Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Int J Mol Sci. 2023 Oct 20;24(20):15387. doi: 10.3390/ijms242015387.
(Group B , GBS) is an important pathogen of bacterial meningitis in neonates. We aimed to investigate the clinical and genetic characteristics of neonatal GBS meningitis. All neonates with GBS meningitis at a tertiary level medical center in Taiwan between 2003 and 2020 were analyzed. Capsule serotyping, multilocus sequence typing, antimicrobial resistance, and whole-genome sequencing (WGS) were performed on the GBS isolates. We identified 48 neonates with GBS meningitis and 140 neonates with GBS sepsis. Neonates with GBS meningitis had significantly more severe clinical symptoms; thirty-seven neonates (77.8%) had neurological complications; seven (14.6%) neonates died; and 17 (41.5%) survivors had neurological sequelae at discharge. The most common serotypes that caused meningitis in neonates were type III (68.8%), Ia (20.8%), and Ib (8.3%). Sequence type (ST) is highly correlated with serotypes, and ST17/III GBS accounted for more than half of GBS meningitis cases (56.3%, = 27), followed by ST19/Ia, ST23/Ia, and ST12/Ib. All GBS isolates were sensitive to ampicillin, but a high resistance rates of 72.3% and 70.7% to erythromycin and clindamycin, respectively, were noted in the cohort. The virulence and pilus genes varied greatly between different GBS serotypes. WGS analyses showed that the presence of PezT; BspC; and ICE was likely associated with the occurrence of meningitis and was documented in 60.4%, 77.1%, and 52.1% of the GBS isolates that caused neonatal meningitis. We concluded that GBS meningitis can cause serious morbidity in neonates. Further experimental models are warranted to investigate the clinical and genetic relevance of GBS meningitis. Specific GBS strains that likely cause meningitis requires further investigation and clinical attention.
(Group B, GBS) 是新生儿细菌性脑膜炎的重要病原体。我们旨在研究新生儿 GBS 脑膜炎的临床和遗传特征。对台湾一家三级医疗中心 2003 年至 2020 年间的所有 GBS 脑膜炎新生儿进行了分析。对 GBS 分离株进行了荚膜血清分型、多位点序列分型、抗菌药物耐药性和全基因组测序 (WGS)。我们鉴定了 48 例 GBS 脑膜炎新生儿和 140 例 GBS 败血症新生儿。GBS 脑膜炎新生儿的临床症状明显更严重；37 例 (77.8%) 新生儿有神经系统并发症；7 例 (14.6%) 新生儿死亡；17 例 (41.5%) 幸存者出院时有神经系统后遗症。导致新生儿脑膜炎的最常见血清型为 III 型 (68.8%)、Ia 型 (20.8%) 和 Ib 型 (8.3%)。序列型 (ST) 与血清型高度相关，ST17/III GBS 占 GBS 脑膜炎病例的一半以上 (56.3%， = 27)，其次是 ST19/Ia、ST23/Ia 和 ST12/Ib。所有 GBS 分离株均对氨苄西林敏感，但该队列中红霉素和克林霉素的耐药率分别高达 72.3%和 70.7%。不同 GBS 血清型的毒力和菌毛基因差异很大。WGS 分析表明，PezT；BspC；和 ICE 的存在可能与脑膜炎的发生有关，在引起新生儿脑膜炎的 60.4%、77.1%和 52.1%的 GBS 分离株中发现了这些基因。我们得出结论，GBS 脑膜炎可导致新生儿严重发病。需要进一步的实验模型来研究 GBS 脑膜炎的临床和遗传相关性。需要进一步研究和临床关注可能导致脑膜炎的特定 GBS 菌株。
