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Abstract
Purpose
This study was aimed at analyzing the serotypes of group B streptococcus (GBS) isolated from Korean infants with invasive disease and evaluating their association with disease manifestation.
Methods
Data were retrospectively collected from invasive GBS infections at Gachon University Gil Medical Center from January 2006 to June 2012 and at Samsung Medical Center from April 2010 to November 2012. Serotypes were determined by slide agglutination test.
Results
A total of 37 cases were identified, which included 22 full-term infants and 15 preterm infants. Fifteen cases (40.5%) were early-onset, 19 (51.4%) was late-onset, and three (8.1%) was very late-onset. Early-onset diseases among preterm infants were higher than those among full-term infants (60.0% [9/15] vs. 27.3% [6/22], P=0.17). The most common manifestation was bacteremia (70.3%), followed by meningitis and septic arthritis. Among 24 isolates retrievable for serotyping, serotype III (41.7%) was most common, followed by V (16.7%), Ia, Ib, and II (12.5%, respectively), and non-typeable (4.2%). Serotype III was more common in isolates from full-term infants (10/22) than from preterm infants (0/15), whereas serotype V was more common in isolates from preterm infants (4/15) than from full-term infants (0/22) (P=0.002). No penicillin-resistant strain was detected, and resistance to erythromycin and clindamycin were both 64.9%.
Conclusions
GBS is an important pathogen in both preterm and full-term infants, and serotype distribution of GBS causing invasive diseases can differ between preterm and full-term infants. It is necessary to monitor the nationwide epidemiology of GBS diseases, including in preterm infants, in order to prepare preventive measures without underestimating early-onset diseases.
Figures and Tables
Fig. 1
Serotype distribution of group B streptococci according to the time of disease onset and clinical diagnosis. (A) It shows the serotype distribution of group B streptococci causing early-onset, late-onset, and very late-onset diseases. (B) It shows the serotype distribution of group B streptococci causing early-onset diseases and late-onset diseases according to clinical diagnosis. All cases (bacteremia one case, meningitis two cases) of very late-onset disease are caused by serotype III. The numbers in the bars indicate the number of cases, and the numbers in parentheses are the percentages within the category. Abbreviation: NT, non-typeable.
Table 1
Comparisons of Demographic and Clinical Characteristics between Term and Preterm Infants with Invasive Group B Streptococcus Diseases
Values are presented as number (%) or median (range).
*Compared between term and preterm infants.
†Analyzed by Fisher exact test.
‡Analyzed by Mann-Whiteney U-test.
∫Between early-onset and late-onset disease.
∥Among early-onset, late-onset, and very late-onset disease.
¶Intracerebral hemorrhage, cerebral infarction, and leukoencephalopathy.
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