Trial Profile.

<p>Trial Profile.</p

Demographics of the study population at time of enrolment (n = 661).

a<p>Data are no (%) of total participants, ^b,cData are row %.</p

Predictive value for 20–25, 26–30 and 31–35 weeks cultures in relation to culture status at 37+ weeks.

<p>PPV: Positive predictive value, NPV: Negative predictive value, CI-Confidence interval.</p

Association of pilus island proteins and serotypes among Group B <i>Streptococcus</i> isolates.

<p>Association of pilus island proteins and serotypes among Group B <i>Streptococcus</i> isolates.</p

Univariate and multivariate association between serotype-specific colonization and observed demographic characteristics at enrolment.

<p>OR: odds ratio; AOR: adjusted OR; CI: confidence interval.</p

Temporal Changes in Invasive Group B <i>Streptococcus</i> Serotypes: Implications for Vaccine Development

<div><p>Introduction</p><p>There is a paucity of longitudinal data on the serotype-specific burden of invasive group B <i>Streptococcus</i> (GBS) disease from low-middle income countries, which could inform selection of vaccine epitopes.</p><p>Methods</p><p>From 2005 to 2014, infants less than 90 days of age with invasive GBS disease were identified through sentinel laboratory and hospital admission surveillance at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa.</p><p>Results</p><p>We identified 820 cases of invasive GBS disease, including 55% among newborns <7 days age (i.e. early-onset disease; EOD). The overall incidence (per 1,000 live births) of invasive GBS disease was 2.59 (95% CI: 2.42–2.77), including 1.41 (95% CI: 1.28–1.55) for EOD and 1.18 (95% CI: 1.06–1.30) in infants 7–89 days age (late-onset disease). Year-on-year, from 2005 to 2014, we observed a 9.4% increase in incidence of serotype Ia invasive disease (RR: 1.09; 95% CI: 1.04–1.15; p<0.001), and a 7.4% decline in serotype III invasive disease (RR: 0.93; 95% CI: 0.90–0.96; p<0.001). Overall, serotypes Ia (28.2%), III (55.4%) and V (7.9%) were the commonest disease causing serotypes.</p><p>Conclusions</p><p>The incidence of invasive GBS disease has remained persistently high in our setting, with some changes in serotype distribution, albeit mainly involving the same group of dominant serotypes.</p></div

Demographic characteristic of infants with invasive Group B streptococcus disease.

<p>Demographic characteristic of infants with invasive Group B streptococcus disease.</p

Association between maternal Group B Streptococcus surface-protein antibody concentrations and invasive disease in their infants

<div><p>Objectives: Group B Streptococcus (GBS) surface-proteins have been shown to be immunogenic and potential vaccine candidates. We aim to determine the association between maternal IgG antibodies to select GBS surface-proteins and invasive GBS disease in their infants. Methods: Using a matched case–control study, maternal antibody levels for GBS-immunogenic bacterial adhesin, fibrinogen-binding protein A and pilus-island (PI) PI-1, PI-2a, PI-2b were compared between infants with invasive GBS disease and well-baby controls. Results: The absolute risk of disease did not differ between cases and colonized controls with increasing antibody concentrations for these surface-proteins. There was, however, a relative risk reduction in invasive disease associated with fibrinogen-binding protein A, with an adjusted odds ratio of 0.04 (95% CI: 0.01–0.69) at antibody levels ≥10,000 AU/ml. Conclusion: We have not demonstrated an association between naturally occurring fibrinogen-binding protein A, GBS-immunogenic bacterial adhesin, and PI surface-protein antibodies and the risk of invasive disease in young infants. These surface-proteins may not be suitable GBS vaccine candidates.</p></div