Late-onset and Recurrent Neonatal Group B Streptococcal Disease Associated with Breast-milk Transmission

  title={Late-onset and Recurrent Neonatal Group B Streptococcal Disease Associated with Breast-milk Transmission 
  author={Michael Kotiw and G W Zhang and Grant Daggard and Elizabeth Reiss-Levy and John W. Tapsall and Andrew H. Numa},
  journal={Pediatric and Developmental Pathology},
The purpose of the study was to determine the epidemiological relationships in three unrelated cases of neonatal late-onset Group B streptococcal (GBS) disease and maternal breast-milk infection with GBS. All deliveries were by cesarean section; case 1 was at term, and cases 2 and 3 were at 32- and 33-wk gestation, respectively. Case 1 relates to a mother with clinical mastitis and recurrent GBS infection in a 20-day-old male infant. Following antibiotic therapy and cessation of breastfeeding… 
Recurrent late-onset group B Streptococcus sepsis in a preterm infant acquired by expressed breastmilk transmission: a case report.
A preterm infant in the neonatal intensive care unit who acquired recurrent late-onset sepsis with Group B Streptococcus with the mother's expressed breastmilk culture growing the same organism that was later matched to the infant's isolate is described.
Group B streptococcal disease in infants: a case control study
Independent of birth weight, a number of maternal, birth and neonatal factors are significantly associated with GBS disease, and the management of babies withGBS disease results in an appreciable use of hospital resources.
Early- and Late-Onset Group B Streptococcal Infections: Overview and Case Studies
It is of utmost importance that clinicians are vigilant in prompt assessment and treatment of infants suspected of having sepsis.
Group B streptococci in milk and late neonatal infections: an analysis of cases in the literature
It is suggested that breast milk, which would account for repeated GBS transmission to the neonate, may favour gut translocation and subsequent LONI and the relative importance of this contamination route compared with persistent postnatal gut Colonisation and the dynamics of milk and neonatal gut colonisation.
Bacterial and Host Determinants of Group B Streptococcal Infection of the Neonate and Infant
The mechanisms known to enable GBS invasion into the neonatal lung, blood vessels and brain are considered, and virulence and host factors that allow the bacteria to exploit the developing neonatal immune system and target organs are summarized.
To Feed or Not to Feed? Case Presentation and Best Practice Guidance for Human Milk Feeding and Group B Streptococcus in Developed Countries
It is reported for the first time the case of both simultaneous and recurrent infection in newborn preterm twins, born 3 weeks apart, resulting from ingestion of GBS positive breast milk.
Neonatal meningitis and recurrent bacteremia with group B Streptococcus transmitted by own mother's milk: A case report and review of previous cases.
Hypervirulent Streptococcus agalactiae septicemia in twin ex-premature infants transmitted by breast milk: report of source detection and isolate characterization using commonly available molecular diagnostic methods
This is the first report of infant twins late-onset GBS infections caused by the hypervirulent S. agalactiae ST-452 with breastmilk as the source with no related events or concerns at the two-year follow up appointment.


It is likely that the pathogenesis of infection in this mother-infant pair was circular, and that either early abscess formation during the mother's first clinical infection and/or milk stasis due to decreased frequency of breast-feeding resulted in transient group B streptococcal bacteremia, with seeding of breast tissue in the newborn.
Perinatal mortality in Victoria, Australia: role of group B Streptococcus.
Clonal analysis of Streptococcus agalactiae isolated from infants with neonatal sepsis or meningitis and their mothers and from healthy pregnant women.
Evaluated group B streptococci isolated from infants with neonatal sepsis or meningitis and their mothers differ from GBS isolated from healthy pregnant women who gave birth to healthy infants, finding a population structure like that of traditional pathogens.
Analysis of DNA restriction fragment length polymorphism extends the evidence for breast milk transmission in Streptococcus agalactiae late-onset neonatal infection.
Analysis of restriction fragment length polymorphism of total DNA and of ribosomal DNA (ribotyping) was used to document four cases of Streptococcus agalactiae mother-to-infant transmission potentially associated with ingestion of infected mother's milk, extending the evidence for breast milk transmission in S. agalACTiae late-onset neonatal infection.
Restriction endonuclease analysis of group B streptococcal isolates from two distinct geographical regions.
Sudden Increase in Isolation of Group B Streptococci, Serotype V, Is Not Due to Emergence of a New Pulsed-Field Gel Electrophoresis Type
The majority of isolates of group B streptococcus, serotype V (GBS-V), are of one PFGE subtype and that this subtype was predominate before the increase in disease caused by G BS-V and that GBS- V disease is caused by several different subtypes.
Identification of a high-virulence clone of type III Streptococcus agalactiae (group B Streptococcus) causing invasive neonatal disease.
Chromosomal genotypes of 128 isolates of six serotypes of Streptococcus agalactiae recovered predominantly from human infants in the United States were characterized by an analysis of electrophoretically demonstrable allelic profiles at 11 metabolic enzyme loci.
Characterization of Streptococcus agalactiae strains by randomly amplified polymorphic DNA analysis
This investigation identified 71 RAPD types and the three families of strains defined by multilocus enzyme electrophoresis analysis, which contain most of the cerebrospinal fluid isolates, were also identified by clustering analysis of RAPD data.
A RAPD‐PCR genotyping assay which correlates with serotypes of group B streptococci
The RAPD‐PCR assay is faster, more convenient and easier to perform than alternative DNA analytical procedures such as Pulsfield Gel Electrophoresis and suggests that the assay may be robust enough for use in routine epidemiological investigations.
Genomic diversity among Streptococcus agalactiae isolates detected by a degenerate oligonucleotide-primed amplification assay.
A random-amplified polymorphic DNA assay using partially degenerate oligonucleotides as primers was used for the characterization of 78 epidemiologically related and unrelated clinical isolates of Streptococcus agalactiae belonging to different serotypes, uncovering the extent of genomic heterogeneity existent within serotypes.