{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T03:06:30Z","timestamp":1784948790609,"version":"3.55.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"9","funder":[{"name":"Imperial College Research Fellow","award":["M683"],"award-info":[{"award-number":["M683"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Potentially linked iGBS cases from infants with early (&amp;lt;7 days of life) or late-onset (7\u201389 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis of sequences indicated a cutoff of \u22645 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 \u22641 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately 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.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciaa1087","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T19:28:59Z","timestamp":1596569339000},"page":"e296-e302","source":"Crossref","is-referenced-by-count":14,"title":["Uncovering Infant Group B Streptococcal (GBS) Disease Clusters in the United Kingdom and Ireland Through Genomic Analysis: A Population-based Epidemiological Study"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1239-1681","authenticated-orcid":false,"given":"Simon M","family":"Collin","sequence":"first","affiliation":[{"name":"Healthcare-Associated Infection and Antimicrobial Resistance (HCAI & AMR) Division, National Infection Service, Public Health England, London, United 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Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshana","family":"Patel","sequence":"additional","affiliation":[{"name":"Respiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cunney","sequence":"additional","affiliation":[{"name":"Health Service Executive Health Protection Surveillance Centre, Dublin, Ireland"},{"name":"Irish Meningitis and Sepsis Reference Laboratory, Children\u2019s Health Ireland at Temple Street, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Meehan","sequence":"additional","affiliation":[{"name":"Irish Meningitis and Sepsis Reference Laboratory, Children\u2019s Health Ireland at Temple Street, Dublin, 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