Frontiers in Immunology (Jun 2021)
Invasive Group B Streptococcus Disease With Recurrence and in Multiples: Towards a Better Understanding of GBS Late-Onset Sepsis
- Mirjam Freudenhammer,
- Mirjam Freudenhammer,
- Mirjam Freudenhammer,
- Konstantinos Karampatsas,
- Kirsty Le Doare,
- Fabian Lander,
- Jakob Armann,
- Daniel Acero Moreno,
- Margaret Boyle,
- Horst Buxmann,
- Ruth Campbell,
- Victoria Chalker,
- Robert Cunney,
- Robert Cunney,
- Lorraine Doherty,
- Eleri Davies,
- Androulla Efstratiou,
- Roland Elling,
- Roland Elling,
- Matthias Endmann,
- Jochen Essers,
- Roland Hentschel,
- Christine E. Jones,
- Steffen Kallsen,
- Georgia Kapatai,
- Marcus Krüger,
- Shamez Ladhani,
- Shamez Ladhani,
- Theresa Lamagni,
- Diane Lindsay,
- Mary Meehan,
- Catherine P. O’Sullivan,
- Darshana Patel,
- Darshana Patel,
- Arlene J. Reynolds,
- Claudia Roll,
- Sven Schulzke,
- Andrew Smith,
- Andrew Smith,
- Anja Stein,
- Axel von der Wense,
- Egbert Voss,
- Christian Wieg,
- Christoph Härtel,
- Christoph Härtel,
- Paul T. Heath,
- Philipp Henneke,
- Philipp Henneke,
- Philipp Henneke
Affiliations
- Mirjam Freudenhammer
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Mirjam Freudenhammer
- Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Mirjam Freudenhammer
- IMM-PACT Clinician Scientist Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Konstantinos Karampatsas
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George’s, University of London, London, United Kingdom
- Kirsty Le Doare
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George’s, University of London, London, United Kingdom
- Fabian Lander
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität (TU) Dresden, Dresden, Germany
- Jakob Armann
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität (TU) Dresden, Dresden, Germany
- Daniel Acero Moreno
- Department of Neonatology, Kinderkrankenhaus Amsterdamer Straße, Cologne, Germany
- Margaret Boyle
- Department of Health Northern Ireland, Belfast, United Kingdom
- Horst Buxmann
- Department of Pediatric and Adolescent Medicine, Division for Neonatology at the University Hospital Frankfurt, Frankfurt/Main, Germany
- Ruth Campbell
- Public Health Agency Northern Ireland, Belfast, United Kingdom
- Victoria Chalker
- 0Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom
- Robert Cunney
- 1Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
- Robert Cunney
- 2Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children’s University Hospital, Dublin, Ireland
- Lorraine Doherty
- Public Health Agency Northern Ireland, Belfast, United Kingdom
- Eleri Davies
- 3Public Health Wales, Cardiff, United Kingdom
- Androulla Efstratiou
- 4National Infection Service, Public Health England, London, United Kingdom
- Roland Elling
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Roland Elling
- Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Matthias Endmann
- 5Department of Pediatric and Adolescent Medicine, St. Franziskus Hospital Ahlen, Ahlen, Germany
- Jochen Essers
- 6Department of Pediatrics, University of Ulm, Ulm, Germany
- Roland Hentschel
- Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Christine E. Jones
- 7Faculty of Medicine and Institute for Life Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Steffen Kallsen
- 8Department of Paediatrics and Youth Medicine, Klinikum Friedrichshafen, Friedrichshafen, Germany
- Georgia Kapatai
- 0Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom
- Marcus Krüger
- 9Department of Neonatology, München Klinik Harlaching and Schwabing, Munich, Germany
- Shamez Ladhani
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George’s, University of London, London, United Kingdom
- Shamez Ladhani
- 0Immunisation and Countermeasures Division, Public Health England, London, United Kingdom
- Theresa Lamagni
- 4National Infection Service, Public Health England, London, United Kingdom
- Diane Lindsay
- 1Scottish Microbiology Reference Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom
- Mary Meehan
- 2Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children’s University Hospital, Dublin, Ireland
- Catherine P. O’Sullivan
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George’s, University of London, London, United Kingdom
- Darshana Patel
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Darshana Patel
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George’s, University of London, London, United Kingdom
- Arlene J. Reynolds
- 2Health Protection Scotland, Glasgow, United Kingdom
- Claudia Roll
- 3Department of Neonatology, Vest Children’s Hospital Datteln, University Witten-Herdecke, Witten-Herdecke, Germany
- Sven Schulzke
- 4Department of Neonatology, University Children’s Hospital Basel UKBB, Basel, Switzerland
- Andrew Smith
- 1Scottish Microbiology Reference Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom
- Andrew Smith
- 5Glasgow Dental Hospital and School, University of Glasgow, Glasgow, United Kingdom
- Anja Stein
- 6Department of Pediatrics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Axel von der Wense
- 7Neonatology and Pediatric Intensive Care, Altonaer Children’s Hospital, Altonaer Kinderkrankenhaus, Hamburg, Germany
- Egbert Voss
- 8Klinik Hallerwiese-Cnopfsche Kinderklinik, Nürnberg, Germany
- Christian Wieg
- 9Department of Neonatology, Klinikum Aschaffenburg, Aschaffenburg, Germany
- Christoph Härtel
- 0Department of Pediatrics, University of Würzburg, Würzburg, Germany
- Christoph Härtel
- 1PRIMAL (Priming Immunity at the Beginning of Life) Consortium, Freiburg/Lübeck, Germany
- Paul T. Heath
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George’s, University of London, London, United Kingdom
- Philipp Henneke
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Philipp Henneke
- Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Philipp Henneke
- 1PRIMAL (Priming Immunity at the Beginning of Life) Consortium, Freiburg/Lübeck, Germany
- DOI
- https://doi.org/10.3389/fimmu.2021.617925
- Journal volume & issue
-
Vol. 12
Abstract
Group B Streptococcus (GBS) is a common intestinal colonizer during the neonatal period, but also may cause late-onset sepsis or meningitis in up to 0.5% of otherwise healthy colonized infants after day 3 of life. Transmission routes and risk factors of this late-onset form of invasive GBS disease (iGBS) are not fully understood. Cases of iGBS with recurrence (n=25) and those occurring in parallel in twins/triplets (n=32) from the UK and Ireland (national surveillance study 2014/15) and from Germany and Switzerland (retrospective case collection) were analyzed to unravel shared (in affected multiples) or fixed (in recurrent disease) risk factors for GBS disease. The risk of iGBS among infants from multiple births was high (17%), if one infant had already developed GBS disease. The interval of onset of iGBS between siblings was 4.5 days and in recurrent cases 12.5 days. Disturbances of the individual microbiome, including persistence of infectious foci are suggested e.g. by high usage of perinatal antibiotics in mothers of affected multiples, and by the association of an increased risk of recurrence with a short term of antibiotics [aOR 4.2 (1.3-14.2), P=0.02]. Identical GBS serotypes in both recurrent infections and concurrently infected multiples might indicate a failed microbiome integration of GBS strains that are generally regarded as commensals in healthy infants. The dynamics of recurrent GBS infections or concurrent infections in multiples suggest individual patterns of exposure and fluctuations in host immunity, causing failure of natural niche occupation.
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