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Placental Streptococcus agalactiae DNA is associated with neonatal unit admission and foetal pro-inflammatory cytokines in term infants.

Gaccioli, F; Stephens, K; Sovio, U; Jessop, F; Wong, HS; Lager, S; Cook, E; de Goffau, MC; Le Doare, K; Peacock, SJ; et al. Gaccioli, F; Stephens, K; Sovio, U; Jessop, F; Wong, HS; Lager, S; Cook, E; de Goffau, MC; Le Doare, K; Peacock, SJ; Parkhill, J; Charnock-Jones, DS; Smith, GCS (2023) Placental Streptococcus agalactiae DNA is associated with neonatal unit admission and foetal pro-inflammatory cytokines in term infants. Nat Microbiol, 8 (12). pp. 2338-2348. ISSN 2058-5276 https://doi.org/10.1038/s41564-023-01528-2
SGUL Authors: Le Doare, Kirsty

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Abstract

Streptococcus agalactiae (Group B Streptococcus; GBS) is a common cause of sepsis in neonates. Previous work detected GBS DNA in the placenta in ~5% of women before the onset of labour, but the clinical significance of this finding is unknown. Here we re-analysed this dataset as a case control study of neonatal unit (NNU) admission. Of 436 infants born at term (≥37 weeks of gestation), 7/30 with placental GBS and 34/406 without placental GBS were admitted to the NNU (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.3-7.8). We then performed a validation study using non-overlapping subjects from the same cohort. This included a further 239 cases of term NNU admission and 686 term controls: 16/36 with placental GBS and 223/889 without GBS were admitted to the NNU (OR 2.4, 95% CI 1.2-4.6). Of the 36 infants with placental GBS, 10 were admitted to the NNU with evidence of probable but culture-negative sepsis (OR 4.8, 95% CI 2.2-10.3), 2 were admitted with proven GBS sepsis (OR 66.6, 95% CI 7.3-963.7), 6 were admitted and had chorioamnionitis (inflammation of the foetal membranes) (OR 5.3, 95% CI 2.0-13.4), and 5 were admitted and had funisitis (inflammation of the umbilical cord) (OR 6.7, 95% CI 12.5-17.7). Foetal cytokine storm (two or more pro-inflammatory cytokines >10 times median control levels in umbilical cord blood) was present in 36% of infants with placental GBS DNA and 4% of cases where the placenta was negative (OR 14.2, 95% CI 3.6-60.8). Overall, ~1 in 200 term births had GBS detected in the placenta, which was associated with infant NNU admission and morbidity.

Item Type: Article
Additional Information: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2023
Keywords: Infant, Newborn, Humans, Pregnancy, Infant, Female, Placenta, Streptococcus agalactiae, Case-Control Studies, Streptococcal Infections, Inflammation, Sepsis, Placenta, Humans, Streptococcus agalactiae, Streptococcal Infections, Sepsis, Inflammation, Case-Control Studies, Pregnancy, Infant, Infant, Newborn, Female, 0605 Microbiology, 1108 Medical Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Nat Microbiol
ISSN: 2058-5276
Language: eng
Dates:
DateEvent
December 2023Published
29 November 2023Published Online
16 October 2023Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDWellcome Trusthttp://dx.doi.org/10.13039/100004440
MR/K021133/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
UNSPECIFIEDNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
PubMed ID: 38030897
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/115946
Publisher's version: https://doi.org/10.1038/s41564-023-01528-2

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