title: Group B streptococcus neonatal invasive infections, France 2007-2012.
abstract: Streptococcus agalactiae (group B streptococcus (GBS)) is the leading cause of invasive infections among newborns in industrialized countries, with two described syndromes: early-onset disease (EOD) and late-onset disease (LOD). Since the introduction in many countries of intrapartum antibioprophylaxis (IAP), the incidence of EOD has dramatically decreased, whereas that of LOD remains unchanged. We describe the clinical and bacteriological characteristics of 438 GBS neonatal invasive infections notified to the French National Reference Centre for Streptococci in France from 2007 to 2012. Clinical data were retrieved from hospitalization reports or questionnaires. Capsular type, assignment to the hypervirulent clonal complex (CC)17 and antibiotic susceptibility profiles were determined. One hundred and seventy-four (39.7%) and 264 (60.3%) isolates were responsible for EOD, including death in utero, and LOD, respectively. EOD was associated with bacteraemia (n = 103, 61%) and LOD with meningitis (n = 145, 55%). EOD was mainly due to capsular polysaccharide (CPS) III isolates (n = 99, 57%) and CPS Ia isolates (n = 40, 23%), and CPS III isolates were responsible for 80% (n = 211) of LOD cases. CC17 accounted for 80% (n = 121) of CPS III isolates responsible for meningitis (n = 151; total cases of meningitis, 188). Bad outcome risk factors were low gestational age and low birthweight. LOD represents almost 60% of cases of neonatal GBS disease in France and other countries in which IAP has been implemented. This observation reinforces the need to develop new prevention strategies targeting CC17, which is predominant in GBS neonatal infections.
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', France; CNRS UMR 8104, France.
authors.forename: C
authors.initials: C
authors.lastname: Joubrel
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', France; CNRS UMR 8104, France.
authors.forename: A
authors.initials: A
authors.lastname: Tazi
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', France; CNRS UMR 8104, France.
authors.forename: A
authors.initials: A
authors.lastname: Six
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Dmytruk
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Touak
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, France.
authors.forename: P
authors.initials: P
authors.lastname: Bidet
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: J
authors.initials: J
authors.lastname: Raymond
authors.affiliation: Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, France; CNRS ERL3526, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Trieu Cuot
authors.affiliation: Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', France; CNRS UMR 8104, France.
authors.forename: A
authors.initials: A
authors.lastname: Fouet
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: S
authors.initials: S
authors.lastname: Kernéis
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, France; Centre National de Référence des Streptocoques, France; DHU Risques et Grossesse, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; INSERM U 1016, Institut Cochin, Team 'Barriers and Pathogens', France; CNRS UMR 8104, France; CNRS ERL3526, Paris, France. Electronic address: claire.poyart@cch.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Poyart
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D012307:Risk Factors; D065288:Serogroup; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D013292:Streptococcus agalactiae / Q000145:classification / Q000302:isolation & purification*; D016019:Survival Analysis
keywords: Capsular serotype; Streptococcus agalactiae; group B streptococcus; hypervirulent CC17; meningitis; neonatal infections; risk factors