Molecular characterization, antimicrobial resistance and invasion of epithelial cells by Streptococcus agalactiae strains isolated from colonized pregnant women and newborns in Rio de Janeiro, Brazil.

AIMS: To evaluate the prevalence, molecular characteristics, antimicrobial susceptibility, and epithelial invasion of Streptococcus agalactiae strains isolated from pregnant women and newborns in Rio de Janeiro, Brazil. METHODS AND RESULTS: A total of 67 S. agalactiae isolates, 48 isolates from pregnant women and 19 from neonates, were analyzed. Capsular type Ia and V were predominant (35.8%/each). The multilocus sequence typing analysis revealed the presence of 19 STs grouped into 6 clonal complexes with prevalence of CC17/40.3% and CC23/34.3%. The lmb and iag virulence genes were found in 100% of isolates. Four S. agalactiae strains, belonging to CC17/ST1249 and CC23/ST23, were able to adhere to A549 respiratory epithelial cells. Antimicrobial resistance was verified mainly to tetracycline (85%), erythromycin (70.8%), and clindamycin (58.3%). Four S. agalactiae isolates were multidrug resistant. The resistance genes tested were found in 92.5% of isolates for tetM, 58.2% for ermB, 28.4% for mefAE, and 10.4% for tetO. CONCLUSION: The study showed a high prevalence of virulence and antimicrobial genes in S. agalactiae strains isolated from pregnant women and newborns, supporting the idea that continued surveillance is necessary to identify risk factors and perform long-term follow-up in pregnant women and neonates in Rio de Janeiro.

Group B Streptococcus Sequence Type 103 as Human and Bovine Pathogen, Brazil.

Group B Streptococcus sequence type 103 is known primarily as a bovine mastitis pathogen. In Brazil, it has circulated in cattle and humans since the 1990s. It lacks scpB and, in humans, was found only among carriage isolates. Bovine-human interspecies transmission may have contributed to its evolution and spread.

Detection of Hanseniaspora opuntiae in anovaginal samples of pregnant women in Rio de Janeiro, Brazil-a case report.

In this study, we report the first isolation of Hanseniaspora opuntiae obtained from four pregnant women in Brazil. Clinical isolates were obtained from four samples taken between 35 and 37 gestational weeks, as part of the routine antenatal care for maternal colonization screening for Streptococcus agalactiae group B. The patients were immunocompetent, with two of them diagnosed with gestational diabetes mellitus. Species identification was performed by MALDI-TOF MS and rDNA sequencing. While Hanseniaspora species have not traditionally been considered a typical opportunist pathogen, our findings emphasize the importance of investigating and screening for Hanseniaspora in pregnant populations, highlighting H. opuntiae as a potential agent of human infections.

Macrolide resistance among Streptococcus agalactiae during COVID-19 public health emergency in Brazil.

During COVID-19 public health emergence, azithromycin was excessively used in Brazil, as part of a controversial "early treatment", recommended by former national health authorities. Excessive usage of macrolides may increase resistance rates among beta-hemolytic streptococci. Therefore, this study aimed to investigate the occurrence of resistance to erythromycin and clindamycin among Streptococcus agalactiae recovered from February 2020 to May 2023. Bacterial isolates (n = 116) were obtained from pregnant women and submitted to antimicrobial susceptibility testing, investigation of macrolide resistance phenotypes and genotypes, and identification of capsular type. The overall rate of erythromycin not susceptible (NS) isolates was 25.9%, while resistance to clindamycin was 5.2%. Drug efflux, associated with the M phenotype and mef(A) gene, was the prevalent mechanism of resistance (80%). Capsular type Ia was predominant (39.8%), followed by II, III, and V (17.7% each). A higher diversity of types was observed in the last years of the study. Type IV has had an increasing trend over time, being the fourth most common in 2023. The majority of the isolates that expressed the M phenotype presented capsular type Ia, while those with iMLS phenotype presented capsular type V. Despite no causal relationship can be established, azithromycin excessive usage may be a possible factor associated with this higher rate of erythromycin NS isolates, compared with most previous national studies. On the other hand, resistance to clindamycin has not changed significantly. Therefore, in the studied clinical setting, clindamycin remains a useful alternative to intrapartum prophylaxis among penicillin-allergic pregnant women.

Development and performance evaluation of a qPCR-based assay for the fully automated detection of group B Streptococcus (GBS) on the Panther Fusion Open Access system.

