{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T14:12:21Z","timestamp":1768486341611,"version":"3.49.0"},"reference-count":38,"publisher":"European Centre for Disease Control and Prevention (ECDC)","issue":"21","license":[{"start":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T00:00:00Z","timestamp":1527120000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,24]]},"abstract":"<jats:p>We characterised Lancefield group B streptococcal (GBS) isolates causing invasive disease among non-pregnant adults in Portugal between 2009 and 2015. All isolates (n\u2009=\u2009555) were serotyped, assigned to clonal complexes (CCs) by multilocus sequence typing and characterised by surface protein and pilus island gene profiling. Antimicrobial susceptibility was tested by disk diffusion and resistance genotypes identified by PCR. Overall, serotype Ia was most frequent in the population (31%), followed by serotypes Ib (24%) and V (18%). Serotype Ib increased significantly throughout the study period (p\u2009&lt;\u20090.001) to become the most frequent serotype after 2013. More than 40% of isolates clustered in the CC1\/<jats:italic>alp<\/jats:italic>3\/PI-1+PI-2a genetic lineage, including most isolates of serotypes Ib (n\u2009=\u2009110) and V (n\u2009=\u200965). Erythromycin and clindamycin resistance rates were 35% and 34%, respectively, both increasing from 2009 to 2015 (p\u2009&lt;\u20090.010) and associated with CC1 and serotype Ib (p\u2009&lt;\u20090.001). The Ib\/CC1 lineage probably resulted from acquisition of the type Ib capsular operon in a single recombination event by a representative of the V\/CC1 macrolide-resistant lineage. Expansion of the new serotype Ib\/CC1 lineage resulted in increased macrolide resistance in GBS, causing invasive disease among adults in Portugal. The presence of this clone elsewhere may predict more widespread increase in resistance.<\/jats:p>","DOI":"10.2807\/1560-7917.es.2018.23.21.1700473","type":"journal-article","created":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T15:55:10Z","timestamp":1527177310000},"update-policy":"https:\/\/doi.org\/10.2807\/1560-7917.es.crp2020","source":"Crossref","is-referenced-by-count":54,"title":["Increasing macrolide resistance among Streptococcus agalactiae causing invasive disease in non-pregnant adults was driven by a single capsular-transformed lineage, Portugal, 2009 to 2015"],"prefix":"10.2807","volume":"23","author":[{"given":"El\u00edsia","family":"Lopes","sequence":"first","affiliation":[{"name":"These authors contributed equally to this work"},{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"T\u00e2nia","family":"Fernandes","sequence":"additional","affiliation":[{"name":"These authors contributed equally to this work"},{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Miguel P","family":"Machado","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Jo\u00e3o Andr\u00e9","family":"Carri\u00e7o","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Jos\u00e9","family":"Melo-Cristino","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"M\u00e1rio","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Elisabete R","family":"Martins","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"name":"the Portuguese Group for the Study of Streptococcal Infections","sequence":"additional","affiliation":[]}],"member":"7995","reference":[{"issue":"3","key":"r1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1128\/CMR.11.3.497","article-title":"Epidemiology of group B streptococcal disease in the United States: shifting paradigms.","volume":"11","author":"Schuchat","year":"1998","journal-title":"Clin Microbiol Rev"},{"issue":"1","key":"r2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1086\/599369","article-title":"Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990-2007.","volume":"49","author":"Skoff","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"5","key":"r3","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1093\/cid\/cit337","article-title":"Emerging trends in the epidemiology of invasive group B streptococcal disease in England and Wales, 1991-2010.","volume":"57","author":"Lamagni","year":"2013","journal-title":"Clin Infect Dis"},{"issue":"7","key":"r4","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1128\/JCM.00355-16","article-title":"Epidemiology of invasive group B streptococcal disease in Alberta, Canada, from 2003 to 2013.","volume":"54","author":"Alhhazmi","year":"2016","journal-title":"J Clin Microbiol"},{"issue":"6","key":"r5","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1093\/jac\/dkv022","article-title":"Classification of group B streptococci with reduced \u03b2-lactam susceptibility (GBS-RBS) based on the amino acid substitutions in PBPs.","volume":"70","author":"Kimura","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"r6","doi-asserted-by":"crossref","unstructured":"Castor ML, Whitney CG, Como-Sabetti K, Facklam RR, Ferrieri P, Bartkus JM, et al. 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