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Genotyping and Phylogenetic Analysis of Group B Streptococcus by Multiple Locus Variable Number Tandem Repeat Analysis in Iran

Farzaneh Khodaei, Behrooz Sadeghi Kalani, Naser Alizadeh, Alka Hassani, Mohammad Najafi, Enayatollah Kalantar, Abbas Amini, Mohammad Aghazadeh

Background: Group B streptococcus (GBS), also known as Streptococcus agalactiae, is well known as a causative agent for neonatal invasive diseases; it is also a major pathogen in adults. Analytic epidemiology is required to monitor the clinical isolates of GBS. However, there is insufficient information on the genetic background of GBS in Iran, and this information is needed to guide and develop a GBS vaccine. Materials and Methods: In total, 90 well-characterized GBS isolates were collected from April 2014 to August 2015. In this study, molecular typing was used to disclose a relationship between the multiple-locus variable number tandem repeat analysis (MLVA) types, serotyping, and pilus islands. The isolates were characterized by the types of capsular polysaccharides and pilus islands and were examined by MLVA to study the epidemiological relationship of isolates. Results: The results indicate that there is a significant relationship between the distribution of serotypes and pilus island genes; GBS isolates were differentiated into 12 types by capsular polysaccharides and pilus islands analysis. The discriminatory power of an MLVA analysis was high based on the five most variable numbers of tandem repeat loci and 44 MLVA types that were identified. Conclusions: This study has provided useful insights into the genetic heterogeneity of GBS isolates in Tehran and Alborz, Iran. The extensive distribution of pilus islands in various serotypes and MLVA types throughout the GBS population refers to the advancement of the pilus-based GBS vaccines. [GMJ.2018;7:e1121]

Antimicrobial Susceptibility; Capsular Antigen; Group B Streptococcus; MLVA Typing; Pilus Island

Hunter PR, Gaston MA. Numerical index of the discriminatory ability of typing systems: an application of Simpson’s index of diversity. J Clin Microbiol. 1988; 26: 2465-6.

Skoff TH FM, Petit S. Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990–2007. Clin Infect Dis. 2009; 14: 85-92.

Eskandarian N, Neela V, Ismail Z, Puzi S, Hamat R, Desa M, et al. Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients. Int J Infect Dis. 2013; 17: e777-e80.

Vergnaud G, and C. Pourcel. Multiple locus variable number of tandem repeats analysis Methods Mol Biol. 2009; 551: 141-58.

Haguenoer E, Baty G, Pourcel C, Lartigue M-F, Domelier A-S, Rosenau A, et al. A multi locus variable number of tandem repeat analysis (MLVA) scheme for Streptococcus agalactiae genotyping. BMC Microbiol 2011; 11: 171.

Gherardi G, Imperi M, Baldassarri L, Pataracchia M, Alfarone G, Recchia S, et al. Molecular Epidemiology and Distribution of Serotypes, Surface Proteins, and Antibiotic Resistance among Group B Streptococci in Italy. J Med Microbiol. 2007;45(9):2909-16.

Jones N, Oliver KA, Barry J, Harding RM, Bisharat N, Spratt BG, et al. Enhanced invasiveness of bovine-derived neonatal sequence type 17 group B streptococcus is independent of capsular serotype. Clin Infect Dis. 2006; 42(7): 915-24.

Luan S-L, Granlund M, Sellin M, Lagergård T, Spratt BG, Norgren M. Multilocus sequence typing of Swedish invasive group B streptococcus isolates indicates a neonatally associated genetic lineage and capsule switching. J Clin Microbiol. 2005; 43(8): 3727-33.

Otaguiri ES, Morguette AEB, Tavares ER, dos Santos PMC, Morey AT, Cardoso JD, et al. Commensal Streptococcus agalactiae isolated from patients seen at University Hospital of Londrina, Paraná, Brazil: capsular types, genotyping, antimicrobial susceptibility and virulence determinants. BMC Microbiol. 2013; 13(1): 297.

Back EE, O'grady EJ, Back JD. High Rates of Perinatal Group B Streptococcus Clindamycin and Erythromycin Resistance in an Upstate New York Hospital. Antimicrob Agents Chemother. 2012; 56(2): 739-42.

Capanna F, Emonet SP, Cherkaoui A, Irion O, Schrenzel J, Martinez De Tejada Weber B. Antibiotic resistance patterns among group B Streptococcus isolates: implications for antibiotic prophylaxis for early-onset neonatal sepsis. Swiss Med Wkly. 2013; 143: w13778.

Lu B CX, Wang J, Wang D, Zeng J, Li Y, Li D, et al. Molecular characteristics and antimicrobial resistance in invasive and noninvasive Group B Streptococcus between 2008 and 2015 in China. Diagn Microbiol Infect Dis. 2016; 86(4): 351-7.

Da Cunha V, Davies MR, Douarre P-E, Rosinski-Chupin I, Margarit I, Spinali S, et al. Streptococcus agalactiae clones infecting humans were selected and fixed through the extensive use of tetracycline. Nat Commun. 2014; 5: 4544.

Uh Y, Jang IH, Hwang GY, Lee MK, Yoon KJ, Kim HY. Serotypes and Genotypes of Erythromycin-Resistant Group B Streptococci in Korea. J Clin Microbiol. 2004; 42: 3306-8.

Martins ER, Andreu A, Correia P, Juncosa T, Bosch J, Ramirez M, et al. Group B Streptococci Causing Neonatal Infections in Barcelona Are a Stable Clonal Population: 18-Year Surveillance. J Clin Microbiol. 2011; 49(8): 2911-8.

Margarit I, Rinaudo CD, Galeotti CL, Maione D, Ghezzo C, Buttazzoni E, et al. Preventing bacterial infections with pilus-based vaccines: the group B streptococcus paradigm. J Infect Dis. 2009; 199: 108-15.

Martins ER AA, Melo-Cristino J, Ramirez M. Distribution of pilus islands in Streptococcus agalactiae that cause human infections: insights into evolution and implication for vaccine development. Clin Vaccine Immunol. 2013; 20: 313-6.

Elisabete R, Martins CP-R, José Melo-Cristino, Mário Ramirez. Streptococcus agalactiae Causing Neonatal Infections in Portugal (2005–2015): Diversification and Emergence of a CC17/PI-2b Multidrug Resistant Sublineage. Front Microbiol. 2017; 8: 499.

Flores AR, Galloway-Peña J, Sahasrabhojane P, Saldaña M, Yao H, Su X, et al. Sequence type 1 group B Streptococcus, an emerging cause of invasive disease in adults, evolves by small genetic changes. Proc Natl Acad Sci USA. 2015; 112: 6431-6.

Madzivhandila M, Adrian PV, Cutland CL, Kuwanda L, Madhi SA, Team PT. Distribution of pilus islands of group B streptococcus associated with maternal colonization and invasive disease in South Africa. J Med Microbiol. 2013; 62: 249-53.

Teatero S, Ferrieri P, Martin I, Demczuk W, McGeer A, Fittipaldi N. Serotype Distribution, Population Structure, and Antimicrobial Resistance of Group B Streptococcus Strains Recovered from Colonized Pregnant Women. J Clin Microbiol. 2017; 55(2): 412-22.


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