Streptococcus agalactiae [group B Streptococcus (GBS)] poses a major threat as the primary cause of early-onset neonatal invasive disease, particularly when mothers are colonized rectovaginally. Although culture remains the gold standard for antepartum GBS screening, quantitative polymerase chain reaction (qPCR) offers advantages in terms of sensitivity and turnaround time. The aim of this study was to validate the clinical utility of an automated qPCR laboratory-developed test (LDT) for antepartum GBS screening using the Panther Fusion Open Access system (Hologic, California, USA). The LDT targeted a conserved region of the GBS surface immunogenic protein gene, demonstrating no cross-reactivity and high coverage (99.82%-99.99%). The limit of detection (LoD) was 118 CFU/mL. Comparison with commercial qPCR assays (Panther Fusion GBS and VIASURE Streptococcus B Real-Time) revealed an overall agreement of 99.7%, with a robust Cohen's kappa coefficient of 0.992. Testing of 285 rectovaginal swabs from pregnant women and 15 external quality assessment samples demonstrated exceptional diagnostic performance of the LDT, achieving a diagnostic sensitivity and specificity of 100%, underscoring its accuracy. Prevalence and predictive values were also determined to reinforce test reliability. Our research highlights the limitations of culture-based screening and supports the suitability of our qPCR-based LDT for GBS detection in a clinical setting.IMPORTANCERectovaginal colonization by GBS is a major risk factor for early-onset invasive neonatal disease. The most effective approach to reducing the incidence of early-onset disease (EOD) has been described as universal screening, involving assessment of GBS colonization status in late pregnancy and intrapartum antibiotic prophylaxis. Despite its turnaround time and sensitivity limitations, culture remains the gold standard method for GBS screening. However, nucleic acid amplification-based tests, such as qPCR, have been utilized due to their speed and high sensitivity and specificity. This study validated the clinical usefulness of an automated qPCR-LDT for antepartum GBS screening through the Panther Fusion Open Access system (Hologic). Our study addresses the critical need for more robust, sensitive, and rapid strategies for GBS screening in pregnant women that could favorably impact the incidence of EOD.

Microbiology and Treatment Outcomes of Community-Acquired Hematogenous Osteoarticular Infections in Infants ≤12 Months of Age.

We investigated the microbiology, management, and orthopedic outcomes of osteoarticular infections in infants age ≤1 year at our institution. Among 87 patients, Staphylococcus aureus was the most common pathogen (44.8%), followed by group B Streptococcus. Twenty-nine patients (33%), with a median age of 9.2 months, were transitioned to oral antibiotic therapy after ≤14 days of parenteral therapy; orthopedic outcomes were similar to those with prolonged parenteral therapy.

Thymomodulin enhances vaccination responses against Streptococcus agalactiae in Nile tilapia / Timomodulina melhora as respostas vacinais contra Streptococcus agalactiae em tilápia-do-Nilo

Streptococcosis caused by Streptococcus agalactiae is a major economic problem for Nile tilapia Oreochromis niloticus production worldwide. Inactivated vaccines are considered an efficient method for controlling streptococcosis. However, during the vaccination process, stress during fish handling could affect the immune response. Immunomodulators, such as thymomodulin, act on the immune system and can improve vaccination responses. Thus, the aim of this study was to assess the immunomodulatory effect of thymomodulin in O. niloticus vaccinated against S. agalactiae. For this, fish were distributed in a factorial design (2x2x6), corresponding to two levels of thymomodulin supplementation (0.0 and 0.3%), two treatments (sterile phosphate buffered saline and inactivated S. agalactiae vaccine). Initially, fish received thymomodulin supplementation for 30 days. Next, fish were vaccinated by injection intraperitoneal (i.p.) of heat inactivated S. agalactiae vaccine. 15 days after vaccination, all fish were challenged i.p. with S. agalactiae and blood samples were collected at 7, 14, 21 days post infection (DPI).Results revealed that fish supplemented with thymomodulin vaccinated or not developed better protection against S. agalactiae than vaccinated fish without thymomodulin. Furthermore, fish vaccinated and supplemented with thymomodulin presented high levels of antibodies after 14 and21 DPI, suggesting that thymomodulin can promote the immune response in Nile tilapia.

