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Group B streptococcal infection in the newborn

Kwan PW, Khoo BH, Lam KL, Puthucheary SD

Med J Malaysia, 1979 Sep;34(1):71-5.
PMID: 396463
Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Distribution of group B streptococcal serotypes in Malaysia

Ngeow YF, Puthucheary SD

J Trop Med Hyg, 1987 Aug;90(4):193-6.
PMID: 3309355

A total of 350 strains of group B streptococci (308 from adults and 42 from neonates) were serotyped. The majority of the isolates from adult patients were from the genito-urinary tract and most of the neonatal isolates were from babies less than 10 days old. Serotype III was the predominant type among all groups of patients and accounted for 50.9% of all serotypes. The second and third most frequently occurring serotypes were II and Ic respectively. Together with type III they made up 87% of the isolates.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Fulltext Molecular characterization of Streptococcus agalactiae strains isolated from fishes in Malaysia

Amal MN, Zamri-Saad M, Siti-Zahrah A, Zulkafli AR, Nur-Nazifah M

J Appl Microbiol, 2013 Jul;115(1):20-9.
PMID: 23557382 DOI: 10.1111/jam.12210

AIMS: The aim of this study was to characterize Streptococcus agalactiae strains that were isolated from fishes in Malaysia using random amplified polymorphic DNA (RAPD) and repetitive extragenic palindromic PCR (REP-PCR) techniques.
METHODS AND RESULTS: A total of 181 strains of Strep. agalactiae isolated from red hybrid tilapia (Oreochromis sp.) and golden pompano (Trachinotus blochii) were characterized using RAPD and REP-PCR techniques. Both the fingerprinting techniques generated reproducible band patterns, differing in the number and molecular mass amplicons. The RAPD technique displayed greater discriminatory power by its production of more complex binding pattern and divided all the strains into 13 groups, compared to 9 by REP-PCR technique. Both techniques showed the availability to differentiate the genetic profiles of the strains according to their geographical location of origin. Three strains of Strep. agalactiae that were recovered from golden pompano showed a genetic dissimilarity from the strains isolated from red hybrid tilapia, while the strain of ATCC 27956 that recovered from bovine displayed a unique profile for both methods.
CONCLUSIONS: Both techniques possess excellent discriminative capabilities and can be used as a rapid means of comparing Strep. agalactiae strains for future epidemiological investigation.
SIGNIFICANCE AND IMPACT OF THE STUDY: Framework as the guideline in traceability of this disease and in the search for potential local vaccine candidates for streptococcosis in this country.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Transmission of Streptococcus agalactiae from a hatchery into a newly established red hybrid tilapia, Oreochromis niloticus (L.) × Oreochromis mossambicus (Peters), farm

Amal MN, Zamri-Saad M, Siti-Zahrah A, Zulkafli AR

J Fish Dis, 2013 Aug;36(8):735-9.
PMID: 23347250 DOI: 10.1111/jfd.12056
Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Streptococcus agalactiae isolates from cultured fishes in Malaysia manifesting low resistance pattern towards selected antibiotics

Aisyhah MA, Amal MN, Zamri-Saad M, Siti-Zahrah A, Shaqinah NN

J Fish Dis, 2015 Dec;38(12):1093-8.
PMID: 25704397 DOI: 10.1111/jfd.12351
Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Fulltext Antimicrobial susceptibility profiles, serotype distribution and virulence determinants among invasive, non-invasive and colonizing Streptococcus agalactiae (group B streptococcus) from Malaysian patients

Eskandarian N, Ismail Z, Neela V, van Belkum A, Desa MN, Amin Nordin S

Eur J Clin Microbiol Infect Dis, 2015 Mar;34(3):579-84.
PMID: 25359580 DOI: 10.1007/s10096-014-2265-x

