A 5-year review of recurrent group B Streptococcal disease: Lessons from twin infants

Recurrent invasive disease due to group B Streptococcus (GBS) in twin infan ts has not been reported. We report 2 cases of recurrent GBS afflicting bot h siblings of a set of dichorionic twin infants. The maternal and infant co lonizing and invasive strains were identical by serotyping and pulsed-field gel electrophoresis (PFGE). Despite attempts at eradication with different antibiotic regimens, the infants remained colonized after treatment of the second episode, A 5-year review of recurrent invasive GBS disease in infan ts in our affiliated hospitals was undertaken, and 6 further cases were ide ntified. Serotyping and PFGE of isolates from initial and second episodes w ere genotypically identical for each case. Three infants each had GBS serot ype Ia or V disease and 2 had GBS serotype III disease. The exact pathogene sis of recurrent GBS disease remains unclear, but our data support the hypo thesis that persistent mucosal colonization with the original GBS strain ra ther than new acquisition is a pivotal factor in disease recurrence.