Multidrug-Resistant Hypervirulent Group B Streptococcus in Neonatal Invasive Infections, France, 2007-2019

Abstract

We analyzed group B Streptococcus (GBS) neonatal invasive infections reported during 2007-2019 in France. The hypervirulent clonal complex (CC) 17 GBS was responsible for 66% (827/1,262) of cases. The role of CC17 GBS increased over time (p for trend = 0.0001), together with the emergence of a multidrug-resistant CC17 GBS sublineage.

Keywords: France; GBS; Streptococcus agalactiae; antimicrobial resistance; bacteria; early-onset disease; group B Streptococcus; hypervirulent CC17 clone; late-onset disease; neonatal infections.

Figure 1

Increasing responsibility of the hypervirulent CC17 clone in GBS neonatal invasive diseases, France, 2007–2019. The annual proportion of infections caused by CC17 GBS during EOD (blue line), LOD (red line), and overall (black line) are represented. Results are expressed as percentage of total GBS isolates per syndrome and per year. Error bars indicate 95% CIs. Evolutionary trends were analyzed using 2-tailed nonparametric Spearman correlation. CC, clonal complex; EOD, early-onset disease; GBS, group B Streptococcus; LOD, late-onset disease.

Figure 2

Increasing prevalence of MDR CC17 GBS among neonatal invasive isolates, France, 2007–2019. The annual proportion of infections caused by MDR CC17 GBS, such as those harboring the determinants tet(O), erm(B), and aphA-3, during EOD (blue line), LOD (red line) and overall (black line) are represented. Results are expressed as percentage of total GBS isolates per syndrome and per year. Error bars indicate 95% CIs. Evolutionary trends were analyzed using 2-tailed nonparametric Spearman correlation. CC, clonal complex; EOD, early-onset disease; GBS, group B Streptococcus; LOD, late-onset disease; MDR, multidrug-resistant.