Are Mikvehs Responsible for GBS Carriers among Orthodox Jewish Women?—A Prospective Observational Study

Jacky Herzlich,Daniel Lubin,Yehudit Schindler,Osnat Wittmann,Ronella Marom

doi:10.4236/ojog.2020.1070086

Jacky Herzlich, Daniel Lubin + Show 3 more

Open Access

https://doi.org/10.4236/ojog.2020.1070086

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Abstract

Background: Maternal colonization with group B streptococcus (GBS) is an important risk factor for neonatal sepsis. A “mikveh” is a pool of water for ritual immersion by Jewish women. It had been reported to be a risk factor for GBS colonization. Objective: To determine whether there is an association between ritual immersion in the mikveh pools and GBS carriership. Methods: Water samples and bacterial swabs were taken from eight mikveh pools centers at two separate occasions and tested for GBS growth. For determination of the total number of live, aerobic bacteria, each sample was grown on strep selective agar for 48 hours at 37°C and CO2 5%. Results: All the samples were tested. No trace of GBS was found in any of the samples. Conclusions: The findings of this study refute earlier findings and suggest that there is no association between ritual immersion in mikvehs and GBS carriership.

Highlights

Invasive group B streptococcal (GBS) disease plays an important role in infectious illness and death during the first week of life
To determine whether there is an association between ritual immersion in the mikveh pools and group B streptococcus (GBS) carriership
Water samples and bacterial swabs were taken from eight mikveh pools centers at two separate occasions and tested for GBS growth

Summary

Introduction

Invasive group B streptococcal (GBS) disease plays an important role in infectious illness and death during the first week of life. Identification of maternal colonization through universal, culture-based screening with the recommendation of providing intrapartum antibiotic prophylaxis (IAP) for women with positive screening results has been recommended since 2002 [6]. This strategy is endorsed by the American Academy of Pediatrics, and it has been widely adopted in the United States, resulting in an estimated 80% decrease in early-onset GBS infection [7]. Objective: To determine whether there is an association between ritual immersion in the mikveh pools and GBS carriership. Conclusions: The findings of this study refute earlier findings and suggest that there is no association between ritual immersion in mikvehs and GBS carriership

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