Abstract

Streptococcus agalactiae is an important pathogen in neonates and pregnant women. Neonatal invasive infections due to S. agalactiae are life-threatening and preventive strategies for this challenge of human have become a concern. The aim of the present study was to determine the prevalence of rectovaginal colonization, related risk factors and antibiotic resistance pattern of S. agalactiae among pregnant women in Iran. The present study was performed on 240 pregnant women. Vaginal and rectal swabs were obtained from all of the women and then were transferred to the laboratory. The isolation and identification of S. agalactiae was performed by standard microbiological tests and polymerase chain reaction (PCR) assay. The antimicrobial susceptibility patterns of the isolates were determined by the Kirby-Bauer disk diffusion. Polymerase chain reaction was used to detect ermB and mefA genes in erythromycin-nonsusceptible isolates. Out of 240 pregnant women, 16 cases (6.7%) were colonized by S. agalactiae. There is no significant association between demographic-obstetric factors and maternal S. agalactiae colonization in the pregnant women. Linezolid, vancomycin and ampicillin were the most effective antibiotics against S. agalactiae. The ermB gene was present in 6 (35.29%) S. agalactiae isolates. However, the mefA gene was not detected in any of the isolates. Given the relatively significant prevalence of S. agalactiae colonization in the pregnant women in the present study and the risk of serious neonatal infections, the screening of pregnant mothers for the bacteria seems necessary. Our findings highlight the importance of appropriate antibiotic prophylaxis during pregnancy for the prevention of early onset S. agalactiae-neonatal infection and comorbidity.

Highlights

  • Streptococcus agalactiae (Group B Streptococcus [GBS]) is considered as the dominant pathogen in causing septicemia and meningitis in infants < 3 months old

  • The isolation and identification of S. agalactiae was performed by standard microbiological tests and polymerase chain reaction (PCR) assay

  • There is no significant association between demographic-obstetric factors and maternal S. agalactiae colonization in the pregnant women

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Summary

Introduction

Streptococcus agalactiae (Group B Streptococcus [GBS]) is considered as the dominant pathogen in causing septicemia and meningitis in infants < 3 months old. Neonatal invasive infections due to S. agalactiae are life-threatening and preventive strategies for this challenge of human have become a concern.[1,2]. As an important opportunistic human pathogen, GBS can be colonized in the rectovaginal area of women and subsequently transmitted to the neonates in the womb or during labor. The rate of GBS colonization among pregnant women varies with ethnic group, marital status, number of deliveries, geographic area and age.[3,4] It is noteworthy that $ between 10 and 30% of women during pregnancy are colonized with S. agalactiae in the vagina and 60% of their infants acquire the bacteria through the birth canal.[5,6] Identification of maternal GBS colonization during pregnancy is important for taking preventive measures to control neonatal diseases.[1,2]

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