Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
권호 표지
DOI QR코드

DOI QR Code

Comparative Analysis of the Molecular Characteristics of Group B Streptococcus Isolates Collected from Pregnant Korean Women Using Whole-genome Sequencing

  • Yangsoon Lee (Department of Laboratory Medicine, Hanyang University College of Medicine) ;
  • Hye Gyung Bae (Seoul Clinical Laboratories) ;
  • Dongju Won (Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Woobin Yun (Department of Laboratory Medicine, Graduate School of Medical Sciences, Brain, Korea 21 Project, Yonsei University College of Medicine) ;
  • Hyukmin Lee (Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Jong Rak Choi (Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Young Uh (Department of Laboratory Medicine, Yonsei University Wonju College of Medicine) ;
  • Kyungwon Lee (Seoul Clinical Laboratories)
  • Received : 2022.05.02
  • Accepted : 2022.09.14
  • Published : 2023.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The incidence of early- and late-onset sepsis and meningitis in neonates due to maternal rectovaginal group B Streptococcus (GBS) colonization may differ with serotype distribution and clonal complex (CC). CC17 strains are associated with hypervirulence and poor disease outcomes. GBS serotypes are distinguished based on the polysaccharide capsule, the most important virulence factor. We determined the sequence type distribution of GBS isolates from pregnant women in Korea and validated whole-genome sequencing (WGS)-based prediction of antimicrobial susceptibility and capsular serotypes in GBS isolates. Methods: Seventy-five GBS isolates collected from pregnant Korean women visiting Wonju Severance Christian Hospital, Wonju, Korea between 2017 and 2019 were subjected to WGS using the NovaSeq 6000 system (Illumina, San Diego, CA, USA). Multilocus sequence types, serotypes, antimicrobial resistance genes, and hemolysin operon mutations were determined by WGS, and the latter three were compared with the results of conventional phenotypic methods. Results: The predominant lineage was CC1 (37.3%), followed by CC19 (32.0%), CC12 (17.3%), and CC17 (4.0%). All isolates were cps typeable (100%, (75/75), and 89.3% of cps genotypes (67/75) were concordant with serotypes obtained using latex agglutination. The cps genotypes of the 75 isolates were serotypes III (24.0%), V (22.7%), and VIII (17.3%). All isolates harboring intact ermB and tet were non-susceptible to erythromycin and tetracycline, respectively. Three non-hemolytic strains had 1-bp frameshift insertions in cylE. Conclusions: The low prevalence of CC17 GBS colonization may explain the low frequency of neonatal GBS infections. WGS is a useful tool for simultaneous genotyping and antimicrobial resistance determination.

Keywords

Acknowledgement

This study was supported by a research grant from Seoul Clinical Laboratories.

