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Multistate, population-based distributions of candidate vaccine targets, clonal complexes, and resistance features of invasive Group B Streptococci within the US: 2015–2017
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3-15-
Source: Clin Infect Dis. 72(6):1004-1013 -
Alternative Title:Clin Infect Dis
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Personal Author:
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Description:Background:
Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis and an important cause of invasive infections in pregnant and nonpregnant adults. Vaccines targeting capsule polysaccharides and common proteins are under development.
Methods:
Using whole genome sequencing (WGS), a validated bioinformatics pipeline, and targeted antimicrobial susceptibility testing, we characterized 6,340 invasive GBS isolates recovered during 2015–2017 through population-based Active Bacterial Core surveillance (ABCs) in eight states.
Results:
Six serotypes accounted for 98.4% of isolates (21.8% Ia, 17.6% V, 17.1% II, 15.6% III, 14.5% Ib, 11.8% IV). Most (> 98%) of these six serotypes were in seven clonal complexes (CCs) comprised of multilocus sequence types (MLSTs) identical or closely related to STs 1, 12, 17, 19, 22, 23, and 459. Fifty-four isolates (0.87%) had point mutations within pbp2x (31 different alleles) associated with reduced susceptibility to one or more β-lactam antibiotics. Genes conferring resistance to macrolides and/or lincosamides were found in 56% of isolates; 85.2% of isolates had tetracycline resistance genes. Two isolates carrying vanG were vancomycin-nonsusceptible (MIC 2μg/ml). Nearly all isolates possessed capsule genes, 1–2 of the three main pilus gene clusters (or islands), and one of four homologous Alpha/Rib family determinants. Presence of hvgA virulence gene was primarily restricted to serotype III/CC17 isolates (465 isolates), but 8 exceptions (7 IV/CC23 and 1 IV/CC17) were observed.
Conclusions:
This first comprehensive, population-based quantitation of strain features in the United States suggests current vaccine candidates should have good coverage. Beta-lactams remain appropriate for first line treatment and prophylaxis, but emergence of nonsusceptibility warrants ongoing monitoring.
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Pubmed ID:32060499
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Pubmed Central ID:PMC8071603
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