A total of 103 group B streptococci (GBS) including 22 invasive, 21 non-invasive, and 60 colonizing isolates were collected in a Malaysian hospital (June 2010-October 2011). Isolates were characterized by conventional and molecular serotyping and analyzed for scpB, lmb, hylB, cylE, bac, bca and rib gene content. Antimicrobial susceptibility to penicillins, macrolides, lincosamides, quinolones and tetracyclines was determined using disk diffusion and the MICs for penicillin were determined by E-test. Molecular serotyping for all eight serotypes (Ia, Ib, II-VII) was in full accordance with conventional serotyping. Overall, taking CS and MS together, serotype VI was the most common capsular type (22.3 %) followed by VII (21.4 %), III (20.4 %), Ia (17.5 %), V (9.7 %), II (7.7 %) and IV (1 %). Susceptibility to beta-lactam antimicrobials was prevalent (100 %). Resistance rates for erythromycin, clindamycin and tetracycline were 23.3 %, 17.5 % and 71.8 %, respectively. PCR-virulence gene screening showed the presence of cylE, lmb, scpB and hylB in almost all the isolates while rib, bca, and bac genes were found in 29.1 %, 14.6 % and 9.7 % of the isolates. Certain genes were significantly associated with specific serotypes, namely, rib with serotypes Ia, II, III and VI; bca and bac with serotypes II and III. Furthermore, serotype Ia was significantly more common among patients with invasive infections (p

Matched MeSH terms: Streptococcus agalactiae/isolation & purification*
An outbreak of Streptococcus agalactiae infection in cage-cultured golden pompano, Trachinotus blochii (Lacépède), in Malaysia

Amal MN, Zamri-Saad M, Iftikhar AR, Siti-Zahrah A, Aziel S, Fahmi S

J Fish Dis, 2012 Nov;35(11):849-52.
PMID: 22913387 DOI: 10.1111/j.1365-2761.2012.01443.x
Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Fulltext Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients

Eskandarian N, Neela V, Ismail Z, Puzi SM, Hamat RA, Desa MN, et al.

Int J Infect Dis, 2013 Sep;17(9):e777-80.
PMID: 23453715 DOI: 10.1016/j.ijid.2013.01.011

Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification*
Group B streptococcus: maternal carriage rate and early neonatal septicaemia

Lim CT, Thong MK, Parasakthi N, Ngeow YF

Ann Acad Med Singap, 1997 Jul;26(4):421-5.
PMID: 9395802

Between January 1984 and December 1994, 30 cases of early neonatal group B streptococcus (GBS) septicaemia were managed in the Neonatal Unit, University Hospital, Kuala Lumpur. Two neonates were outborn and 28 were inborn, giving an average annual incidence of neonatal GBS septicaemia of 0.4/1000 livebirths among inborn babies. In a separate survey over a three-month period, GBS genital carriage rate among 196 parturients was found to be 9.7%. Of the infants with GBS septicaemia, the mean gestational age was 37.5 +/- 3.8 weeks and the mean birthweight was 2540 +/- 716 g. Twelve (40%) were preterm infants and 14 (47%) were low birthweight infants. Male and female infants were almost equally affected. Prolonged rupture of membranes and maternal pyrexia accounted for only 5 (17%) and 3 (10%) of the cases respectively. Twenty-four (80%) neonates had onset of symptoms within 6 hours of life and respiratory symptoms were observed in 24 (80%) of the cases, while meningitis was uncommon. Six (20%) neonates died. Preterm and low birthweight infants had higher mortality than their term counterparts: 42% versus 6% and 36% versus 6% respectively. Of those who died, 4 (67%) required respiratory support right from birth and the mean time of onset of symptoms was 4 hours (range 0 to 21 hours) and the duration of survival was only 28.8 hours (range 12 to 38 hours). As the incidence of neonatal GBS septicaemia was low, mass screening and chemoprophylaxis for GBS were not recommended. All the GBS isolates were sensitive to penicillin and ampicillin, thus one of these antibiotics should be included in the antimicrobial therapy of septic neonates.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification*
Fulltext One hypervirulent clone, sequence type 283, accounts for a large proportion of invasive Streptococcus agalactiae isolated from humans and diseased tilapia in Southeast Asia

Barkham T, Zadoks RN, Azmai MNA, Baker S, Bich VTN, Chalker V, et al.

