1. Uncovering Infant Group B Streptococcal (GBS) Disease Clusters in the United Kingdom and Ireland Through Genomic Analysis: A Population-based Epidemiological Study
- Author
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Baharak Afshar, Peter Lamb, Elita Jauneikaite, Sooria Balasegaram, Derren Ready, Robert Cunney, Eleri Davies, Paul T. Heath, Colin S Brown, Victoria Chalker, Diane S. J. Lindsay, Natalie Groves, Mary Meehan, Lorraine Doherty, Juliana Coelho, Shiranee Sriskandan, Darshana Patel, Androulla Efstratiou, Kirsty Le Doare, Arlene Reynolds, Simon M Collin, Theresa Lamagni, Andrew Smith, Catherine O'Sullivan, National Institute for Health Research, Medical Research Council (MRC), and Rosetrees Trust
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Single-nucleotide polymorphism ,Ireland/epidemiology ,medicine.disease_cause ,Microbiology ,Group B ,Streptococcus agalactiae ,03 medical and health sciences ,0302 clinical medicine ,healthcare-associated infection ,Streptococcal Infections/epidemiology ,Streptococcal Infections ,Internal medicine ,Epidemiology ,Humans ,Medicine ,SNP ,030212 general & internal medicine ,cluster ,Index case ,11 Medical and Health Sciences ,Whole genome sequencing ,group B streptococcal disease ,whole genome sequencing ,United Kingdom/epidemiology ,business.industry ,Streptococcus agalactiae/genetics ,Infant ,Outbreak ,Genomics ,06 Biological Sciences ,United Kingdom ,Epidemiologic Studies ,Disease Hotspot ,030104 developmental biology ,Infectious Diseases ,business ,Ireland - Abstract
BackgroundThe true frequency of hospital outbreaks of invasive group B streptococcal (iGBS; Streptococcus agalactiae) disease in infants is unknown. We used whole genome sequencing (WGS) of iGBS isolates collected during a period of enhanced surveillance of infant iGBS disease in the UK and Ireland to determine the number of clustered cases.MethodsPotentially linked iGBS cases from infants with early (ResultsAnalysis of sequences indicated a cutoff of ≤5 SNP differences to define iGBS clusters. Among 410 infant iGBS isolates, we identified 7 clusters (4 genetically identical pairs with 0 SNP differences, 1 pair with 3 SNP differences, 1 cluster of 4 cases with ≤1 SNP differences) of which 4 clusters were uncovered for the first time. The clusters comprised 16 cases, of which 15 were late-onset (of 192 late-onset cases with sequenced isolates) and 1 an early-onset index case. Serial intervals between cases ranged from 0 to 59 (median 12) days.ConclusionsApproximately 1 in 12 late-onset infant iGBS cases were part of a hospital cluster. Over half of the clusters were previously undetected, emphasizing the importance of routine submission of iGBS isolates to reference laboratories for cluster identification and genomic confirmation.
- Published
- 2020
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