Characterization of invasive Group B Streptococcus isolates from Western Australian infants, 2004-2020

Hilpipre, G; Furfaro, LL; Porter, M; Blyth, CC; Yeoh, DK

Author(s): Hilpipre, G; Furfaro, LL; Porter, M; Blyth, CC; Yeoh, DK;
Journal Title: Journal of Medical Microbiology
Publication Type: Research article
Abstract: Background. Invasive Group B Streptococcus (GBS; Streptococcus agalactiae) remains a leading cause of infant morbidity and mortality. Intrapartum antibiotic prophylaxis (IAP) has been implemented in many countries with a reduction in early-onset disease, but an effective vaccine may further reduce the disease burden. Candidate vaccines targeting capsular polysaccharides and surface proteins are now in clinical trials.Methods. Using whole-genome sequencing and phenotypic antimicrobial susceptibility testing, we characterized sterile-site GBS isolates recovered from Western Australian infants between 2004 and 2020. Characteristics were compared between three time periods: 2004-2008, 2009-2015 and 2016-2020.Results. A total of 135 isolates were identified. The proportion of serotype III (22.7 % in Period 1 to 47.9 % in Period 3, P=0.04) and clonal complex 17 (13.6-39.6 %, P=0.01) isolates increased over time. Overall coverage of vaccines currently being trialled was >95 %. No isolates were penicillin resistant (MIC>0.25 mg l(-1)), but 21.5 % of isolates had reduced penicillin susceptibility (MIC>0.12 mg l(-1)) and penicillin MIC increased significantly over time (P=0.04). Clindamycin resistance increased over time to 45.8 % in the latest period.Conclusions. Based on comprehensive characterization of invasive infant GBS in Western Australia, we found that coverage for leading capsular polysaccharide and surface protein vaccine candidates was high. The demonstrated changes in serotype and molecular type highlight the need for ongoing surveillance, particularly with regard to future GBS vaccination programmes. The reduced susceptibility to IAP agents over time should inform changes to antibiotic guidelines.
Publisher: Microbiology Society
Keywords: Infant; Humans; Streptococcus agalactiae; *Streptococcal Infections/drug therapy; Western Australia/epidemiology; Australia/epidemiology; Anti-Bacterial Agents/pharmacology/therapeutic use; Penicillins; Serogroup; *Vaccines/therapeutic use; Microbial Sensitivity Tests; Drug Resistance, Bacterial; Gbs; Group B Streptococcus; capsular serotypes; multi-locus sequence types; resistance; surface proteins; vaccine
Department(s): Laboratory Research
Publisher's Version: https://doi.org/10.1099/jmm.0.001822
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-07-09 08:01:44

Last Modified: 2024-07-09 08:03:53