학술논문
Risk Factors for Infant Colonization by Hypervirulent CC17 Group B Streptococcus: Toward the Understanding of Late-onset Disease.
Document Type
Article
Author
Tazi, Asmaa; Plainvert, Céline; Anselem, Olivia; Ballon, Morgane; Marcou, Valérie; Seco, Aurélien; Alaoui, Fatma El; Joubrel, Caroline; Helali, Najoua El; Falloukh, Emile; Frigo, Amandine; Raymond, Josette; Trieu-Cuot, Patrick; Branger, Catherine; Monnier, Alban Le; Azria, Elie; Ancel, Pierre-Yves; Jarreau, Pierre Henri; Mandelbrot, Laurent; Goffinet, François
Source
Subject
*FECAL analysis
*BREAST milk
*CONFIDENCE intervals
*DELIVERY (Obstetrics)
*HOST-bacteria relationships
*LONGITUDINAL method
*MATERNAL health services
*MEDICAL cooperation
*MULTIVARIATE analysis
*POSTNATAL care
*PRENATAL care
*RESEARCH
*RISK assessment
*STREPTOCOCCAL diseases
*VAGINA
*MICROBIAL virulence
*SYMPTOMS
*DISEASE incidence
*VERTICAL transmission (Communicable diseases)
*ODDS ratio
*DISEASE risk factors
*CHILDREN
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Language
ISSN
1058-4838
Abstract
Background In infants, the mode of acquisition of CC17 group B Streptococcus (GBS), the hypervirulent clone responsible for late-onset disease (LOD), remains elusive Methods In a prospective multicenter study in France, we evaluated GBS colonization in mother–baby pairs with 2 months of follow-up between 2012 and 2015. Criteria included positivity for GBS colonization at antenatal screening or at delivery. Maternal vaginal samples and infant oral cavity and stool samples were analyzed at delivery, 21 ± 7 days (D21), and 60 ± 7 days (D60) post-delivery Results A total of 890 mother–baby pairs were analyzed. GBS colonized 7%, 21%, and 23% of the infants at birth, D21, and D60, respectively, of which 10%, 11%, and 13% were identified as CC17 GBS. Concordance between maternal and infant GBS type was 96%. At D21, the main risk factors for infant colonization by GBS were simultaneous maternal colonization of the vagina (odds ratio [OR], 4.50; 95% confidence interval [CI], 1.69–15.61) and breast milk (OR, 7.93; 95% CI, 3.81–17.14). Importantly, 38% (95% CI, 23%–56%) of infants colonized by CC17 GBS appeared colonized for the first time at D60 vs 18% (95% CI, 14%–24%; P <.049) of infants colonized by non-CC17 GBS. Multivariate analysis showed a higher risk for de novo infant colonization by CC17 at D60 than by other GBS (OR, 2.45; 95% CI, 1.02–5.88). Conclusions The high incidence of CC17 GBS in LOD is likely due to an enhanced post-delivery mother-to-infant transmission. [ABSTRACT FROM AUTHOR]