References

  1. Nuccitelli A, Rinaudo CD, Maione D. Group B Streptococcus vaccine: state of the art. Ther Adv Vaccines 2015;3:76-90. https://doi.org/10.1177/2051013615579869
  2. Kardos S, Tóthpál A, Laub K, Kristóf K, Ostorházi E, Rozgonyi F, et al. High prevalence of group B streptococcus ST17 hypervirulent clone among non-pregnant patients from a Hungarian venereology clinic. BMC Infect Dis 2019;19:1009. https://doi.org/10.1186/s12879-019-4626-7
  3. Jamrozy D, Bijlsma MW, de Goffau MC, van de Beek D, Kuijpers TW, Parkhill J, et al. Increasing incidence of group B Streptococcus neonatal infections in the Netherlands is associated with clonal expansion of CC17 and CC23. Sci Rep 2020;10:9539. https://doi.org/10.1038/s41598-020-66214-3
  4. Hsu JF, Tsai MH, Lin LC, Chu SM, Lai MY, Huang HR, et al. Genomic characterization of serotype III/ST-17 group B Streptococcus strains with antimicrobial resistance using whole genome sequencing. Biomedicines 2021;9:1477. https://doi.org/10.3390/biomedicines9101477
  5. Russell NJ, Seale AC, O'Driscoll M, O'Sullivan C, Bianchi-Jassir F, Gonzalez-Guarin J, et al. Maternal colonization with group B Streptococcus and serotype distribution worldwide: systematic review and meta-analyses. Clin Infect Dis 2017;65(S2):S100-11. https://doi.org/10.1093/cid/cix658
  6. 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; 47:1143-8. https://doi.org/10.1128/JCM.01424-08
  7. Kapatai G, Patel D, Efstratiou A, Chalker VJ. Comparison of molecular serotyping approaches of Streptococcus agalactiae from genomic sequences. BMC Genomics 2017;18:429. https://doi.org/10.1186/s12864-017-3820-5
  8. Sheppard AE, Vaughan A, Jones N, Turner P, Turner C, Efstratiou A, et al. Capsular typing method for Streptococcus agalactiae using wholegenome sequence data. J Clin Microbiol 2016;54:1388-90. https://doi.org/10.1128/JCM.03142-15
  9. Metcalf BJ, Chochua S, Gertz RE, Jr., Hawkins PA, Ricaldi J, Li Z, et al. Short-read whole genome sequencing for determination of antimicrobial resistance mechanisms and capsular serotypes of current invasive Streptococcus agalactiae recovered in the USA. Clin Microbiol Infect 2017; 23:574.e7-14. https://doi.org/10.1016/j.cmi.2017.02.021
  10. Shin H, Takahashi T, Lee S, Choi EH, Maeda T, Fukushima Y, et al. Comparing genomic characteristics of Streptococcus pyogenes associated with invasiveness over a 20-year period in Korea. Ann Lab Med 2022; 42:438-46. https://doi.org/10.3343/alm.2022.42.4.438
  11. Choi SJ, Kang J, Uh Y. Recent epidemiological changes in Group B Streptococcus among pregnant Korean women. Ann Lab Med 2021;41:380-5. https://doi.org/10.3343/alm.2021.41.4.380
  12. Six A, Firon A, Plainvert C, Caplain C, Bouaboud A, Touak G, et al. Molecular characterization of nonhemolytic and nonpigmented group B streptococci responsible for human invasive infections. J Clin Microbiol 2016;54:75-82. https://doi.org/10.1128/JCM.02177-15
  13. 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;48:3100-4. https://doi.org/10.1128/JCM.00277-10
  14. Lin HC, Chen CJ, Chiang KH, Yen TY, Ho CM, Hwang KP, et al. Clonal dissemination of invasive and colonizing clonal complex 1 of serotype VI group B Streptococcus in central Taiwan. J Microbiol Immunol Infect 2016;49:902-9. https://doi.org/10.1016/j.jmii.2014.11.002
  15. Furfaro LL, Chang BJ, Payne MS. Perinatal Streptococcus agalactiae epidemiology and surveillance targets. Clin Microbiol Rev 2018;31:e00049-18. https://doi.org/10.1128/CMR.00049-18
  16. Nagaoka K, Konno S, Murase K, Kikuchi T, Nakagawa I. Complete genome sequence of Streptococcus agalactiae serotype III, multilocus sequence type 335 strain HU-GS5823, isolated from a human patient in Japan with severe invasive infection. Microbiol Resour Announc 2018; 7:e01303-18. https://doi.org/10.1128/MRA.01303-18
  17. Park KH, Kim KH, Kang JH, Kim KN, Kim DS, Kim YK, et al. Current status and clinical presentations of invasive neonatal Group B streptococcal infections in Korea. Pediatr Int 2011;53:236-9. https://doi.org/10.1111/j.1442-200X.2010.03165.x
  18. Kim SJ, Kim GE, Park JH, Lee SL, Kim CS. Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit. Korean J Pediatr 2019;62:36-41. https://doi.org/10.3345/kjp.2018.06807
  19. Kong F, Lambertsen LM, Slotved HC, Ko D, Wang H, Gilbert GL. Use of phenotypic and molecular serotype identification methods to characterize previously nonserotypeable group B streptococci. J Clin Microbiol 2008;46:2745-50. https://doi.org/10.1128/JCM.00189-08
  20. Paoletti LC and Madoff LC. Vaccines to prevent neonatal GBS infection. Semin Neonatol 2002;7:315-23. https://doi.org/10.1053/siny.2002.0114
  21. Ramaswamy SV, Ferrieri P, Flores AE, Paoletti LC. Molecular characterization of nontypeable group B Streptococcus. J Clin Microbiol 2006;44: 2398-403. https://doi.org/10.1128/JCM.02236-05
  22. Morozumi M,Wajima T, Kuwata Y, Chiba N, Sunaoshi K, Sugita K, et al. Associations between capsular serotype, multilocus sequence type, and macrolide resistance in Streptococcus agalactiae isolates from Japanese infants with invasive infections. Epidemiol Infect 2014;142:812-9. https://doi.org/10.1017/S0950268813001647
  23. Mudzana R, Mavenyengwa RT, Gudza-Mugabe M. Analysis of virulence factors and antibiotic resistance genes in group B Streptococcus from clinical samples. BMC Infect Dis 2021;21:125. https://doi.org/10.1186/s12879-021-05820-6
  24. Mingoia M, Morici E, Marini E, Brenciani A, Giovanetti E, Varaldo PE. Macrolide resistance gene erm(TR) and erm(TR)-carrying genetic elements in Streptococcus agalactiae: characterization of ICESagTR7, a new composite element containing IMESp2907. J Antimicrob Chemother 2016;71:593-600. https://doi.org/10.1093/jac/dkv408