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Association between capsular serotype V and macrolide resistance in group B Streptococcus

Published online by Cambridge University Press:  05 June 2014

P. SENDI  and
S. FRÖHLICHER
P. SENDI*
Affiliation:
Department of Infectious Diseases, University Hospital of Bern, Switzerland Institute of Infectious Diseases, University of Bern, Switzerland
S. FRÖHLICHER
Affiliation:
Institute of Infectious Diseases, University of Bern, Switzerland
*
*Author for correspondence: Dr P. Sendi, Department of Infectious Diseases, University Hospital of Bern and Institute of Infectious Diseases, University of Bern, 3010, Bern, Switzerland. (Email: parham.sendi@ifik.unibe.ch)
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Correspondence
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Epidemiology & Infection , Volume 143 , Issue 4 , March 2015 , pp. 754 - 756
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Copyright © Cambridge University Press 2014 

To the Editor

Group B Streptococcus (GBS) expresses a polysaccharide antigen on its surface that is used for serotype identification (serotypes Ia, Ib, II–IX). Serotyping can be performed by use of a rapid latex agglutination test or by polymerase chain reaction (PCR) analysis [Reference Kong1]. The serotype distribution of both invasive and colonizing GBS isolates is continuously evolving and demonstrates not only regional, but also temporal variation. Thus, we read with interest the article by Morozumi et al. [Reference Morozumi2]. The authors investigated the serotypes, the genetic diversity by multilocus sequence typing, and the frequency of macrolide (ML) resistance of GBS isolates responsible for invasive infections in neonates in Japan from 2006 to 2011. Although their data add important information to epidemiological studies on GBS serotype distribution worldwide, we kindly request further exploration of their results on the frequency of serotype V.

Without intrapartum antimicrobial prophylaxis, peripartum transmission to the newborn is estimated to be 50–70% [Reference Anthony3], resulting in a high frequency of early-onset GBS sepsis. In previous studies, about 20% of GBS isolates found in colonized Japanese women were designated as serotype V [Reference Kimura4, Reference Ueno5]. However, in the study by Morozumi et al. [Reference Morozumi2], the frequency of serotype V isolates in 150 GBS isolates obtained from invasive infections in neonates was zero.

We recently found a highly significant association between serotype V and ML resistance in GBS-colonized Swiss women [Reference Fröhlicher6]. This is in line with previous findings in the Asia, Europe and the United States (Table 1 [Reference Fröhlicher6–Reference Andrews19]). In the study by Morozumi et al. [Reference Morozumi2], 7/32 (21·9%) serotype Ia and 24/88 (27·3%) serotype III GBS isolates showed ML resistance. We wonder whether the lack of serotype V GBS isolates is an epidemiological variation in Japan, or alternatively, whether it can be attributed to the ability of GBS to switch capsular serotypes [Reference Luan20]. Recent studies using genome analysis confirmed capsular switching in serotype IV GBS isolates designated as clonal complex (CC)17 and its variant (i.e. ST291) [Reference Meehan, Cunney and Cafferkey15, Reference Bellais21], even though CC17 GBS isolates are typically associated with serotype III. Such a phenomenon in serotype V would be, to the best of our knowledge, novel.

Table 1. Association of macrolide resistance and serotype V

AD, Adults; AGGL, agglutination test; EEM, enzymatic extraction method; ID, immunodiffusion, INF, infants; NR, not reported; NN, neonates; PCR, polymerase chain reaction; PNW, pregnant women; RFLP, restriction fragment length polymorphism.

Countries in Europe are presented in alphabetical order. The list is not exhaustive.

Acknowledgements

Our research mentioned in this letter received no specific grant from any funding agency, commercial or not-for-profit sectors.

Declaration of Interest

None.