PLoS Negl Trop Dis, 2019 06;13(6):e0007421.
PMID: 31246981 DOI: 10.1371/journal.pntd.0007421

BACKGROUND: In 2015, Singapore had the first and only reported foodborne outbreak of invasive disease caused by the group B Streptococcus (GBS; Streptococcus agalactiae). Disease, predominantly septic arthritis and meningitis, was associated with sequence type (ST)283, acquired from eating raw farmed freshwater fish. Although GBS sepsis is well-described in neonates and older adults with co-morbidities, this outbreak affected non-pregnant and younger adults with fewer co-morbidities, suggesting greater virulence. Before 2015 ST283 had only been reported from twenty humans in Hong Kong and two in France, and from one fish in Thailand. We hypothesised that ST283 was causing region-wide infection in Southeast Asia.
METHODOLOGY/PRINCIPAL FINDINGS: We performed a literature review, whole genome sequencing on 145 GBS isolates collected from six Southeast Asian countries, and phylogenetic analysis on 7,468 GBS sequences including 227 variants of ST283 from humans and animals. Although almost absent outside Asia, ST283 was found in all invasive Asian collections analysed, from 1995 to 2017. It accounted for 29/38 (76%) human isolates in Lao PDR, 102/139 (73%) in Thailand, 4/13 (31%) in Vietnam, and 167/739 (23%) in Singapore. ST283 and its variants were found in 62/62 (100%) tilapia from 14 outbreak sites in Malaysia and Vietnam, in seven fish species in Singapore markets, and a diseased frog in China.
CONCLUSIONS: GBS ST283 is widespread in Southeast Asia, where it accounts for a large proportion of bacteraemic GBS, and causes disease and economic loss in aquaculture. If human ST283 is fishborne, as in the Singapore outbreak, then GBS sepsis in Thailand and Lao PDR is predominantly a foodborne disease. However, whether transmission is from aquaculture to humans, or vice versa, or involves an unidentified reservoir remains unknown. Creation of cross-border collaborations in human and animal health are needed to complete the epidemiological picture.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification*
Late onset group b beta-hemolytic streptococcus infection in a neonate manifesting as a urinary tract infection: a rare clinical presentation

Zurina Z, Rohani A, Neela V, Norlijah O

Southeast Asian J Trop Med Public Health, 2012 Nov;43(6):1470-3.
PMID: 23413711

Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification
Fulltext Characterization of a Group B Streptococcus infection based on the demographics, serotypes, antimicrobial susceptibility and genotypes of selected isolates from sterile and non-sterile isolation sites in three major hospitals in Malaysia

Suhaimi MES, Desa MNM, Eskandarian N, Pillay SG, Ismail Z, Neela VK, et al.

J Infect Public Health, 2017 Jan-Feb;10(1):14-21.
PMID: 27095302 DOI: 10.1016/j.jiph.2016.01.009

BACKGROUND/PURPOSE: The purpose of this study is to characterize GBS isolates that were collected from three major hospitals in a densely populated area of Klang Valley for their demographics, serotypes, antibiotic susceptibility patterns and genetic background.

METHODS: Sixty GBS isolates from sterile and non-sterile samples in three major hospitals in the Klang Valley area of Malaysia were collected by convenience sampling from 2012 until March 2014. These isolates were studied for their antimicrobial susceptibilities, serotypes and genotypes. Patients' demographic data and clinical information were collected from lab request forms.

RESULTS: Diabetes mellitus was the only underlying condition (7 patients, 23.3%); the remaining samples were from patients who were immunocompromised due to medications. Fifty-nine (98%) isolates were sensitive to penicillin, while 78.3% and 88.3% of the isolates were sensitive to erythromycin and clindamycin, respectively. Serotype Ia was the most common serotype (n=27, 45%), followed by serotype III (n=10, 16.7%), V (n=9, 15%), VI (n=8, 13.3%), VIII (n=2, 3.3%) and VII (n=1, 1.7%). Random Amplified Polymorphic DNA (RAPD) typing showed a diverse genetic pedigree for all isolates, including four major groups that clustered according to geographical location.

CONCLUSION: This preliminary study determines the prevalence of limited common serotypes and antimicrobial resistance in distinct GBS isolates. Nonetheless, the RAPD clustering pattern suggests a close genetic lineage of the GBS isolates based on their isolation sites and location of hospitals.

Matched MeSH terms: Streptococcus agalactiae/isolation & purification*