TY  - JOUR
A1  - Freudenhammer, Mirjam
A1  - Karampatsas, Konstantinos
A1  - Le Doare, Kirsty
A1  - Lander, Fabian
A1  - Armann, Jakob
A1  - Moreno, Daniel Acero
A1  - Boyle, Margaret
A1  - Buxmann, Horst
A1  - Campbell, Ruth
A1  - Chalker, Victoria
A1  - Cunney, Robert
A1  - Doherty, Lorraine
A1  - Davies, Eleri
A1  - Efstratiou, Androulla
A1  - Elling, Roland
A1  - Endmann, Matthias
A1  - Essers, Jochen
A1  - Hentschel, Roland
A1  - Christine E. Jones, Christine E.
A1  - Kallsen, Steffen
A1  - Kapatai, Georgia
A1  - Krüger, Marcus
A1  - Ladhani, Shamez
A1  - Lamagni, Theresa
A1  - Lindsay, Diane
A1  - Meehan, Mary
A1  - O’Sullivan, Catherine P.
A1  - Patel, Darshana
A1  - Reynolds, Arlene J.
A1  - Roll, Claudia
A1  - Schulzke, Sven
A1  - Smith, Andrew
A1  - Stein, Anja
A1  - Wense, Axel von der
A1  - Voss, Egbert
A1  - Wieg, Christian
A1  - Härtel, Christoph
A1  - Heath, Paul T.
A1  - Henneke, Philipp
T1  - Invasive group B streptococcus disease with recurrence and in multiples: towards a better understanding of GBS late-onset sepsis
T2  - Frontiers in immunology
N2  - 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.
KW  - group B Streptococcus
KW  - late-onset sepsis
KW  - microbiome
KW  - multiples
KW  - recurrence
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62042
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-620426
SN  - 1664-3224
N1  - This work was supported by the Else-Kröner-Fresenius Foundation; the German Ministry of Education and Research (grants 01EO0803, 01GL1746A, 01EK1602A to PH); the German Research Council (grants HE3127/9, HE3127/12, SFB/TRR167 to PH, 413517907 as an IMM-PACT Clinician Scientist fellowship to MF) and Meningitis Now (grant 13.0189). The article processing charge was funded by the Baden-Wuerttemberg Ministry of Science, Research and Art and the University of Freiburg in the funding programme Open Access Publishing.
VL  - 12
IS  - art. 617925
SP  - 1
EP  - 12
PB  - Frontiers Media
CY  - Lausanne
ER  -