References

REFERENCES

1. Kong, F, et al. Serotype identification of group B streptococci by PCR and sequencing. Journal of Clinical Microbiology 2002; 40: 216–226.Google Scholar
2. Morozumi, M, et al. Associations between capsular serotype, multilocus sequence type, and macrolide resistance in Streptococcus agalactiae isolates from Japanese infants with invasive infections. Epidemiology and Infection 2014; 142: 812–819.CrossRefGoogle ScholarPubMed
3. Anthony, BF. Carriage of group B streptococci during pregnancy: a puzzler. Journal of Infectious Diseases 1982; 145: 789–793.Google Scholar
4. Kimura, K, et al. Active screening of group B streptococci with reduced penicillin susceptibility and altered serotype distribution isolated from pregnant women in Kobe, Japan. Japanese Journal of Infectious Diseases 2013; 66: 158–160.Google Scholar
5. Ueno, H, et al. Characterization of group B streptococcus isolated from women in Saitama city, Japan. Japanese Journal of Infectious Diseases 2012; 65: 516–521.CrossRefGoogle ScholarPubMed
6. Fröhlicher, S, et al. Serotype distribution and antimicrobial susceptibility of group B streptococci in pregnant women: results from a Swiss tertiary centre. Swiss Medical Weekly 2014; 144: w13935.Google Scholar
7. Uh, Y, et al. Emerging erythromycin resistance among group B streptococci in Korea. European Journal of Clinical Microbiology & Infectious Diseases 2001; 20: 52–54.Google Scholar
8. Uh, Y, et al. Serotypes and genotypes of erythromycin-resistant group B streptococci in Korea. Journal of Clinical Microbiology 2004; 42: 3306–3308.Google Scholar
9. Uh, Y, et al. Correlation of serotypes and genotypes of macrolide-resistant Streptococcus agalactiae . Yonsei Medical Journal 2005; 46: 480–483.Google Scholar
10. Seo, YS, et al. Changing molecular epidemiology of group B streptococcus in Korea. Journal of Korean Medical Science 2010; 25: 817–823.CrossRefGoogle ScholarPubMed
11. Domelier, AS, et al. Molecular characterization of erythromycin-resistant Streptococcus agalactiae strains. Journal of Antimicrobial Chemotherapy 2008; 62: 1227–1233.Google Scholar
12. von Both, U, et al. A serotype V clone is predominant among erythromycin-resistant Streptococcus agalactiae isolates in a southwestern region of Germany. Journal of Clinical Microbiology 2003; 41: 2166–2169.Google Scholar
13. Gherardi, G, et al. Molecular epidemiology and distribution of serotypes, surface proteins, and antibiotic resistance among group B streptococci in Italy. Journal of Clinical Microbiology 2007; 45: 2909–2916.Google Scholar
14. Savoia, D, et al. Streptococcus agalactiae in pregnant women: phenotypic and genotypic characters. Journal of Infection 2008; 56: 120–125.Google Scholar
15. Meehan, M, Cunney, R, Cafferkey, M. Molecular epidemiology of group B streptococci in Ireland reveals a diverse population with evidence of capsular switching. European Journal of Clinical Microbiology & Infectious Diseases (in press).Google Scholar
16. Sadowy, E, Matynia, B, Hryniewicz, W. Population structure, virulence factors and resistance determinants of invasive, non-invasive and colonizing Streptococcus agalactiae in Poland. Journal of Antimicrobial Chemotherapy 2010; 65: 1907–1914.Google Scholar
17. Usein, CR, et al. Molecular characterization of adult-colonizing Streptococcus agalactiae from an area-based surveillance study in Romania. European Journal of Clinical Microbiology & Infectious Diseases 2012; 31: 2301–2310.Google Scholar
18. Martins, ER, et al. Group B streptococci causing neonatal infections in Barcelona are a stable clonal population: 18-year surveillance. Journal of Clinical Microbiology 2011; 49: 2911–2918.Google Scholar
19. Andrews, JI, et al. Group B streptococci causing neonatal bloodstream infection: antimicrobial susceptibility and serotyping results from SENTRY centers in the Western Hemisphere. American Journal of Obstetrics and Gynecology 2000; 183: 859–862.Google Scholar
20. Luan, SL, et al. Multilocus sequence typing of Swedish invasive group B streptococcus isolates indicates a neonatally associated genetic lineage and capsule switching. Journal of Clinical Microbiology 2005; 43: 3727–3733.Google Scholar
21. Bellais, S, et al. Capsular switching in group B Streptococcus CC17 hypervirulent clone: a future challenge for polysaccharide vaccine development. Journal of Infectious Diseases 2012; 206: 1745–1752.Google Scholar
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Table 1. Association of macrolide resistance and serotype V