Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 19, Number 4—April 2013

Serotype IV and Invasive Group B Streptococcus Disease in Neonates, Minnesota, USA, 2000–20101

Patricia FerrieriComments to Author , Ruth Lynfield, Roberta Creti, and Aurea E. Flores
Author affiliations: University of Minnesota Medical School, Minneapolis, Minnesota, USA (P. Ferrieri, A.E. Flores); Minnesota Department of Health, St. Paul, Minnesota, USA (R. Lynfield); Istituto Superiore di Sanità, Rome, Italy (R. Creti)

Main Article

Table 5

Molecular characteristics of serotype IV GBS isolates causing invasive disease in infants and adults, Minnesota*

Isolate source† PFGE profile† Allelic profile‡ Sequence type§ Clonal complex¶
Mother, early-onset 38d 1,1,3,1,1,12,2 196 1
Infant, early-onset 40 1,1,3,1,1,12,2 196 1
Nonpregnant adult 39a 1,1,3,1,41,12,2 459 1
Mother, early-onset 36c 2,25,1,2,1,1,1 291 17
Nonpregnant adult 36d 2,25,1,2,1,1,1 291 17
Infant, late-onset 37 5,25,4,3,2,3,3 452 23
Infant, late-onset 37a 5,25,4,3,2,3,3 452 23
Infant, early-onset 37a 5,25,4,3,2,3,1 468 23

*GBS, group B Streptococcus; PFGE, pulsed-field gel electrophoresis.
†Early-onset, patient age birth–6 days or mother during peripartum period; late-onset, patient age 7–180 days.
‡Multilocus sequence type of 7 housekeeping genes (adhP, pheS, atr, glnA, sdhA, glcK, tkt).
§From database.
¶Determined by eBurst analysis (25).

