Abstract
BackgroundColonization and transmission precede invasive group B streptococcal (GBS) disease. Data on GBS colonization prevalence, detection methods and risk factors for carriage are relevant for vaccine development and to understand GBS pathogenesis. ObjectivesTo evaluate GBS colonization prevalence after the first week of life in the healthy non-pregnant population. Data sourcesPubmed/Medline, Embase, Latin American and Caribbean Health Sciences Literature, World Health Organization Library Information System, and Scopus. Search performed 12 January 2021 with search terms related to ‘GBS’ and ‘colonization, epidemiology, prevalence or screening’ without restrictions. Study eligibility criteriaAll studies that reported prevalence of GBS colonization (any site) in the healthy population. ParticipantsAll individuals (>6 days of age), with no indication of pregnancy, invasive disease or severe underlying immunological co-morbidities. MethodsLogit transformation and a random effects model (DerSimonian and Laird) were used to pool colonization estimates. Subgroup analysis and meta-regression on a priori determined subgroups were performed. ResultsWe included 98 studies with 43 112 participants. Our search identified 9309 studies of which 8831 were excluded based on title and abstract and 380 after reading the full text. Colonization rates varied considerably between studies (I2 = 97%), which could be partly explained by differences in culture methods (R2 = 27%), culture sites (R2 = 24%), continent (R2 = 10%) and participant's age (R2 = 6%). Higher prevalence was found with selective culture methods (19%, 95% CI 16%–23% versus non-selective methods 8%, 95% CI 6%–9%; p < 0.0001). Colonization rates were highest in rectum (19%, 95% CI 15%–24%), vagina (14%, 95% CI 12%–17%) and urethra (9%, 95% CI 5%–18%). In participants with negative rectal cultures, 7% (95% CI 5%–9%) had GBS cultured from another niche. Colonization prevalence was lower in children (6 months to 16 years; 3%, 95% CI 2%–5%) compared with adults (16%, 95% CI 14%–20%; p < 0.0001). Using selective culture methods in adults resulted in a prevalence of 26% (95% CI 19%–33%) rectal, 21% (95% CI 17%–25%) vaginal and 9% (95% CI 6%–14%) urethral colonization. ConclusionThe rectum is the most common body site colonized by GBS. The best approach to screen for any GBS colonization is to screen multiple body sites using selective culture methods.
Highlights
Group B streptococcus (GBS; Streptococcus agalactiae) is a Grampositive bacterium that frequently colonizes the gastrointestinal and genitourinary tracts, and can be found in the oropharynx [1e3]
We used the search terms relating to Streptococcus agalactiae or Group B streptococcus and carriage or colonization or prevalence
Comparing studies with higher (JBI 6e10) to studies with lower (JBI 0e3) methodological quality, we found no significant difference in the prevalence of colonization (15.5%, 95% CI 11.0%e21.3% versus 10.7%, 95% CI 8.0%e14.1%; p 0.10)
Summary
Group B streptococcus (GBS; Streptococcus agalactiae) is a Grampositive bacterium that frequently colonizes the gastrointestinal and genitourinary tracts, and can be found in the oropharynx [1e3]. GBS colonization, transmission and invasive disease have been most extensively studied in pregnant women and their newborns. Vertical transmission before or during birth leads to invasive disease in the first 3 days of life in an estimated 0.1% of all neonates born to GBS-colonized mothers [10,11]. Invasive disease after the first days of life and into adulthood can follow GBS transmission from sources other than the mother and is often preceded by a period of asymptomatic colonization [11,12]. Using selective culture methods in adults resulted in a prevalence of 26% (95% CI 19%e33%) rectal, 21% (95% CI 17%e25%) vaginal and 9% (95% CI 6%e14%) urethral colonization.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