A estreptococose causada pelo Streptococcus agalactiae é um grande problema econômico para a produção de tilápia-do-nilo Oreochromis niloticus em todo o mundo. As vacinas inativadas são consideradas um método eficiente para o controle da estreptococose. No entanto, durante o processo de vacinação o estresse durante o manejo dos peixes pode afetar sua resposta imune. Imunomoduladores como a timomodulina, atuam no sistema imunológico e podem melhorar as respostas vacinais. Assim, o objetivo deste estudo foi avaliar o efeito imunomodulador da timomodulina em O. niloticus vacinado contra S. agalactiae. Para isso, os peixes foram distribuídos em esquema fatorial (2x2x6), correspondendo a dois níveis de suplementação de timodulina (0,0 e 0,3%), dois tratamentos (solução salina tamponada com fosfato estéril e vacina S. agalactiae inativada). Inicialmente, os peixes receberam suplementação de timomodulina por 30 dias. Em seguida, os peixes foram vacinados por via intraperitoneal (i.p.) da vacina de S. agalactiae inativada pelo calor. 15 dias após a vacinação, todos os peixes foram desafiados i.p. com S. agalactiae e amostras de sangue foram coletadas aos 7, 14, 21 dias após a infecção (DPI). Os resultados revelaram que os peixes suplementados com timomodulina vacinados ou não desenvolveram melhor proteção contra S. agalactiae do que os peixes vacinados sem timomodulina. Além disso, os peixes vacinados e suplementados com timomodulina apresentaram altos níveis de anticorpos após 14 e 21 DPI, sugerindo que a timomodulina pode promover a resposta imune em tilápia-do-nilo.

Detection of Group B Streptococcus in vaginal swabs, without prior enrichment, by qPCR.

Group B Streptococcus (GBS) infection in newborns during childbirth can result in death. We described a method to detect GBS from vaginal swabs in pregnant women, without prior enrichment, using real-time polymerase chain reaction (qPCR), and compared its results to the culture method. The qPCR outperforms culture method.

Prevalence, serotypes and virulence genes of Streptococcus agalactiae isolated from pregnant women with 35-37 weeks of gestation.

BACKGROUND: In pregnant women Streptococcus agalactiae (GBS) can be transmitted to newborn causing severe infections. It is classified into 10 serotypes (Ia, Ib, II-IX). The severity of neonatal disease is determined by the capsular serotype and virulence factors such as the polysaccharide capsule, encoded by the cps gene, protein C, which includes the Cα surface proteins (bca gene), Rib (rib gene) and Cß (bac gene); the proteins Lmb (lmb gene), FbsB (fbsB gene), FbsA (fbsA gene), the cyl operon encoding a ß-hemolysin (hylB gene), the CAMP factor (cfb gene) and the C5a peptidase (scpB gene). The aim of this work was to determine the degree of GBS colonization in pregnant women, the serotypes distribution and to investigate virulence-associated genes. METHODS: We worked with 3480 samples of vagino-rectal swabs of women with 35-37 weeks of gestation. The identification of the strains was carried out using conventional biochemical tests and group confirmatory serology using a commercial latex particle agglutination kit. Two hundred GBS strains were selected. Their serotype was determined by agglutination tests. The monoplex PCR technique was used to investigate nine virulence-associated genes (cps, bca, rib, bac, lmb, fbsB, fbsA, hylB and scpB). RESULTS: The maternal colonization was 9.09%. The serotypes found were: Ia (33.50%), III (19.00%), Ib (15.50%), II (14.00%), V (7.00%) and IX (5.50%). 5.50% of strains were found to be non-serotypeable (NT). The nine virulence genes investigated were detected simultaneously in 36.50% of the strains. The genes that were most frequently detected were scpB (100.00%), fbsA (100.00%), fbsB (100.00%), cylB (95.00%), lmb (94.00%) and bca (87.50%). We found associations between serotype and genes bac (p = 0.003), cylB (p = 0.02), rib (p = 0.01) and lmb (p < 0.001). CONCLUSIONS: The frequency of vaginal-rectal colonization, serotypes distribution and associated virulence genes, varies widely among geographical areas. Therefore, epidemiological surveillance is necessary to provide data to guide decision-making and planning of prevention and control strategies.

Streptococcus agalactiae strains isolated from cancer patients in Rio de Janeiro, Brazil.

Streptococcus agalactiae is a recognized pathogen associated with infections in neonates, elderly, and immunocompromised adults, particularly those with cancer. In the present investigation, clinical-epidemiological features, multidrug resistance profiles, and virulence genes of S. agalactiae strains isolated from cancer patients were investigated. S. agalactiae capsular distribution assays demonstrated that Ia (43.6%) and V (23.6%) types were predominantly detected among 55 clinical isolates tested; only one strain (GBS1428) was capsular type III/ST-17. The fbsB and hylB genes were detected in all isolates, while the iag, lmb, and fbsA genes were detected in 94.5%, 91%, and 91% of oncological isolates, respectively. The combination of PI-1 and PI-2a was the most common (60%) among S. agalactiae strains isolated from oncologic patients. S. agalactiae strains were resistant to tetracycline (85.5%), erythromycin (9%), and clindamycin (5.5%). Norfloxacin non-susceptible was detected in 7.3% of S. agalactiae strains. Our findings reinforce the need for S. agalactiae control measures in Brazil, including cancer patients.

