Group B Streptococcal Colonisation among Pregnant Women Attending a Tertiary Care Hospital of Northeast India

Abstract

Introduction: Group B Streptococcus (GBS) is an important cause of maternal as well as neonatal morbidity and mortality worldwide. Early identification of colonisation of GBS among pregnant women plays an important role in preventing neonatal disease by taking measures such as antibiotic prophylaxis. In India, the spectrum of disease caused due to GBS is largely unrecognised due to lack of screening practices and also there is no specific guideline to prevent the disease. Aim: To determine the group B streptococcal colonisation and their antibiotic susceptibility profile among pregnant women of North-east India. Materials and Methods: The study was a hospital based cross- sectional survey conducted from April to June 2019. A total of 295 pregnant women with gestational age more than 35 weeks attending the Outpatient and Inpatient Departments were included in the study. Two vaginal swabs and two rectal swabs were collected from each participant and were processed according to standard laboratory protocol. Identification of GBS was done on the basis of Christie-Atkins-Munch-Peterson (CAMP) test and Lancefield grouping by latex agglutination test. Antibiotic susceptibility profile was also obtained for these isolates for certain antibiotics. Chi-square test was applied to determine the association of isolation among different types of cases. Results: Out of 295 pregnant women, 15(5.1%) showed GBS colonisation. There was no significant association found with age or socioeconomic status. However, GBS colonisation was found to be significantly associated with increasing gravidity (p-value=0.03). GBS colonisation of vaginal flora is siginficantly associated with rectal colonisation (p-value <0.01). Although certain isolates were found to be resistant to macrolide antibiotics (66.7%), all strains were uniformly sensitive (100%) to penicillin, levofloxacin, quinupristin-dalfopristin, vancomycin and linezolid. Conclusion: A low rate of colonisation was determined among the pregnant women and it is not associated with age and socioeconomic status. However, it is suggested that routine screening of pregnant women especially multigravida women should be done to prevent the transmission to the newborn.