is a major cause of GBS infection in infants in Iceland. This clone is associated with LOD, which has been increasing in incidence. Because intrapartum antibiotic prophylaxis only prevents EOD, it is important to continue the development of a GBS vaccine in order to prevent LOD infections.
B 组链球菌（GBS）是导致新生儿侵袭性感染的主要原因。这些感染可分为早发型疾病（EOD；<7 天）和晚发型疾病（LOD；7-89 天），不同的 GBS 克隆复合体（CC）与不同的疾病表现相关。不同的 GBS CC 与感染时间（EOD 或 LOD）和临床表现（败血症、脑膜炎或肺炎）相关。研究 1975 年至 2019 年冰岛婴儿 GBS 感染情况。特定的 GBS CC 是否与疾病表现相关？冰岛婴儿 GBS 感染中 CC17 是否过度表达？本研究纳入了 1975 年至 2019 年冰岛所有经培养证实的<90 天婴儿侵袭性 GBS 感染。从病历中收集临床信息。共诊断出 127 例婴儿侵袭性 GBS 感染，但有 105 例婴儿纳入研究。其中 56 例为 EOD，49 例为 LOD。GBS 感染的发病率从 2000 年开始下降，但在研究期末再次上升。此外，LOD 在研究期间显著增加（0.0001）。最常见的表现症状为呼吸困难和发热，最常见的表现为单纯败血症。约三分之一的病例由 III 型血清型 GBS CC17 引起，表面蛋白 RIB 和纤毛 PI-1+PI-2b 或 PI-2b。CC17 与 LOD 显著相关（<0.001）。CC17 是冰岛婴儿 GBS 感染的主要原因。该克隆与发病率不断增加的 LOD 相关。由于产时抗生素预防仅能预防 EOD，因此重要的是继续开发 GBS 疫苗以预防 LOD 感染。
