期刊
NATURE MICROBIOLOGY
卷 1, 期 7, 页码 -出版社
NATURE RESEARCH
DOI: 10.1038/NMICROBIOL.2016.67
关键词
-
类别
资金
- Wellcome Trust [093804, 098532, HICF-T5-358, WT098615/Z/12/Z, 087646/Z/08/Z, 077092]
- Health Innovation Challenge Fund
- Department of Health
- UK Clinical Research Collaboration
- Medical Research Council [G0800778]
- Biotechnology and Biological Sciences Research Council
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention
- Medical Research Council [G0800778] Funding Source: researchfish
- MRC [G0800778] Funding Source: UKRI
- Wellcome Trust [087646/Z/08/Z] Funding Source: Wellcome Trust
Streptococcus agalactiae (group B streptococcus, GBS) causes neonatal disease and stillbirth, but its burden in sub-Saharan Africa is uncertain. We assessed maternal recto-vaginal GBS colonization (7,967 women), stillbirth and neonatal disease. Whole-genome sequencing was used to determine serotypes, sequence types and phylogeny. We found low maternal GBS colonization prevalence (934/7,967, 12%), but comparatively high incidence of GBS-associated stillbirth and early onset neonatal disease (EOD) in hospital (0.91 (0.25-2.3)/1,000 births and 0.76 (0.25-1.77)/1,000 live births, respectively). However, using a population denominator, EOD incidence was considerably reduced (0.13 (0.07-0.21)/1,000 live births). Treated cases of EOD had very high case fatality (17/36, 47%), especially within 24 h of birth, making under-ascertainment of community-born cases highly likely, both here and in similar facility-based studies. Maternal GBS colonization was less common in women with low socio-economic status, HIV infection and undernutrition, but when GBS-colonized, they were more probably colonized by the most virulent clone, CC17. CC17 accounted for 267/915 (29%) of maternal colonizing (265/267 (99%) serotype III; 2/267 (0.7%) serotype IV) and 51/73 (70%) of neonatal disease cases (all serotype III). Trivalent (Ia/II/III) and pentavalent (Ia/Ib/II/III/V) vaccines would cover 71/73 (97%) and 72/73 (99%) of disease-causing serotypes, respectively. Serotype IV should be considered for inclusion, with evidence of capsular switching in CC17 strains.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据