Main Article

  1. Edwards  MS, Baker  CJ. Group B streptococcal infections. In: Remington JS, Klein JO, editors. Infectious diseases of the fetus and newborn infant. 5th ed. Philadelphia: Saunders; 2001. p. 1091–156.
  2. Ferrieri  P, Wallen  L. Neonatal bacterial sepsis. In: Gleason CA, Devaskar S, editors. Avery’s diseases of the newborn. 9th ed. Philadelphia: Elsevier/Saunders; 2012. p. 538–50.
  3. Guilbert  J, Levy  C, Cohen  R; Bacterial Meningitis Group. Delacourt C, Renolleau S, et al. Late and ultra late onset Streptococcus B meningitis: clinical and bacteriological data over 6 years in France. Acta Paediatr. 2010;99:47–51.DOIPubMedGoogle Scholar
  4. Imperi  M, Gherardi  G, Berardi  A, Baldassarri  L, Pataracchia  M, Dicuonzo  G, Invasive neonatal GBS infections from an area-based surveillance study in Italy. Clin Microbiol Infect. 2011;17:18349 and .DOIPubMedGoogle Scholar
  5. Manning  SD, Springman  AC, Lehotzky  E, Lewis  MA, Whittam  TS, Davies  HD. Multilocus sequence types associated with neonatal group B streptococcal sepsis and meningitis in Canada. J Clin Microbiol. 2009;47:11438 and .DOIPubMedGoogle Scholar
  6. Martins  ER, Pessanha  MA, Ramirez  M, Melo-Cristino  J; The Portuguese Group for the Study of Streptococcal Infections. Analysis of group B streptococcal isolates from infants and pregnant women in Portugal revealing two lineages with enhanced invasiveness. J Clin Microbiol. 2007;45:32249 and .DOIPubMedGoogle Scholar
  7. Schrag  S, Gorwitz  R, Fultz-Butts  K, Schuchat  A. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep. 2002;51(RR-11):122 .PubMedGoogle Scholar
  8. Jordan  HT, Farley  MM, Craig  A, Mohle-Boetani  J, Harrison  LH, Petit  S, Revisiting the need for vaccine prevention of late-onset neonatal group B streptococcal disease: a multistate, population-based analysis. Pediatr Infect Dis J. 2008;27:105764 and .DOIPubMedGoogle Scholar
  9. Zaleznik  DF, Rench  MA, Hillier  S, Krohn  MA, Platt  R, Lee  M-LT, Invasive disease due to group B streptococcus in pregnant women and neonates from diverse population groups. Clin Infect Dis. 2000;30:27681 and .DOIPubMedGoogle Scholar
  10. Harrison  LH, Elliott  JA, Dwyer  DM, Libonati  JP, Ferrieri  P, Billmann  L, Serotype distribution of invasive group B streptococcal isolates in Maryland: implications for vaccine formulation. J Infect Dis. 1998;177:9981002 and .DOIPubMedGoogle Scholar
  11. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep. 1996;45(RR-7):124 .PubMedGoogle Scholar
  12. Phares  CR, Lynfield  R, Farley  MM, Mohle-Boetani  J, Harrison  LH, Petit  S, Epidemiology of invasive group B streptococcal disease in the United States, 1999–2005. JAMA. 2008;299:205665 and .DOIPubMedGoogle Scholar
  13. Verani  JR, McGee  L, Schrag  SJ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010;59(RR-10):136 .PubMedGoogle Scholar
  14. Gherardi  G, Imperi  M, Baldassarri  L, Pataracchia  M, Alfarone  G, Recchia  S, Molecular epidemiology and distribution of serotypes, surface proteins, and antibiotic resistance among group B streptococci in Italy. J Clin Microbiol. 2007;45:290916 and .DOIPubMedGoogle Scholar
  15. Shet  A, Ferrieri  P. Neonatal & maternal group B streptococcal infections: a comprehensive review. Indian J Med Res. 2004;120:14150 .PubMedGoogle Scholar
  16. Diedrick  MJ, Flores  AE, Hillier  SL, Creti  R, Ferrieri  P. Clonal analysis of colonizing group B Streptococcus, serotype IV, an emerging pathogen in the United States. J Clin Microbiol. 2010;48:31004 and .DOIPubMedGoogle Scholar
  17. Slotved  H-C, Kong  F, Lambertsen  L, Sauer  S, Gilbert  GL. Serotype IX, a proposed new Streptococcus agalactiae serotype. J Clin Microbiol. 2007;45:292936 and .DOIPubMedGoogle Scholar
  18. Ferrieri  P, Baker  CJ, Hillier  SL, Flores  AE. Diversity of surface protein expression in group B streptococcal colonizing & invasive isolates. Indian J Med Res. 2004;119(Suppl):1916 .PubMedGoogle Scholar
  19. Johnson  DR, Ferrieri  P. Group B streptococcal Ibc protein antigen: distribution of two determinants in wild-type strains of common serotypes. J Clin Microbiol. 1984;19:50610 .PubMedGoogle Scholar
  20. Erdogan  S, Fagan  PK, Talay  SR, Rohde  M, Ferrieri  P, Flores  AE, Molecular analysis of group B protective surface protein, a new cell surface protective antigen of group B streptococci. Infect Immun. 2002;70:80311 and .DOIPubMedGoogle Scholar
  21. Ramaswamy  SV, Ferrieri  P, Madoff  LC, Flores  AE, Kumar  N, Tettelin  H, Identification of novel cps locus polymorphisms in nontypable group B Streptococcus. J Med Microbiol. 2006;55:77583 and .DOIPubMedGoogle Scholar
