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@article{Collin:2021:cid/ciaa1087,
author = {Collin, SM and Groves, N and O', Sullivan C and Jauneikaite, E and Patel, D and CUnney, R and Meehan, M and Reynolds, A and Smith, A and Lindsay, D and Doherty, L and Davies, E and Chalker, V and Lamb, P and Afshar, B and Balasegaram, S and Coelho, J and Ready, D and Brown, CS and Efstratiou, A and Le, Doare K and Sriskandan, S and Heath, PT and Lamagni, T},
doi = {cid/ciaa1087},
journal = {Clinical Infectious Diseases},
pages = {e296--e302},
title = {Uncovering infant group B streptococcal (GBS) disease clusters in the UK and Ireland through genomic analysis: a population-based epidemiological study},
url = {http://dx.doi.org/10.1093/cid/ciaa1087},
volume = {72},
year = {2021}
}

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TY  - JOUR
AB  - 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 (<7 days of life) or late-onset (7–89 days) disease were identified from WGS data (HiSeq 2500 platform, Illumina) from clinical sterile site isolates collected between 04/2014 and 04/2015. We assessed time and place of cases to determine a single-nucleotide polymorphism (SNP) difference threshold for clustered cases. Case details were augmented through linkage to national hospital admission data and hospital record review by local microbiologists.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.
AU  - Collin,SM
AU  - Groves,N
AU  - O',Sullivan C
AU  - Jauneikaite,E
AU  - Patel,D
AU  - CUnney,R
AU  - Meehan,M
AU  - Reynolds,A
AU  - Smith,A
AU  - Lindsay,D
AU  - Doherty,L
AU  - Davies,E
AU  - Chalker,V
AU  - Lamb,P
AU  - Afshar,B
AU  - Balasegaram,S
AU  - Coelho,J
AU  - Ready,D
AU  - Brown,CS
AU  - Efstratiou,A
AU  - Le,Doare K
AU  - Sriskandan,S
AU  - Heath,PT
AU  - Lamagni,T
DO  - cid/ciaa1087
EP  - 302
PY  - 2021///
SN  - 1058-4838
SP  - 296
TI  - Uncovering infant group B streptococcal (GBS) disease clusters in the UK and Ireland through genomic analysis: a population-based epidemiological study
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciaa1087
UR  - http://hdl.handle.net/10044/1/81338
VL  - 72
ER  -

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