8 research outputs found
Invasive bacterial disease trends and characterization of group B streptococcal isolates among young infants in southern Mozambique, 2001-2015
BACKGROUND: Maternal group B streptococcal (GBS) vaccines under
development hold promise to prevent GBS disease in young
infants. Sub-Saharan Africa has the highest estimated disease
burden, although data on incidence and circulating strains are
limited. We described invasive bacterial disease (IBD) trends
among infants <90 days in rural Mozambique during 2001-2015,
with a focus on GBS epidemiology and strain characteristics.
METHODS: Community-level birth and mortality data were obtained
from Manhica's demographic surveillance system. IBD cases were
captured through ongoing surveillance at Manhica district
hospital. Stored GBS isolates from cases underwent serotyping by
multiplex PCR, antimicrobial susceptibility testing, and whole
genome sequencing. RESULTS: There were 437 IBD cases, including
57 GBS cases. Significant declines in overall IBD, neonatal
mortality, and stillbirth rates were observed (P<0.0001), but
not for GBS (P = 0.17). In 2015, GBS was the leading cause of
young infant IBD (2.7 per 1,000 live births). Among 35 GBS
isolates available for testing, 31 (88.6%) were highly related
serotype III isolates within multilocus sequence types (STs) 17
(68.6%) or 109 (20.0%). All seven ST109 isolates (21.9%) had
elevated minimum inhibitory concentration (MIC) to penicillin
(>/=0.12 mug/mL) associated with penicillin-binding protein
(PBP) 2x substitution G398A. Epidemiologic and molecular data
suggest this is a well-established clone. CONCLUSION: A notable
young infant GBS disease burden persisted despite improvements
in overall maternal and neonatal health. We report an
established strain with pbp2x point mutation, a first-step
mutation associated with reduced penicillin susceptibility
within a well-known virulent lineage in rural Mozambique. Our
findings further underscores the need for non-antibiotic GBS
prevention strategies
Invasive bacterial disease trends and characterization of group B streptococcal isolates among young infants in southern Mozambique, 2001-2015
BACKGROUND: Maternal group B streptococcal (GBS) vaccines under
development hold promise to prevent GBS disease in young
infants. Sub-Saharan Africa has the highest estimated disease
burden, although data on incidence and circulating strains are
limited. We described invasive bacterial disease (IBD) trends
among infants <90 days in rural Mozambique during 2001-2015,
with a focus on GBS epidemiology and strain characteristics.
METHODS: Community-level birth and mortality data were obtained
from Manhica's demographic surveillance system. IBD cases were
captured through ongoing surveillance at Manhica district
hospital. Stored GBS isolates from cases underwent serotyping by
multiplex PCR, antimicrobial susceptibility testing, and whole
genome sequencing. RESULTS: There were 437 IBD cases, including
57 GBS cases. Significant declines in overall IBD, neonatal
mortality, and stillbirth rates were observed (P<0.0001), but
not for GBS (P = 0.17). In 2015, GBS was the leading cause of
young infant IBD (2.7 per 1,000 live births). Among 35 GBS
isolates available for testing, 31 (88.6%) were highly related
serotype III isolates within multilocus sequence types (STs) 17
(68.6%) or 109 (20.0%). All seven ST109 isolates (21.9%) had
elevated minimum inhibitory concentration (MIC) to penicillin
(>/=0.12 mug/mL) associated with penicillin-binding protein
(PBP) 2x substitution G398A. Epidemiologic and molecular data
suggest this is a well-established clone. CONCLUSION: A notable
young infant GBS disease burden persisted despite improvements
in overall maternal and neonatal health. We report an
established strain with pbp2x point mutation, a first-step
mutation associated with reduced penicillin susceptibility
within a well-known virulent lineage in rural Mozambique. Our
findings further underscores the need for non-antibiotic GBS
prevention strategies
Trends of invasive GBS disease incidence rates in young infants (<90 days), Manhiça, 2001–2015.
<p>Trends of invasive GBS disease incidence rates in young infants (<90 days), Manhiça, 2001–2015.</p
Bacterial isolations and incidence of invasive infections among young infants, Manhica demographic and health surveillance system, Mozambique, 2001–2015.
<p>Bacterial isolations and incidence of invasive infections among young infants, Manhica demographic and health surveillance system, Mozambique, 2001–2015.</p
Microbiological and molecular characteristics of GBS isolates (n = 35).
<p>Microbiological and molecular characteristics of GBS isolates (n = 35).</p
Summary of young infants aged <90 days admitted for invasive bacterial disease, Manhiça demographic and health surveillance system, Mozambique, 2001–2015.
<p>Summary of young infants aged <90 days admitted for invasive bacterial disease, Manhiça demographic and health surveillance system, Mozambique, 2001–2015.</p
Descriptive characteristics of young infants days 0–89 of age with IBD, Manhiça demographic and health surveillance system, Mozambique, 2001–2013.
<p>Descriptive characteristics of young infants days 0–89 of age with IBD, Manhiça demographic and health surveillance system, Mozambique, 2001–2013.</p