title: A 5-year review of recurrent group B streptococcal disease: lessons from twin infants.
abstract: Recurrent invasive disease due to group B Streptococcus (GBS) in twin infants has not been reported. We report 2 cases of recurrent GBS afflicting both siblings of a set of dichorionic twin infants. The maternal and infant colonizing and invasive strains were identical by serotyping and pulsed-field gel electrophoresis (PFGE). Despite attempts at eradication with different antibiotic regimens, the infants remained colonized after treatment of the second episode. A 5-year review of recurrent invasive GBS disease in infants in our affiliated hospitals was undertaken, and 6 further cases were identified. Serotyping and PFGE of isolates from initial and second episodes were genotypically identical for each case. Three infants each had GBS serotype Ia or V disease and 2 had GBS serotype III disease. The exact pathogenesis of recurrent GBS disease remains unclear, but our data support the hypothesis that persistent mucosal colonization with the original GBS strain rather than new acquisition is a pivotal factor in disease recurrence.
authors.affiliation: Section of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA. emoylett@bcm.tmc.edu
authors.forename: E H
authors.initials: EH
authors.lastname: Moylett
authors.forename: M
authors.initials: M
authors.lastname: Fernandez
authors.forename: M A
authors.initials: MA
authors.lastname: Rench
authors.forename: M E
authors.initials: ME
authors.lastname: Hickman
authors.forename: C J
authors.initials: CJ
authors.lastname: Baker
mesh_terms: D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D004269:DNA, Bacterial / Q000302:isolation & purification; D003625:Data Collection; D004200:Diseases in Twins / Q000175:diagnosis* / Q000453:epidemiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012703:Serotyping; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D013292:Streptococcus agalactiae / Q000145:classification* / Q000302:isolation & purification; D014429:Twins, Dizygotic
chemical_list: D004269:DNA, Bacterial