Antimicrobial susceptibility profile of Streptococcus agalactiaestrains isolated from bovine mastitis / Perfil de susceptibilidade a antimicrobianos em Streptococcus agalactiae isolados de mastite bovina

Bovine mastitis is the most important disease of dairy herds worldwide. Its main etiologic agents are bacteria, including Streptococcus agalactiae. The importance of this agent in bovine mastitis is because it is highly contagious and has a high impact on the occurrence of clinical mastitis cases and in the increase of the bulk milk somatic cell counts. The dry cow therapy and the treatment of the clinical mastitis cases stand out among the measures to control intramammary infections in cows. However, these strategies require knowledge about the antimicrobial susceptibility of the causal microorganisms. Thus, this study aimed to evaluate the antimicrobial susceptibility of 89 S. agalactiae strains isolated from bovine mastitis between the years 2004 and 2008 in dairy herds from Campo das Vertentes region, Minas Gerais State, Brazil. The disc diffusion technique was used and the antimicrobials currently used in mastitis therapy were tested. The isolates tested showed 100% susceptibility to chloramphenicol, ceftiofur, cefotaxime, enrofloxacin, and cefquinome. High frequencies of susceptibility (>95%) were also observed for the beta-lactams (penicillin G, ampicillin, and oxacillin), cephalosporins (cephalotin, ceftiofur, cefotaxime, cefoperazone, and cefquinome), florfenicol, gentamicin, lincomycin, nitrofurantoin, and sulfamethoprim. The strains showed high frequencies of resistance to neomycin (15.74%), and tetracycline (21.35%). Multidrug resistance was detected in 2.25% of the tested isolates. The results pointed to variations in the antimicrobial susceptibility profiles of the studied strains and the importance of the use of the susceptibility tests to determine the correct antimicrobial to be applied in the treatment of bovine mastitis caused by S. agalactiae. The high frequencies of resistance observed to some antimicrobials, such as neomycin and tetracycline, commonly used in the treatment of mastitis and other pathologies, highlighted the need for more judicious use of antimicrobials on dairy farms.(AU)

A mastite é a principal doença de bovinos leiteiros em todo o mundo e tem como principais agentes as bactérias, entre as quais Streptococcus agalactiae. Esse agente se destaca por ser altamente contagioso e pelos reflexos que causa na incidência de casos clínicos e no incremento da contagem de células somáticas do leite do tanque. Para o controle desta enfermidade, destacam-se a terapia de vacas secas e o tratamento de casos clínicos, medidas que requerem o conhecimento do perfil de sensibilidade dos agentes causais aos antimicrobianos. Este estudo teve como objetivo avaliar os perfis de suscetibilidade a antimicrobianos em 89 amostras de S. agalactiae isoladas de casos de mastite bovina em rebanhos da região de Campo das Vertentes, Minas Gerais, no período de 2004 a 2008. A técnica de difusão em discos foi utilizada e os antimicrobianos correntemente empregados na terapia da mastite foram testados. Os testes de suscetibilidade antimicrobiana apontaram 100% de susceptibilidade para cloranfenicol, ceftiofur, cefotaxima, enrofloxacina e cefquimona. Níveis elevados de susceptibilidade (>95%) foram observados para os betalactâmicos, florfenicol, gentamicina, lincomicina, nitrofurantoína e sulfametoprim. Altas frequências de resistência foram observadas para neomicina (15,74%) e tetraciclina (21,35%). Dois isolados multirresistentes (2,25%) foram encontrados. Os resultados apontaram variações nos perfis se suscetibilidade aos antimicrobianos na população analisada, indicando a importância do uso do antibiograma para a escolha mais criteriosa dos antibacterianos a serem utilizados para o tratamento da mastite bovina causada por S. agalactiae. As altas frequências de resistência detectadas para alguns dos antimicrobianos comumente utilizados para o tratamento de mastite e outras patologias, tais como a neomicina e a tetraciclina, salientam a necessidade de monitoramento permanente do perfil de suscetibilidade aos antimicrobianos e do uso mais criterioso dos mesmos nos rebanhos leiteiros.(AU)

Antimicrobial susceptibility profile of Streptococcus agalactiaestrains isolated from bovine mastitis / Perfil de susceptibilidade a antimicrobianos em Streptococcus agalactiae isolados de mastite bovina

