Katharina Zürn1, Fabian Lander1, Markus Hufnagel2, Stefan Monecke3, Reinhard Berner1. 1. From the Department of Pediatrics, University Hospital Carl Gustav Carus, Dresden, Germany. 2. Department of Pediatrics and Adolescent Medicine, University Medical Center, Medical Faculty, University of Freiburg, Freiburg im Breisgau, Germany. 3. Leibniz Institute of Photonic Technology (IPHT), Germany/Institute for Medical Microbiology and Hygiene, Medical Faculty "Carl Gustav Carus," Technische Universität Dresden, Dresden, Germany.
Abstract
BACKGROUND: Group B Streptococcus is the leading cause of meningitis and sepsis in newborns. Until now, there is no data of fast and simple typing of group B Streptococcus virulence factors using a genetic microarray and comparing these data to clinical manifestations. METHODS: A prospective active surveillance study was conducted via 2 independent and nationwide reporting systems, the German Pediatric Surveillance Unit (ESPED) and the Laboratory Sentinel Group at Robert Koch-Institute. Surveillance was performed between 2001 and 2003 and between 2008 and 2010. Typing of virulence factors, serotypes, pilus islands and alpha-like proteins was done by means of a newly developed microarray method. RESULTS: We evaluated 475 isolates of invasive neonatal infections. Predominant virulence factors were serotype III (63%), pilus island 2b and pilus island 1 (50%) and alp rib (64%) (alp - alpha-like protein, rib -resistance to proteases, immunity, group B). There was no significant change over time or geographically within Germany. Serotype III, pilus island 2b + 1 and alp rib showed significant associations with late-onset disease and meningitis, whereas alp 5 had a significant association with early-onset disease. Based on serotypes, pilus islands and alpha-like proteins, it was possible to cluster 86% of all isolates into 5 genetic groups. CONCLUSIONS: The molecular epidemiology of a large collection of invasive neonatal infections showed similar distributions, as shown in smaller cohorts before. The microarray used proved to be a fast and reliable technique. Using this new tool, we were able to cluster the isolates according to their virulence factors. The clusters showed a better association with clinical data than single virulence factors.
BACKGROUND:Group B Streptococcus is the leading cause of meningitis and sepsis in newborns. Until now, there is no data of fast and simple typing of group B Streptococcus virulence factors using a genetic microarray and comparing these data to clinical manifestations. METHODS: A prospective active surveillance study was conducted via 2 independent and nationwide reporting systems, the German Pediatric Surveillance Unit (ESPED) and the Laboratory Sentinel Group at Robert Koch-Institute. Surveillance was performed between 2001 and 2003 and between 2008 and 2010. Typing of virulence factors, serotypes, pilus islands and alpha-like proteins was done by means of a newly developed microarray method. RESULTS: We evaluated 475 isolates of invasive neonatal infections. Predominant virulence factors were serotype III (63%), pilus island 2b and pilus island 1 (50%) and alp rib (64%) (alp - alpha-like protein, rib -resistance to proteases, immunity, group B). There was no significant change over time or geographically within Germany. Serotype III, pilus island 2b + 1 and alp rib showed significant associations with late-onset disease and meningitis, whereas alp 5 had a significant association with early-onset disease. Based on serotypes, pilus islands and alpha-like proteins, it was possible to cluster 86% of all isolates into 5 genetic groups. CONCLUSIONS: The molecular epidemiology of a large collection of invasive neonatal infections showed similar distributions, as shown in smaller cohorts before. The microarray used proved to be a fast and reliable technique. Using this new tool, we were able to cluster the isolates according to their virulence factors. The clusters showed a better association with clinical data than single virulence factors.