Abstract
BackgroundStreptococcus agalactiae or Group B Streptococcus (GBS) is the leading cause of neonatal morbidity and mortality resulting in septicaemia, bacteraemia and meningitis. Long term problems in children range from loss of hearing to mental retardation. While Intrapartum Antibiotic Prophylaxis (IAP) has reduced the incidence of S. agalactiae infection, it still remains the leading cause of disease in neonates. GBS has ten capsular types whose distribution varies across the world. Therefore, this study sought to determine the prevalence of GBS in Namibia and South Africa amongst pregnant women between 35 and 37 weeks gestation and elucidate the capsular types.MethodsLower vaginal and rectal swabs were collected from pregnant women between 35 and 37 weeks gestation. Five hundred and thirty pregnant women were recruited into the study in Windhoek, Namibia while one hundred pregnant women were recruited in the Eastern Cape, South Africa. The swabs were cultured on 5% sheep blood agar (Biomerieux, New Jersey, USA) for isolation of GBS. Presumptive isolates were confirmed using both the Vitek (2) and molecular techniques targeting the scpB gene. Capsular typing was performed in a multiplex PCR with capsular specific primer pairs.ResultsThe prevalence of GBS in Namibia was 13.6 and 37% in South Africa respectively. In both countries most women were dually colonised with GBS. Capsular types II, III and V were the most prevalent.ConclusionsThe prevalence of GBS in Namibia was lower than in South Africa in this study. The prevalence in both countries was not different from those reported in other African countries and around the world. The predominant capsular types in this study are the ones commonly associated with adverse maternal outcomes.
Highlights
Streptococcus agalactiae or Group B Streptococcus (GBS) is the leading cause of neonatal morbidity and mortality resulting in septicaemia, bacteraemia and meningitis
In Namibia, samples were transported to the Microbiology laboratory, Faculty of Health and Applied Sciences, Namibia University of Science and Technology (NUST) for culture and presumptive identification of GBS while samples collected in South Africa were processed at the Applied and Environmental Microbiology Research Group (AEMREG) laboratory, Department of Microbiology and Biochemistry, University of Fort Hare (UFH)
Out of the 530 pregnant women recruited in Namibia, 72(13.6 %) were colonized with GBS vaginally, rectally or both while in South Africa, out of 100 women screened, 37 (37%) were colonized with GBS
Summary
Streptococcus agalactiae or Group B Streptococcus (GBS) is the leading cause of neonatal morbidity and mortality resulting in septicaemia, bacteraemia and meningitis. In the 1970s, GBS emerged as the leading cause of neonatal sepsis and meningitis with case fatality rates of up to 50% and since it has remained the leading cause of neonatal sepsis and meningitis in the United States [3] The pathogenesis of these infections is based on GBS colonization of the mother vaginally or rectally and on transmission of the organism during labour or delivery [4]. Colonization rates vary between countries but as Mukesi et al BMC Infectious Diseases (2019) 19:179 many as 20–40% of healthy women are asymptomatically colonized and are at risk of transmitting it to their new-born babies [5] It can cause serious disease in neonates, pregnant women and immune-compromised patients. While infection does not cause death in pregnant women, in 10–60% of the cases it results in either miscarriage or stillbirth in developing countries when compared to with 7–11% in developed countries [6, 7]
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