Journal article
Maternal colonisation with Streptococcus agalactiae, and associated stillbirth and neonatal disease in coastal Kenya
- Abstract:
- 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 colonisation (7967 women), stillbirth and neonatal disease. Whole genome sequencing was used to determine serotypes, sequence types (ST), and phylogeny. We found low maternal GBS colonisation prevalence (934/7967, 12%), but comparatively high incidence of GBS associated stillbirth and early onset neonatal disease (EOD) in hospital (0.91(0.25-2.3)/1000 births; 0.76(0.25-1.77)/1000 live-births respectively). However, using a population denominator, EOD incidence was considerably reduced (0.13(0.07-0.21)/1000 live-births). Treated cases of EOD had very high case fatality (17/36, 47%), especially within 24 hours of birth, making under ascertainment of community-born cases highly likely, both here and in similar facility-based studies. Maternal GBS colonisation was less common in women with low socio-economic status, HIV infection and undernutrition, but when GBS-colonised, they were more likely colonised by the most virulent clone, CC17. CC17 accounted for 267/915(29%) of maternal colonising (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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Authors
+ Biotechnology and Biological Sciences Research Council
More from this funder
- Funding agency for:
- Sheppard, A
- Walker, A
- Crook, D
- Grant:
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
+ Medical Research Council
More from this funder
- Funding agency for:
- Sheppard, A
- Walker, A
- Crook, D
- Grant:
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
+ Department of Health UK
More from this funder
- Funding agency for:
- Sheppard, A
- Walker, A
- Crook, D
- Grant:
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
+ National Institute for Health Research
More from this funder
- Funding agency for:
- Sheppard, A
- Walker, A
- Crook, D
- Grant:
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
+ Wellcome Trust
More from this funder
- Funding agency for:
- Berkley, J
- Seale, A
- Sheppard, A
- Sheppard, A
- Walker, A
- Walker, A
- Crook, D
- Crook, D
- Grant:
- 098532
- 093804
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
- 087646/Z/08/Z
- 077092
- Publisher:
- Nature Publishing Group
- Journal:
- Nature Microbiology More from this journal
- Volume:
- 67
- Article number:
- 16067
- Publication date:
- 2016-01-01
- DOI:
- EISSN:
-
2058-5276
- Keywords:
- Pubs id:
-
pubs:616612
- UUID:
-
uuid:de0cb1f5-9618-4eb5-8db8-a82255fb60c7
- Local pid:
-
pubs:616612
- Source identifiers:
-
616612
- Deposit date:
-
2016-04-19
Terms of use
- Copyright holder:
- Macmillian Publishers Limited
- Copyright date:
- 2016
- Notes:
- © Macmillian Publishers Limited
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