Bovine mastitis is the most important disease of dairy herds worldwide. Its main etiologic agents are bacteria, including Streptococcus agalactiae. The importance of this agent in bovine mastitis is because it is highly contagious and has a high impact on the occurrence of clinical mastitis cases and in the increase of the bulk milk somatic cell counts. The dry cow therapy and the treatment of the clinical mastitis cases stand out among the measures to control intramammary infections in cows. However, these strategies require knowledge about the antimicrobial susceptibility of the causal microorganisms. Thus, this study aimed to evaluate the antimicrobial susceptibility of 89 S. agalactiae strains isolated from bovine mastitis between the years 2004 and 2008 in dairy herds from Campo das Vertentes region, Minas Gerais State, Brazil. The disc diffusion technique was used and the antimicrobials currently used in mastitis therapy were tested. The isolates tested showed 100% susceptibility to chloramphenicol, ceftiofur, cefotaxime, enrofloxacin, and cefquinome. High frequencies of susceptibility (>95%) were also observed for the beta-lactams (penicillin G, ampicillin, and oxacillin), cephalosporins (cephalotin, ceftiofur, cefotaxime, cefoperazone, and cefquinome), florfenicol, gentamicin, lincomycin, nitrofurantoin, and sulfamethoprim. The strains showed high frequencies of resistance to neomycin (15.74%), and tetracycline (21.35%). Multidrug resistance was detected in 2.25% of the tested isolates. The results pointed to variations in the antimicrobial susceptibility profiles of the studied strains and the importance of the use of the susceptibility tests to determine the correct antimicrobial to be applied in the treatment of bovine mastitis caused by S. agalactiae. The high frequencies of resistance observed to some antimicrobials, such as neomycin and tetracycline, commonly used in the treatment of mastitis and other pathologies, highlighted the need for more judicious use of antimicrobials on dairy farms.(AU)

A mastite é a principal doença de bovinos leiteiros em todo o mundo e tem como principais agentes as bactérias, entre as quais Streptococcus agalactiae. Esse agente se destaca por ser altamente contagioso e pelos reflexos que causa na incidência de casos clínicos e no incremento da contagem de células somáticas do leite do tanque. Para o controle desta enfermidade, destacam-se a terapia de vacas secas e o tratamento de casos clínicos, medidas que requerem o conhecimento do perfil de sensibilidade dos agentes causais aos antimicrobianos. Este estudo teve como objetivo avaliar os perfis de suscetibilidade a antimicrobianos em 89 amostras de S. agalactiae isoladas de casos de mastite bovina em rebanhos da região de Campo das Vertentes, Minas Gerais, no período de 2004 a 2008. A técnica de difusão em discos foi utilizada e os antimicrobianos correntemente empregados na terapia da mastite foram testados. Os testes de suscetibilidade antimicrobiana apontaram 100% de susceptibilidade para cloranfenicol, ceftiofur, cefotaxima, enrofloxacina e cefquimona. Níveis elevados de susceptibilidade (>95%) foram observados para os betalactâmicos, florfenicol, gentamicina, lincomicina, nitrofurantoína e sulfametoprim. Altas frequências de resistência foram observadas para neomicina (15,74%) e tetraciclina (21,35%). Dois isolados multirresistentes (2,25%) foram encontrados. Os resultados apontaram variações nos perfis se suscetibilidade aos antimicrobianos na população analisada, indicando a importância do uso do antibiograma para a escolha mais criteriosa dos antibacterianos a serem utilizados para o tratamento da mastite bovina causada por S. agalactiae. As altas frequências de resistência detectadas para alguns dos antimicrobianos comumente utilizados para o tratamento de mastite e outras patologias, tais como a neomicina e a tetraciclina, salientam a necessidade de monitoramento permanente do perfil de suscetibilidade aos antimicrobianos e do uso mais criterioso dos mesmos nos rebanhos leiteiros.(AU)

[Streptococcus agalactiae: an unusual cause of septic arthritis beyond 3 months of age. Case report]. / Streptococcus agalactiae: causa de artritis séptica inusual a partir de los 3 meses de edad. Caso clínico.

Septic arthritis is not a very frequent disease, but with a high morbidity due to the important sequelae that it can cause. The etiology is age-specific, with Staphylococcus aureus being the most frequent microorganism in all ages. Streptococcus agalactiae or group B Streptococcus is an uncommon cause of infection outside the neonatal period. Beyond 3 months of age, infections by this pathogen are associated with serious infections in immunocompromised patients. The treatment of choice is penicillin G or ampicillin. A 4.5-month-old child who developed a group B Streptococcus septic arthritis is reported. The onset was insidious, and the etiological diagnosis prompted us to rule out meningitis and associated immunodeficiency. The extremely low frequency of group B Streptococcus septic arthritis at this age and the importance of ruling out a disseminated disease are crucial learning points in this case.

