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Maternal group B Streptococcus and the infant gut microbiota

  • A. E. Cassidy-Bushrow (a1) (a2), A. Sitarik (a1) (a2), A. M. Levin (a1) (a2), S. V. Lynch (a3), S. Havstad (a1) (a2), D. R. Ownby (a2) (a4), C. C. Johnson (a1) (a2) and G. Wegienka (a1) (a2)...


Early patterns of gut colonization may predispose children to adult disease. Exposures in utero and during delivery are associated with the infant gut microbiome. Although ~35% of women carry group B strep (GBS; Streptococcus agalactiae) during pregnancy, it is unknown if GBS presence influences the infant gut microbiome. As part of a population-based, general risk birth cohort, stool specimens were collected from infant’s diapers at research visits conducted at ~1 and 6 months of age. Using the Illumina MiSeq (San Diego, CA) platform, the V4 region of the bacterial 16S rRNA gene was sequenced. Infant gut bacterial community compositional differences by maternal GBS status were evaluated using permutational multivariate analysis of variance. Individual operational taxonomic units (OTUs) were tested using a zero-inflated negative binomial model. Data on maternal GBS and infant gut microbiota from either 1 (n=112) or 6-month-old stool (n=150) specimens was available on 262 maternal-child pairs. Eighty women (30.5%) were GBS+, of who 58 (72.5%) were given intrapartum antibiotics. After adjusting for maternal race, prenatal antifungal use and intrapartum antibiotics, maternal GBS status was statistically significantly associated with gut bacterial composition in the 6 month visit specimen (Canberra R 2=0.008, P=0.008; Unweighted UniFrac R 2=0.010, P=0.011). Individual OTU tests revealed that infants of GBS+ mothers were significantly enriched for specific members of the Clostridiaceae, Ruminococcoceae, and Enterococcaceae in the 6 month specimens compared with infants of GBS- mothers. Whether these taxonomic differences in infant gut microbiota at 6 months lead to differential predisposition for adult disease requires additional study.


Corresponding author

*Address for Correspondence: A. E. Cassidy-Bushrow, PhD, MPH, Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202, USA. (Email


