Abstract

Rectovaginal area of pregnant women can be colonized transiently with group B Streptococcus (GBS) without causing disease. The bacteria can be transmitted to the newborn before and during birth and cause early-onset neonatal disease. In this study, we aimed to determine the GBS colonization rate among pregnant women before delivery and their newborns and serotypes distribution of GBS. Two hundred-eighty pregnant women along with their newborns were screened for GBS colonization from June 2014 to October 2014 at Adama Hospital Medical College. Rectovaginal swabs from pregnant women before delivery and specimen from nasal area, external ear, umbilical cord and throat of newborns were collected and cultured. The serotyping of GBS was performed by using serotype-specific antisera. To collect sociodemographic and clinical data we employed a structured questionnaire. GBS colonization among pregnant women and their newborns were 13.2% 95% CI (8.9–17.5) and 7.4% 95% CI (4.6–10.6). Out of 37 GBS strains recovered from pregnant women, the prevalent serotypes were Ia 6(16.2%), Ib 8(21.6%), II 10(27%), III 3(8.1%), and V 8(21.6%). Out of 21 GBS strains recovered from newborns, prevalent serotypes were Ia 3(14.3%), Ib 6(28.6%), II 6(28.6%), III 4(19%), and V 1(4.8%). This study indicated the existence of primary risk factors for neonatal disease in Adama area. Serotype II was the common serotype detected in this study which is followed by serotype Ib, Ia, and V. As colonizing GBS serotypes could cause invasive disease among newborns, vaccine formulation which includes serotype II, Ia, V, Ib, and III can prevent of invasive disease caused by GBS in the study area.

Highlights

  • The primary risk factor for EOD is rectovaginal colonization of pregnant women with group B Streptococcus (GBS) during delivery[4]

  • Maternal GBS colonization rate found in this study (13.2%) was comparable with maternal GBS colonization rate reported from Nekemte, Ethiopia (12.2%)[14], Addis Ababa, Ethiopia (14.6%)[15], Eastern Ethiopia (13.68%)[16], Namibia (13.6%)[17], Kenya (12%)[18], Western Cape, South Africa (16.6%)[19]

  • Maternal GBS colonization rate found in the present study was comparable to maternal GBS colonization rate reported from Brazil (14.6%)[33] Thai-Myanmar (12%)[34], it is low compared to Germany (16%)[35], USA (21%)[36], Sweden (25.4%)[37], The Netherlands (21%)[38], and New Zealand 20%39

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Summary

Introduction

The primary risk factor for EOD is rectovaginal colonization of pregnant women with GBS during delivery[4]. The maternal GBS colonization rate varies in different settings. The lowest colonization rate was reported from India, 7.6%5 and the highest was reported from Norway, 34.8%6 Factors such as prolonged rupture of membrane, prematurity, chorioamnionitis, low level of anti-GBS capsular antibody and previous newborn with EOD can increase the risk of disease among newborns[7,8]. The strategy was updated in 2002 and 2010 to further reduce neonatal disease caused by GBS1. Even though IAP has substantially reduced EOD caused by GBS, it has several limitations. The strategy does not eliminate all cases of EOD; it does not affect LOD caused by GBS and there is a concern of the selection of antimicrobial resistance bacteria[3]. This study was sought to provide valuable data on maternal and newborns GBS colonization rate, associated risk factors and serotypes distribution

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