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Increased risk of group B streptococcal sepsis and meningitis in HIV-exposed uninfected infants in a high-income country

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Abstract

The purpose of this study is to compare group B Streptococcus (GBS) infection incidence in HIV-exposed uninfected (HEU) and HIV-unexposed (HU) infants in a Spanish cohort. We conducted a retrospective study in 5 hospitals in Madrid (Spain). Infants ≤ 90 days of life with a GBS infection were included from January 2008 to December 2017. Incidence of GBS infection in HEU and HU children was compared. HEU infants presented a sevenfold greater risk of GBS infection and a 29-fold greater risk of GBS meningitis compared to HU, with statistical significance. Early-onset infection was tenfold more frequent in HEU children, with statistical significance, and late-onset infection was almost fivefold more frequent in the HUE infants’ group, without statistical significance.

Conclusion: HEU infants presented an increased risk of GBS sepsis and meningitis. One in each 500 HEU infants of our cohort had a central nervous system infection and 1 in each 200, a GBS infection. Although etiological causes are not well understood, this should be taken into account by physicians when attending this population.

What is Known:

• HIV-exposed uninfected infants are at higher risk of severe infections.

• An increased susceptibility of these infants to group B Streptococcus infections has been described in low- and high-income countries, including a higher risk of meningitis in a South African cohort.

What is New:

• Group B Streptococcal meningitis is more frequent in HIV-exposed uninfected infants also in high-income countries.

• Physicians should be aware of this increased risk when attending these infants.

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Availability of data and materials

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials. Additional data are available under request.

Abbreviations

ART:

Antiretroviral therapy

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

GBS:

Group B Streptococcus

HEU:

HIV-exposed uninfected

HIV:

Human immunodeficiency virus

HU:

HIV-unexposed

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Funding

Alicia Hernanz Lobo is funded by the Spanish Ministry of Science and Innovation-Instituto de Salud Carlos III and Fondos FEDER (Contrato Río Hortega CM20/00128). The authors declare that no other funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Pediatric Infectious Disease Unit, Department of Pediatrics, Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria, Hospital 12 de Octubre (imas12), Madrid, Spain

    Á. Manzanares, L. M. Prieto-Tato & C. Epalza

  2. Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain

    L. M. Prieto-Tato, M. Navarro & C. Epalza

  3. Pediatric Infectious Disease Unit, Department of Pediatrics, CIBER en Enfermedades Infecciosas (CIBERINFEC), Hospital Universitario Carlos III-La Paz, Instituto de Salud Carlos III, Madrid, Spain

    L. Escosa-García

  4. Pediatric Infectious Disease Unit, Department of Pediatrics, Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain

    M. Navarro & A. Hernanz-Lobo

  5. Universidad Complutense de Madrid, Madrid, Spain

    L. M. Prieto-Tato, M. Navarro & J. T. Ramos-Amador

  6. Pediatric Infectious Disease Unit, Hospital de Getafe, Madrid, Spain

    S. Guillén

  7. CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain

    M. Navarro, S. Guillén & A. Hernanz-Lobo

  8. Department of Pediatrics, Hospital Universitario Ppe de Asturias, Madrid, Spain

    M. Penin

  9. Department of Pediatrics, Hospital de Getafe, Madrid, Spain

    B. Soto-Sánchez

  10. Department of Neonatology, Hospital Universitario Ppe de Asturias, Madrid, Spain

    J. Beceiro-Mosquera

  11. Microbiology and Parasitology Department, CIBER en Enfermedades Infecciosas (CIBERINFEC), Hospital Universitario La Paz, Instituto de Salud Carlos III, Madrid, Spain

    I. Falces-Romero

  12. Department of Paediatrics, CIBER en Enfermedades Infecciosas (CIBERINFEC), Universidad Complutense-Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Instituto de Salud Carlos III, Madrid, Spain

    J. T. Ramos-Amador

  13. Department of Microbiology, Hospital Universitario, Instituto de Investigación Sanitaria Hospital, 12 de Octubre12 de Octubre (imas12), Madrid, Spain

    M.Á. Orellana-Miguel

Authors
  1. Á. Manzanares
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  2. L. M. Prieto-Tato
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  3. L. Escosa-García
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  4. M. Navarro
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  5. S. Guillén
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  6. M. Penin
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  7. A. Hernanz-Lobo
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  8. B. Soto-Sánchez
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  9. J. Beceiro-Mosquera
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  10. I. Falces-Romero
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  11. J. T. Ramos-Amador
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  12. M.Á. Orellana-Miguel
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  13. C. Epalza
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Contributions

CE conceptualized the study. CE and AM design and implemented the study. CE, LMPT, and JTRA contributed to design the data collection. IFR, MAOM, LE, MN, SG, MP, AH, BSS, JBM, and AM acquired and validate the quality of the data. AM analysed the data. CE and AM interpretate the data. AM drafts the first manuscript of the work. All the authors carefully and critically review the manuscript and provided valuable intellectual contributions to the final version of the manuscript. All the authors approved the version of the manuscript and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Á. Manzanares.

Ethics declarations

Ethics approval and consent to participate

The study protocol was approved by the Scientific Committee of Hospital Universitario 12 de Octubre (code TP18/0438), who determined that no ethical approval was required. Inform consent to participants was not required as it is an observational retrospective study and no images or identifiable personal data from the participants are included, according to Spanish Real Decreto 957/2020.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Tobias Tenenbaum

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Manzanares, Á., Prieto-Tato, L.M., Escosa-García, L. et al. Increased risk of group B streptococcal sepsis and meningitis in HIV-exposed uninfected infants in a high-income country. Eur J Pediatr 182, 575–579 (2023). https://doi.org/10.1007/s00431-022-04710-6

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  • DOI: https://doi.org/10.1007/s00431-022-04710-6

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