La artritis séptica es una patología poco frecuente, pero con una alta morbilidad, debido a las importantes secuelas que puede originar. La etiología varía según la edad, y Staphylococcus aureus es el microorganismo más frecuente en todas ellas. Streptococcus agalactiae o del grupo B es una causa infrecuente de infección fuera del período neonatal; se asocia, a partir de los 3 meses de edad, con infecciones graves en pacientes inmunocomprometidos. El tratamiento de elección es penicilina G o ampicilina. Aquí se describe el caso de un niño de cuatro meses y medio de edad que desarrolló una artritis séptica por Streptococcus agalactiae o del grupo B, con inicio insidioso de la clínica. El diagnóstico etiológico obligó a descartar meningitis y una inmunodeficiencia asociada. La frecuencia extremadamente baja de dicha artritis a esta edad y la importancia de descartar una enfermedad diseminada son importantes puntos de aprendizaje en este caso.

Group B Streptococcus Meningitis in an Infant with Respiratory Syncytial Virus Detection.

We report our experience caring for an infant with respiratory syncytial virus infection (RSV) and group B Streptococcus (GBS) bacteremia and meningitis. Concurrent GBS meningitis and RSV is rare but highlights the importance of correlating clinical symptoms with viral diagnostic testing during the evaluation of infants at risk for serious bacterial infection.

Development and analytical validation of real-time PCR for the detection of Streptococcus agalactiae in pregnant women.

BACKGROUND: Group B Streptococcus (GBS) is the leading cause of invasive neonatal infection. In this study, we aimed to evaluate the analytical validation of qualitative real-time polymerase chain reaction (qPCR) as a means to detect GBS. METHODS: Genomic DNA (gDNA) was purified from 12 ATCC bacterial strains, two belonging to GBS and the remainder acting as negative controls. Additionally, gDNA was isolated from 21 strains of GBS from various serotypes (Ia, Ib and II-VIII). All gDNA was used to evaluate the analytical validation of the qPCR method employing a specific Taqman probe. Inclusivity, exclusivity, anticipated reportable range, the limit of detection and robustness were evaluated. The methods used are described in international guidelines and other existing reports. The performance of this qPCR method for detecting GBS was compared to other microbiological methods used with vaginal-rectal samples from pregnant women. RESULTS: Our qPCR method for detecting GBS was analytically validated. It has a limit of detection of 0.7 GE/µL and 100% analytical specificity. It detects all strains of GBS with the same level of performance as microbiological methods. CONCLUSION: Data suggest that this qPCR method performs adequately as a means to detect GBS in vaginal-rectal swabs from pregnant women.

Comparative genomic analysis and identification of pathogenicity islands of hypervirulent ST-17 Streptococcus agalactiae Brazilian strain.

Streptococcus agalactiae are important pathogenic bacteria that cause severe infections in humans, especially neonates. The mechanism by which ST-17 causes invasive infections than other STs is not well understood. In this study, we sequenced the first genome of a S. agalactiae ST-17 strain isolated in Brazil using the Illumina HiSeq 2500 technology. S. agalactiae GBS90356 ST-17 belongs to the capsular type III and was isolated from a neonatal with a fatal case of meningitis. The genome presented a size of 2.03 Mbp and a G + C content of 35.2%. S. agalactiae has 706 genes in its core genome and an open pan-genome with a size of 5.020 genes, suggesting a high genomic plasticity. GIPSy software was used to identify 10 Pathogenicity islands (PAIs) which corresponded to 15% of the genome size. IslandViewer4 corroborated the prediction of six PAIs. The pathogenicity islands showed important virulence factors genes for S. agalactiae e.g. neu, cps, dlt, fbs, cfb, lmb. SignalP detected 20 proteins with signal peptides among the 352 proteins found in PAIs, which 60% were located in the SagPAI_5. SagPAI_2 and 5 were mainly detected in ST-17 strains studied. Moreover, we identified 51 unique genes, 9 recombination regions and a large number of SNPs with an average of 760.3 polymorphisms, which can be related with high genomic plasticity and virulence during host-pathogen interactions. Our results showed implications for pathogenesis, evolution, concept of species and in silico analysis value to understand the epidemiology and genome plasticity of S. agalactiae.

Prevalence of rectovaginal colonization by group B Streptococcus in pregnant women seen at prenatal care program of a health organization.