  22. Amundson  NR, Flores  AE, Hillier  SL, Baker  CJ, Ferrieri  P. DNA macrorestriction analysis of nontypeable group B streptococcal isolates: clonal evolution of nontypeable and type V isolates. J Clin Microbiol. 2005;43:5726 and .DOIPubMedGoogle Scholar
  23. Benson  JA, Ferrieri  P. Rapid pulsed-field gel electrophoresis method for group B streptococcus isolates. J Clin Microbiol. 2001;39:30068 and .DOIPubMedGoogle Scholar
  24. Jones  N, Bohnsack  JF, Takahashi  S, Oliver  KA, Chan  M-S, Kunst  F, Multilocus sequence typing system for group B streptococcus. J Clin Microbiol. 2003;41:25306 and .DOIPubMedGoogle Scholar
  25. Feil  EJ, Li  B, Aanensen  DM, Hanage  WP, Spratt  BG. eBURST: inferring patterns of evolutionary descent among clusters of related bacterial genotypes from multilocus sequence typing data. J Bacteriol. 2004;186:151830 and .DOIPubMedGoogle Scholar
  26. Castor  ML, Whitney  CG, Como-Sabetti  K, Facklam  RR, Ferrieri  P, Bartkus  JM, Antibiotic resistance patterns in invasive group B streptococcal isolates. Infect Dis Obstet Gynecol. 2008;2008:727505.DOIGoogle Scholar
  27. Edmond  KM, Kortsalioudaki  C, Scott  S, Schrag  SJ, Zaidi  AKM, Cousens  S, Group B streptococcal disease in infants aged younger than 3 months: systemic review and meta-analysis. Lancet. 2012;379:54756 and .DOIPubMedGoogle Scholar
  28. Lin  F-YC, Weisman  LE, Troendle  J, Adams  K. Prematurity is the major risk factor for late-onset group B streptococcus disease. J Infect Dis. 2003;188:26771 and .DOIPubMedGoogle Scholar
  29. Hamada  S, Vearncombe  M, McGeer  A, Shah  PS. Neonatal group B streptococcal disease: incidence, presentation, and mortality. J Matern Fetal Neonatal Med. 2008;21:537 and .DOIPubMedGoogle Scholar
  30. Van Dyke  MK, Phares  CR, Lynfield  R, Thomas  AR, Arnold  KE, Craig  AS, Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009;360:262636 and .DOIPubMedGoogle Scholar
  31. Thigpen  MC, Whitney  CG, Messonnier  NE, Zell  ER, Lynfield  R, Hadler  JL, Bacterial meningitis in the United States, 1998–2007. N Engl J Med. 2011;364:201625 and .DOIPubMedGoogle Scholar
  32. Puopolo  KM, Madoff  LC. Type IV neonatal early-onset group B streptococcal disease in a United States hospital. J Clin Microbiol. 2007;45:13602 and .DOIPubMedGoogle Scholar
  33. Blumberg  HM, Stephens  DS, Modansky  M, Erwin  M, Elliot  J, Facklam  RR, Invasive group B streptococcal disease: the emergence of serotype V. J Infect Dis. 1996;173:36573 and .DOIPubMedGoogle Scholar
  34. Elliott  JA, Farmer  KD, Facklam  RR. Sudden increase in isolation of group B streptococci, serotype V, is not due to emergence of a new pulsed-field gel electrophoresis type. J Clin Microbiol. 1998;36:21156 .PubMedGoogle Scholar
  35. Manning  SD, Foxman  B, Pierson  CL, Tallman  P, Baker  CJ, Pearlman  MD. Correlates of antibiotic-resistant group B streptococcus isolated from pregnant women. Obstet Gynecol. 2003;101:749 and .DOIPubMedGoogle Scholar
  36. Kothari  NJ, Morin  CA, Glennen  A, Jackson  D, Harper  J, Schrag  SJ, Invasive group B streptococcal disease in the elderly, Minnesota, USA, 2003–2007. Emerg Infect Dis. 2009;15:127981 and .DOIPubMedGoogle Scholar
  37. Koenig  JM, Keenan  WJ. Group B streptococcus and early-onset sepsis in the era of maternal prophylaxis. Pediatr Clin North Am. 2009;56:689708 and .DOIPubMedGoogle Scholar
  38. Luan  S-L, Granlund  M, Sellin  M, Lagergård  T, Spratt  BG, Norgren  M. Multilocus sequence typing of Swedish invasive group B streptococcus isolates indicates a neonatally associated genetic lineage and capsule switching. J Clin Microbiol. 2005;43:372733 and .DOIPubMedGoogle Scholar
  39. Martins  ER, Andreu  A, Correia  P, Juncosa  T, Bosch  J, Ramirez  M, Group B streptococci causing neonatal infections in Barcelona are a stable clonal population: 18-year surveillance. J Clin Microbiol. 2011;49:29118 and .DOIPubMedGoogle Scholar
  40. Edwards  MS, Lane  HJ, Hillier  SL, Rench  MA, Baker  CJ. Persistence of functional antibodies to group B streptococcal capsular polysaccharides following immunization with glycoconjugate vaccines. Vaccine. 2012;30:41236 and .DOIPubMedGoogle Scholar

Main Article

1This work was presented in part at the XVIII Lancefield International Symposium on Streptococci and Streptococcal Diseases, September 4–8, 2011, Palermo, Italy.

Page created: March 14, 2013
Page updated: March 14, 2013
Page reviewed: March 14, 2013
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.