Invasive bacterial disease trends and characterization of group B streptococcal isolates among young infants in southern Mozambique, 2001-2015
PLoS One
; 13(1): 1-16, Jan. 2018. ilus, tab, graf
Artigo
em Inglês
| RDSM
| ID: biblio-1526897
Biblioteca responsável:
MZ1.1
ABSTRACT
Maternal group B streptococcal (GBS) vaccines under development hold promise to prevent GBS disease in young infants. Sub-Saharan Africa has the highest estimated disease burden, although data on incidence and circulating strains are limited. We described invasive bacterial disease (IBD) trends among infants <90 days in rural Mozambique during 2001-2015, with a focus on GBS epidemiology and strain characteristics. Methods:
Community-level birth and mortality data were obtained from Manhiça's demographic surveillance system. IBD cases were captured through ongoing surveillance at Manhiça district hospital. Stored GBS isolates from cases underwent serotyping by multiplex PCR, antimicrobial susceptibility testing, and whole genome sequencing.Results:
There were 437 IBD cases, including 57 GBS cases. Significant declines in overall IBD, neonatal mortality, and stillbirth rates were observed (P<0.0001), but not for GBS (P = 0.17). In 2015, GBS was the leading cause of young infant IBD (2.7 per 1,000 live births). Among 35 GBS isolates available for testing, 31 (88.6%) were highly related serotype III isolates within multilocus sequence types (STs) 17 (68.6%) or 109 (20.0%). All seven ST109 isolates (21.9%) had elevated minimum inhibitory concentration (MIC) to penicillin (≥0.12 µg/mL) associated with penicillin-binding protein (PBP) 2x substitution G398A. Epidemiologic and molecular data suggest this is a well-established clone.Conclusion:
A notable young infant GBS disease burden persisted despite improvements in overall maternal and neonatal health. We report an established strain with pbp2x point mutation, a first-step mutation associated with reduced penicillin susceptibility within a well-known virulent lineage in rural Mozambique. Our findings further underscores the need for non-antibiotic GBS prevention strategies.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Moçambique
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 10: Doenças transmissíveis
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Meta 3.1: Reduzir a mortalidade materna
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Meta 3.2: Reduzir as mortes de recém nascidos e crianças com menos de 5 anos
Base de dados:
RDSM
Assunto principal:
Infecções Estreptocócicas
/
Streptococcus agalactiae
/
Infecções Bacterianas
Tipo de estudo:
Estudo de incidência
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Masculino
/
Recém-Nascido
/
Gravidez
País/Região como assunto:
África
Idioma:
Inglês
Revista:
PLoS One
Ano de publicação:
2018
Tipo de documento:
Artigo
Instituição/País de afiliação:
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique/MZ
/
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States f America/US
/
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America/MZ
/
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America/US