OBJECTIVE: To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. METHODS: This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, minimal and maximal values. Parity and socioeconomic status were described by absolute frequency and percentages. We used logistic regression models in the software (SPSS) to analyze correlations of variables according to vaginal-rectal culture, considering a 95%CI and p-values. Variables were age, number of pregnancies, weight gain in pregnancy and gestational age at delivery. RESULTS: A total of 347 medical records were included, and after applying the exclusion criteria, 287 medical records composed the final sample. Patients' age ranged between 17 and 44 years. Mean age was 30.6 years, 67 patients had positive result for group B Streptococcus (prevalence of 23.3%; 95%CI: 18.7-28.5). CONCLUSION: Considering the high prevalence of group B Streptococcus in our service, the antibiotic prophylaxis strategy based on rectovaginal culture screening approach seems to be cost-effective.

Prevalence of rectovaginal colonization by group B Streptococcus in pregnant women seen at prenatal care program of a health organization / Prevalência de colonização retovaginal por estreptococo do grupo B em gestantes de programa de atendimento pré-natal de instituição de saúde

ABSTRACT Objective To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. Methods This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, minimal and maximal values. Parity and socioeconomic status were described by absolute frequency and percentages. We used logistic regression models in the software (SPSS) to analyze correlations of variables according to vaginal-rectal culture, considering a 95%CI and p-values. Variables were age, number of pregnancies, weight gain in pregnancy and gestational age at delivery. Results A total of 347 medical records were included, and after applying the exclusion criteria, 287 medical records composed the final sample. Patients' age ranged between 17 and 44 years. Mean age was 30.6 years, 67 patients had positive result for group B Streptococcus (prevalence of 23.3%; 95%CI: 18.7-28.5). Conclusion Considering the high prevalence of group B Streptococcus in our service, the antibiotic prophylaxis strategy based on rectovaginal culture screening approach seems to be cost-effective.

RESUMO Objetivo Identificar a prevalência de estreptococo do grupo B entre gestantes que frequentaram um programa de saúde corporativa, bem como as correlações com a colonização positiva. Métodos Estudo retrospectivo dos prontuários do pré-natal de um hospital privado em São Paulo, no período de 2015 a 2016. Foram excluídas as mulheres que abandonaram o programa ou apresentavam dados incompletos nos prontuários. As variáveis quantitativas foram descritas por média, desvios padrão, mediana, valores mínimos e máximos. A paridade e a condição socioeconômica foram descritos por frequência absoluta e percentagens. Utilizamos modelos de regressão logística no programa (SPSS) para analisar as correlações de variáveis de acordo com a cultura retovaginal, considerando IC95% e valores de p. As variáveis foram idade, número de gestações, peso ganho na gestação e idade gestacional no parto. Resultados Foram incluídos 347 prontuários e, após a aplicação dos critérios de exclusão, 287 prontuários compuseram a amostra final. A idade dos pacientes variou entre 17 e 44 anos. A média de idade foi de 30,6 anos, e 67 pacientes tiveram resultado positivo para o estreptococo do grupo B (prevalência de 23,3%; IC95%: 18,7-28,5). Conclusão Considerando a alta prevalência de estreptococos do grupo B em nosso serviço, existem evidências de que a estratégia de antibiótico profilaxia baseada na cultura retovaginal é custo-efetiva.

Vagino-rectal colonization prevalence by Streptococcus agalactiae and its susceptibility profile in pregnant women attending a third-level hospital / Prevalencia de colonización vaginorrectal por Streptococcus agalactiae y su perfil de sensibilidad en mujeres embarazadas atendidas en un hospital de tercer nivel

Introduction: Streptococcus agalactiae is the main etiological agent causing invasive infection of the newborn with symptoms that may be associated with septicemia, pneumonia or meningitis and prevalences up to 50% worldwide where there is an increase in antibiotic resistance. Objective: To estimate the prevalence of vagino-rectal colonization by S. agalactiae and its sensitivity profile in pregnant women attending a third-level hospital. Materials and methods: One hundred and twenty one pregnant women were sampled by vaginal and rectal swabs. The cultures were carried out following the methodology recommended by the CDC, and chromID Strepto B agar was added. The suggestive colonies were identified biochemically and the sensitivity profiles according to CLSI were determined. As control, S. pneumoniae ATCC 49619 and S. agalactiae ATCC 12403 were used. Results: Pregnant colonization prevalence by S. agalactiae was 20.66%, with a total of 40 isolates of which 12.5% were non-sensitivity to penicillin. Sensitivity to levofloxacin, clindamycin and erythromycin was 100%, 92.5% y 87.5%, respectively, with the phenotypes iMLSB (3/40) and M (2/40). No sensitivity to tetracycline was found. Conclusions: The prevalence of vagino-rectal colonization by S. agalactiae in the study population was 20.66%, obtaining isolates not sensitive to penicillin and resistance to macrolides and lincosamidas by the Kirby-Bauer technique, so the importance of carrying out active active in pregnant women colonized by Streptococcus agalactiae and to perform constant epidemiological surveillance to detect changes in the sensitivity profiles of the isolates.

