Abstract
This study investigated the prevalence of recto-vaginal Group B Streptococcus (GBS) colonization, serotype distribution, and antimicrobial susceptibility patterns among pregnant women in Dongguan, China. Recto-vaginal swabs were collected from pregnant women at gestational age 35–37 weeks between January 1st 2009 and December 31st 2014. Isolates were serotyped by latex-agglutination and were tested against seven antimicrobials by disk diffusion. Of 7,726 pregnant women who completed GBS testing, 636 (8.2%) were GBS carriers. Of 153 GBS isolates available for typing, 6 serotypes (Ia, Ib, III, V, VI and VIII) were identified with type III being predominant, while 9 (5.9%) were non-typable isolates. All isolates were sensitive to penicillin, ceftriaxone, linezolid and vancomycin, whereas 52.4% were resistant to clindamycin, 25.9% were resistant to levofloxacin and 64.9% were resistant to erythromycin. This study showed the recto-vaginal colonization prevalence of GBS in Dongguan is significant. Due to 100% susceptibility to penicillin of all GBS samples, penicillin remains the first recommendation for treatment and prevention against GBS infection. Susceptibility testing should be performed for women allergic to penicillin in order to choose the most appropriate antibacterial agents for treatment and prevention of vertical transmission to neonates. In addition, we suggest establishing standard processes for GBS culture and identification in China as early as possible.
Highlights
Group B Streptococcus (GBS) bacteria cause invasive disease primarily in infants, pregnant or postpartum women, and older adults, with the highest incidence in the United States being among black infants [1]
Isolates were tested against penicillin, ceftriaxone, levofloxacin, clindamycin, erythromycin, linezolid, and vancomycin, by the K-B disk diffusion (Oxoid Limited, United Kingdom) method according to Clinical and Laboratory Standards Institute (CLSI) 2009 guidelines, using Streptococcus pneumoniae ATCC49619 as a control strain[12]
A review by Stoll reported that overall maternal GBS colonization rate in developing countries was 12.7% [13]
Summary
Group B Streptococcus (GBS) bacteria cause invasive disease primarily in infants, pregnant or postpartum women, and older adults, with the highest incidence in the United States being among black infants [1]. Epidemiological studies have revealed that pregnant women colonized with GBS are 25-times more likely to deliver infants with early onset of GBS disease (EOD, occurring before 7 days of age) than women with negative prenatal cultures [5, 6]. The introduction of routine screening for rectovaginal colonization in late pregnancy (35–37 weeks) and intrapartum antibiotic prophylaxis (IAP) administration at delivery has significantly reduced the incidence of EOD in countries where it has been implemented [1, 9, 10]. There are no specific guidelines for GBS screening and prevention in China, and no surveillance program exists to monitor the prevalence of GBS infection among pregnant women or infants [11]. We explored GBS susceptibility to seven common antibiotics to guide intrapartum antibiotic prophylaxis, and to reduce newborn EOD infection
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