OBJECTIVES: Current predominant routes of group B Streptococcus (GBS) transmission in preterm neonates admitted to neonatal intensive care unit (NICU) are poorly defined. We report 2 overlapping clusters of GBS late-onset disease (LOD) from June to September 2015 in an Italian NICU.METHODS: During the outbreak, possible sources of transmission (equipment, feeding bottles and breast pumps) were swabbed. Specimens from throat and rectum were collected on a weekly basis from all neonates admitted to NICU. Colonized or infected neonates had cohorting. Bacterial isolates were characterized by serologic and molecular typing methods.RESULTS: GBS was isolated in 2 full-term and 7 preterm neonates. Strains belonged to serotype III, with 3 different sequence types (ST17, ST182 and ST19). Full-term neonates were colonized with GBS strains unrelated to the clusters (ST182 and ST19). Two distinct ST17 strains caused 2 clusters in preterm neonates: a first cluster with 1 case of LOD and a second, larger cluster with 6 LOD in 5 neonates (one of them had recurrence). ST17 strains were isolated from vaginorectal and milk samples of 2 mothers. Two preterm neonates had no evidence of colonization for weeks, until they presented with LOD.CONCLUSIONS: Molecular analyses identified the presence of multiclonal GBS strains and 2 clusters of 7 cases of GBS-LOD. The dynamics of transmission of GBS within the NICU were complex. Breast milk was suspected to be one of the possible sources. In a research setting, the screening of GBS carrier mothers who deliver very preterm could contribute to the tracking of GBS transmission.

Two Overlapping Clusters of Group B Streptococcus Late-onset Disease in a Neonatal Intensive Care Unit / Berardi, Alberto; Guidotti, Isotta; Creti, Roberta; Alfarone, Giovanna; Grottola, Antonella; Venturelli, Claudia; Fregni Serpini, Giulia; Della Casa, Elisa; Vecchi, Elena; Boncompagni, Alessandra; Toffoli, Carlotta; Ferrari, Fabrizio. - In: THE PEDIATRIC INFECTIOUS DISEASE JOURNAL. - ISSN 1532-0987. - 37:11(2018), pp. 1160-1164.

Two Overlapping Clusters of Group B Streptococcus Late-onset Disease in a Neonatal Intensive Care Unit

Berardi, Alberto;Guidotti, Isotta;Grottola, Antonella;VECCHI, Elena;Boncompagni, Alessandra;Toffoli, Carlotta;Ferrari, Fabrizio
2018

Abstract

OBJECTIVES: Current predominant routes of group B Streptococcus (GBS) transmission in preterm neonates admitted to neonatal intensive care unit (NICU) are poorly defined. We report 2 overlapping clusters of GBS late-onset disease (LOD) from June to September 2015 in an Italian NICU.METHODS: During the outbreak, possible sources of transmission (equipment, feeding bottles and breast pumps) were swabbed. Specimens from throat and rectum were collected on a weekly basis from all neonates admitted to NICU. Colonized or infected neonates had cohorting. Bacterial isolates were characterized by serologic and molecular typing methods.RESULTS: GBS was isolated in 2 full-term and 7 preterm neonates. Strains belonged to serotype III, with 3 different sequence types (ST17, ST182 and ST19). Full-term neonates were colonized with GBS strains unrelated to the clusters (ST182 and ST19). Two distinct ST17 strains caused 2 clusters in preterm neonates: a first cluster with 1 case of LOD and a second, larger cluster with 6 LOD in 5 neonates (one of them had recurrence). ST17 strains were isolated from vaginorectal and milk samples of 2 mothers. Two preterm neonates had no evidence of colonization for weeks, until they presented with LOD.CONCLUSIONS: Molecular analyses identified the presence of multiclonal GBS strains and 2 clusters of 7 cases of GBS-LOD. The dynamics of transmission of GBS within the NICU were complex. Breast milk was suspected to be one of the possible sources. In a research setting, the screening of GBS carrier mothers who deliver very preterm could contribute to the tracking of GBS transmission.
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Two Overlapping Clusters of Group B Streptococcus Late-onset Disease in a Neonatal Intensive Care Unit / Berardi, Alberto; Guidotti, Isotta; Creti, Roberta; Alfarone, Giovanna; Grottola, Antonella; Venturelli, Claudia; Fregni Serpini, Giulia; Della Casa, Elisa; Vecchi, Elena; Boncompagni, Alessandra; Toffoli, Carlotta; Ferrari, Fabrizio. - In: THE PEDIATRIC INFECTIOUS DISEASE JOURNAL. - ISSN 1532-0987. - 37:11(2018), pp. 1160-1164.
Berardi, Alberto; Guidotti, Isotta; Creti, Roberta; Alfarone, Giovanna; Grottola, Antonella; Venturelli, Claudia; Fregni Serpini, Giulia; Della Casa, Elisa; Vecchi, Elena; Boncompagni, Alessandra; Toffoli, Carlotta; Ferrari, Fabrizio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1168361
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