Invasive Group B Streptococcus Disease With Recurrence and in Multiples: Towards a Better Understanding of GBS Late-Onset Sepsis

被引：22

作者：

Freudenhammer, Mirjam ^{[1
,2
,3
]}

Karampatsas, Konstantinos ^{[4
]}

Le Doare, Kirsty ^{[4
]}

Lander, Fabian ^{[5
,6
]}

Armann, Jakob ^{[5
,6
]}

Acero Moreno, Daniel ^{[7
]}

Boyle, Margaret ^{[8
]}

Buxmann, Horst ^{[9
]}

Campbell, Ruth ^{[10
]}

Chalker, Victoria ^{[11
]}

Cunney, Robert ^{[12
,13
]}

Doherty, Lorraine ^{[10
]}

Davies, Eleri ^{[14
]}

Efstratiou, Androulla ^{[15
]}

Elling, Roland ^{[1
,2
]}

Endmann, Matthias ^{[16
]}

Essers, Jochen ^{[17
]}

Hentschel, Roland ^{[2
]}

Jones, Christine E. ^{[18
,19
,20
,21
]}

Kallsen, Steffen ^{[22
]}

Kapatai, Georgia ^{[11
]}

Kruger, Marcus ^{[23
]}

Ladhani, Shamez ^{[4
,24
]}

Lamagni, Theresa ^{[15
]}

Lindsay, Diane ^{[25
]}

Meehan, Mary ^{[13
]}

O'Sullivan, Catherine P. ^{[4
]}

Patel, Darshana ^{[1
,4
]}

Reynolds, Arlene J. ^{[26
]}

Roll, Claudia ^{[27
]}

Schulzke, Sven ^{[28
]}

Smith, Andrew ^{[25
,29
]}

Stein, Anja ^{[30
]}

von der Wense, Axel ^{[31
]}

Voss, Egbert ^{[32
]}

Wieg, Christian ^{[33
]}

Hartel, Christoph ^{[34
,35
]}

Heath, Paul T. ^{[4
]}

Henneke, Philipp ^{[1
,2
,35
]}

机构：

[1] Univ Freiburg, Inst Immunodeficiency, Ctr Chron Immunodeficiency, Med Ctr, Freiburg, Germany

[2] Univ Freiburg, Ctr Pediat & Adolescent Med, Med Ctr, Fac Med, Freiburg, Germany

[3] Univ Freiburg, IMM PACT Clinician Scientist Programme, Fac Med, Freiburg, Germany

[4] St Georges Univ London, Inst Infect & Immun, Paediat Infect Dis Res Grp, London, England

[5] Tech Univ TU Dresden, Univ Hosp, Dept Pediat, Dresden, Germany

[6] Tech Univ TU Dresden, Med Fac Carl Gustav Carus, Dresden, Germany

[7] Kinderkrankenhaus Amsterdamer Str, Dept Neonatol, Cologne, Germany

[8] Dept Hlth Northern Ireland, Belfast, Antrim, North Ireland

[9] Univ Hosp Frankfurt, Dept Pediat & Adolescent Med, Div Neonatol, Frankfurt, Germany

[10] Publ Hlth Agcy Northern Ireland, Belfast, Antrim, North Ireland

[11] Publ Hlth England, Immunisat Hepatitis & Blood Safety Dept, London, England

[12] Hlth Protect Surveillance Ctr, Hlth Serv Execut, Dublin, Ireland

[13] Temple St Childrens Univ Hosp, Irish Meningitis & Sepsis Reference Lab, Dublin, Ireland

[14] Publ Hlth Wales, Cardiff, Wales

[15] Publ Hlth England, Natl Infect Serv, London, England

[16] St Franziskus Hosp Ahlen, Dept Pediat & Adolescent Med, Ahlen, Germany

[17] Univ Ulm, Dept Pediat, Ulm, Germany

[18] Univ Southampton, Fac Med, Southampton, Hants, England

[19] Univ Southampton, Inst Life Sci, Southampton, Hants, England

[20] Univ Hosp Southampton NHS Fdn Trust, NIHR Southampton Clin Res Facil, Southampton, Hants, England

[21] Univ Hosp Southampton NHS Fdn Trust, NIHR Southampton Biomed Res Ctr, Southampton, Hants, England

[22] Klinikum Friedrichshafen, Dept Paediat & Youth Med, Friedrichshafen, Germany

[23] Munchen Klin Harlaching & Schwabing, Dept Neonatol, Munich, Germany

[24] Publ Hlth England, Immunisat & Countermeasures Div, London, England

[25] Glasgow Royal Infirm, Scottish Microbiol Reference Lab, Glasgow, Lanark, Scotland

[26] Hlth Protect Scotland, Glasgow, Lanark, Scotland

[27] Univ Witten Herdecke, Vest Childrens Hosp Datteln, Dept Neonatol, Witten, Germany

[28] Univ Childrens Hosp Basel UKBB, Dept Neonatol, Basel, Switzerland

[29] Univ Glasgow, Glasgow Dent Hosp & Sch, Glasgow, Lanark, Scotland

[30] Univ Duisburg Essen, Univ Hosp Essen, Dept Pediat, Essen, Germany

[31] Altonaer Childrens Hosp, Neonatol & Pediat Intens Care, Altonaer Kinderkrankenhaus, Hamburg, Germany

[32] Cnopfsche Kinderklin, Klin Hallerwiese, Nurnberg, Germany

[33] Klinikum Aschaffenburg, Dept Neonatol, Aschaffenburg, Germany

[34] Univ Wurzburg, Dept Pediat, Wurzburg, Germany

[35] PRIMAL Priming Immun Beginning Life Consortium, Freiburg, Germany

来源：

FRONTIERS IN IMMUNOLOGY | 2021年 / 12卷

关键词：

group B Streptococcus; late-onset sepsis; microbiome; multiples; recurrence; GUT MICROBIOME; COLONIZATION; INTRAPARTUM; INFANTS; ANTIBIOTICS; PROPHYLAXIS; RESISTANCE; FAILURE; PRETERM;

D O I：

10.3389/fimmu.2021.617925

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Group B Streptococcus (GBS) is a common intestinal colonizer during the neonatal period, but also may cause late-onset sepsis or meningitis in up to 0.5% of otherwise healthy colonized infants after day 3 of life. Transmission routes and risk factors of this late-onset form of invasive GBS disease (iGBS) are not fully understood. Cases of iGBS with recurrence (n=25) and those occurring in parallel in twins/triplets (n=32) from the UK and Ireland (national surveillance study 2014/15) and from Germany and Switzerland (retrospective case collection) were analyzed to unravel shared (in affected multiples) or fixed (in recurrent disease) risk factors for GBS disease. The risk of iGBS among infants from multiple births was high (17%), if one infant had already developed GBS disease. The interval of onset of iGBS between siblings was 4.5 days and in recurrent cases 12.5 days. Disturbances of the individual microbiome, including persistence of infectious foci are suggested e.g. by high usage of perinatal antibiotics in mothers of affected multiples, and by the association of an increased risk of recurrence with a short term of antibiotics [aOR 4.2 (1.3-14.2), P=0.02]. Identical GBS serotypes in both recurrent infections and concurrently infected multiples might indicate a failed microbiome integration of GBS strains that are generally regarded as commensals in healthy infants. The dynamics of recurrent GBS infections or concurrent infections in multiples suggest individual patterns of exposure and fluctuations in host immunity, causing failure of natural niche occupation.

引用

页数：12

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