Introducción. Streptococcus agalactiae es el principal agente etiológico causante de infección invasiva del recién nacido con cuadros clínicos que pueden cursar con septicemia, neumonía o meningitis con prevalencias hasta del 50 % a nivel mundial, donde se viene presentando un incremento en su resistencia antibiótica. Objetivo. Estimar la prevalencia de colonización vaginorrectal por S. agalactiae y su perfil de sensibilidad, en mujeres embarazadas atendidas en un hospital de tercer nivel. Materiales y métodos. Se muestrearon 121 mujeres gestantes mediante hisopado vaginal y rectal. Los cultivos se desarrollaron siguiendo la metodología recomendada por los Centers for Disease Control and Prevention (CDC) y se agregó el agar chromID Strepto B. Las colonias sugestivas se identificaron bioquímicamente y se determinaron los perfiles de sensibilidad según el Clinical and Laboratory Standards Institute (CLSI). Resultados. La prevalencia de colonización por S. agalactiae en las mujeres gestantes fue del 20,66 %. Se obtuvieron 40 aislamientos del total de muestras analizadas, de los cuales, el 12,5 % no presentó sensibilidad a la penicilina. La sensibilidad a la levofloxacina, la clindamicina y la eritromicina fue de 100 %, 92,5 % y 87,5 %, respectivamente; no se encontró sensibilidad a la tetraciclina. El fenotipo iMLSB se encontró en tres y, el M, en dos de los 40 aislamientos. Conclusiones. La prevalencia de colonización vaginorrectal por S. agalactiae en la población de estudio, fue de 20,66 %. Se obtuvieron aislamientos no sensibles a la penicilina, y con resistencia a los macrólidos y las lincosamidas mediante el método de Kirby-Bauer. Por ello, es importante la búsqueda activa en las mujeres gestantes colonizadas por estreptococos del grupo B y la vigilancia epidemiológica constante para detectar cambios en los perfiles de sensibilidad de los aislamientos.

Distribution of serotypes, antimicrobial resistance and virulence genes among Streptococcus agalactiae isolated from bovine in China

Background: Bovine mastitis, a global disease that is responsible for large economic losses each year due to lower milkyield and reduced milk quality. In some countries, especially in China, Streptococcus agalactiae has become one of themost frequently detected pathogen. Antibiotic treatment and vaccine immunization are important strategies for the controlof infectious diseases. The main objective of the present study was to evaluate distribution of bovine mastitis pathogensand antimicrobial resistance of S. agalactiae, and contribute to the treatment of bovine mastitis.Materials, Methods & Results: Clinical mastitis samples (n= 1,122) were collected from 27 dairy farms located in 15different provinces of China during 2012-2018. The pathogens were identified by 16S rDNA method. Antimicrobial susceptibility was assessed by disc diffusion method. Molecular characteristics was distinguished based on PCR. The resultsshowed that the main pathogens were Streptococcus agalactiae (n= 324, 26.2%), Escherichia coli (n= 287, 23.2%), andStaphylococcus aureus (n= 131, 10.6%). The serotypes of Streptococcus agalactiae were serotype II (53.6%), Ia (44 %)and VII (1.2%), respectively. Streptococcus agalactiae were resistant to kanamycin (93.8%), gentamicin (49.4%), vancomycin (49.4%), tetracycline (35.8%), clindamycin (34.6%) and erythromycin (32.1%). The main resistance genes wereermA (53.1%) and ermB (85.2%). Resistance to erythromycin was attributed to the genes ermA (P < 0.05) and resistanceto tetracycline was attributed to the genes tetK, tetM, tetO (P < 0.01). The virulence genes scpB (81.4%), cyl (100%), glnA(76.6%), cfb (98.8%), hylB (98.8%), scaA (69.1%) were detected in almost all isolates.Discussion: In the present study, Streptococcus agalactiae, Escherichia coli and Staphylococcus aureus were the pathogens isolated most frequently from clinical mastitis. In the case of S. agalactiae, we performed capsular serotyping ofisolates...(AU)