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1. Penders, J, Stobberingh, EE, van den Brandt, PA, Thijs, C. The role of the intestinal microbiota in the development of atopic disorders. Allergy. 2007; 62, 12231236.
2. Saavedra, JM, Dattilo, AM. Early development of intestinal microbiota: implications for future health. Gastroenterol Clin North Am. 2012; 41, 717731.
3. Palmer, C, Bik, EM, DiGiulio, DB, Relman, DA, Brown, PO. Development of the human infant intestinal microbiota. PLoS Biol. 2007; 5, e177.
4. Koenig, JE, Spor, A, Scalfone, N, et al. Succession of microbial consortia in the developing infant gut microbiome. Proc Natl Acad Sci USA. 2011; 108(Suppl. 1), 45784585.
5. Dominguez-Bello, MG, Blaser, MJ, Ley, RE, Knight, R. Development of the human gastrointestinal microbiota and insights from high-throughput sequencing. Gastroenterology. 2011; 140, 17131719.
6. Adlerberth, I. Factors influencing the establishment of the intestinal microbiota in infancy. Nestle Nutr Workshop Ser Pediatr Program. 2008; 62, 1329.
7. Penders, J, Thijs, C, Vink, C, et al. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics. 2006; 118, 511521.
8. Azad, MB, Konya, T, Maughan, H, et al. Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months. CMAJ. 2013; 185, 385394.
9. Dillon, HC Jr., Gray, E, Pass, MA, Gray, BM. Anorectal and vaginal carriage of group B streptococci during pregnancy. J Infect Dis. 1982; 145, 794799.
10. ACOG Committee Opinion: number 279, December 2002. Prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol. 2002; 100, 14051412.
11. ACOG Committee Opinion No. 485. Prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol. 2011; 117, 10191027.
12. Sheehy, A, Davis, D, Homer, CS. Assisting women to make informed choices about screening for Group B Streptococcus in pregnancy: a critical review of the evidence. Women Birth. 2013; 26, 152157.
13. Bedford Russell, AR, Murch, SH. Could peripartum antibiotics have delayed health consequences for the infant? BJOG. 2006; 113, 758765.
14. Kubota, T, Nojima, M, Itoh, S. Vaginal bacterial flora of pregnant women colonized with group B streptococcus. J Infect Chemother. 2002; 8, 326330.
15. Bayo, M, Berlanga, M, Agut, M. Vaginal microbiota in healthy pregnant women and prenatal screening of group B streptococci (GBS). Int Microbiol. 2002; 5, 8790.
16. Brzychczy-Wloch, M, Pabian, W, Majewska, E, et al. Dynamics of colonization with group B streptococci in relation to normal flora in women during subsequent trimesters of pregnancy. New Microbiol. 2014; 37, 307319.
17. Aloisio, I, Mazzola, G, Corvaglia, LT, et al. Influence of intrapartum antibiotic prophylaxis against group B Streptococcus on the early newborn gut composition and evaluation of the anti-Streptococcus activity of Bifidobacterium strains. Appl Microbiol Biotechnol. 2014; 98, 60516060.
18. Havstad, S, Wegienka, G, Zoratti, EM, et al. Effect of prenatal indoor pet exposure on the trajectory of total IgE levels in early childhood. J Allergy Clin Immunol. 2011; 128, 880885.
19. Wegienka, G, Havstad, S, Joseph, CL, et al. Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years. Clinical & Experimental Allergy. 2012; 42, 909917.
20. Caporaso, JG, Kuczynski, J, Stombaugh, J, et al. QIIME allows analysis of high-throughput community sequencing data. Nat Methods. 2010; 7, 335336.
21. Wegienka, G, Havstad, S, Zoratti, EM, et al. Combined effects of prenatal medication use and delivery type are associated with eczema at age 2 years. Clin Exp Allergy. 2015; 45, 660668.
22. Oken, E, Kleinman, KP, Rich-Edwards, J, Gillman, MW. A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr. 2003; 3, 6.
23. Oksanen, J, Guillaume Blanchet, F, Kindt, R. et al. Vegan: community ecology package. R package version 2.0-9. 2013.
24. Chen, J. GUniFrac: Generalized UniFrac distances, 2012. Retrieved 30 January 2015 from
25. Lozupone, C, Knight, R. UniFrac: a new phylogenetic method for comparing microbial communities. Appl Environ Microbiol. 2005; 71, 82288235.
26. Chen, J, Bittinger, K, Charlson, ES, et al. Associating microbiome composition with environmental covariates using generalized UniFrac distances. Bioinformatics. 2012; 28, 21062113.
27. Storey, JD, Tibshirani, R. Statistical significance for genomewide studies. Proc Natl Acad Sci USA. 2003; 100, 94409445.
28. Olivares, M, Neef, A, Castillejo, G, et al. The HLA-DQ2 genotype selects for early intestinal microbiota composition in infants at high risk of developing coeliac disease. Gut. 2015; 64, 406417.
29. Ling, Z, Li, Z, Liu, X, et al. Altered fecal microbiota composition associated with food allergy in infants. Appl Environ Microbiol. 2014; 80, 25462554.
30. Bryant, AS, Cheng, YW, Caughey, AB. Equality in obstetrical care: racial/ethnic variation in group B streptococcus screening. Matern Child Health J. 2011; 15, 11601165.
31. Winn, HN. Group B streptococcus infection in pregnancy. Clinics Perinatol. 2007; 34, 387392.
32. Berardi, A, Rossi, C, Creti, R, et al. Group B streptococcal colonization in 160 mother-baby pairs: a prospective cohort study. J Pediatr. 2013; 163, 10991104 e1091.
33. Van Dyke, MK, Phares, CR, Lynfield, R, et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009; 360, 26262636.
34. Schrag, SJ, Verani, JR. Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease: experience in the United States and implications for a potential group B streptococcal vaccine. Vaccine. 2013; 31(Suppl. 4), D20D26.
35. Jaureguy, F, Carton, M, Panel, P, et al. Effects of intrapartum penicillin prophylaxis on intestinal bacterial colonization in infants. J Clin Microbiol. 2004; 42, 51845188.
36. Arboleya, S, Sanchez, B, Milani, C, et al. Intestinal microbiota development in preterm neonates and effect of perinatal antibiotics. J Pediatr. 2015; 166, 538544.
37. Berardi, A, Rossi, C, Lugli, L, et al. Group B streptococcus late-onset disease: 2003-2010. Pediatrics. 2013; 131, e361e368.
38. Hickman, ME, Rench, MA, Ferrieri, P, Baker, CJ. Changing epidemiology of group B streptococcal colonization. Pediatrics. 1999; 104, 203209.
39. Dominguez-Bello, MG, Costello, EK, Contreras, M, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA. 2010; 107, 1197111975.
40. Towers, CV, Rumney, PJ, Asrat, T, et al. The accuracy of late third-trimester antenatal screening for group B streptococcus in predicting colonization at delivery. Am J Perinatol. 2010; 27, 785790.
41. Illuzzi, JL, Bracken, MB. Duration of intrapartum prophylaxis for neonatal group B streptococcal disease: a systematic review. Obstet Gynecol. 2006; 108, 12541265.
42. Berardi, A, Rossi, C, Guidotti, I, et al. Factors associated with intrapartum transmission of group B streptococcus. Pediatr Infect Dis J. 2014; 33, 12111215.


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