Abstract
BackgroundIn pregnant women Streptococcus agalactiae (GBS) can be transmitted to newborn causing severe infections. It is classified into 10 serotypes (Ia, Ib, II-IX). The severity of neonatal disease is determined by the capsular serotype and virulence factors such as the polysaccharide capsule, encoded by the cps gene, protein C, which includes the Cα surface proteins (bca gene), Rib (rib gene) and Cβ (bac gene); the proteins Lmb (lmb gene), FbsB (fbsB gene), FbsA (fbsA gene), the cyl operon encoding a β-hemolysin (hylB gene), the CAMP factor (cfb gene) and the C5a peptidase (scpB gene). The aim of this work was to determine the degree of GBS colonization in pregnant women, the serotypes distribution and to investigate virulence-associated genes.MethodsWe worked with 3480 samples of vagino-rectal swabs of women with 35–37 weeks of gestation. The identification of the strains was carried out using conventional biochemical tests and group confirmatory serology using a commercial latex particle agglutination kit. Two hundred GBS strains were selected. Their serotype was determined by agglutination tests. The monoplex PCR technique was used to investigate nine virulence-associated genes (cps, bca, rib, bac, lmb, fbsB, fbsA, hylB and scpB).ResultsThe maternal colonization was 9.09%. The serotypes found were: Ia (33.50%), III (19.00%), Ib (15.50%), II (14.00%), V (7.00%) and IX (5.50%). 5.50% of strains were found to be non-serotypeable (NT). The nine virulence genes investigated were detected simultaneously in 36.50% of the strains. The genes that were most frequently detected were scpB (100.00%), fbsA (100.00%), fbsB (100.00%), cylB (95.00%), lmb (94.00%) and bca (87.50%). We found associations between serotype and genes bac (p = 0.003), cylB (p = 0.02), rib (p = 0.01) and lmb (p < 0.001).ConclusionsThe frequency of vaginal-rectal colonization, serotypes distribution and associated virulence genes, varies widely among geographical areas. Therefore, epidemiological surveillance is necessary to provide data to guide decision-making and planning of prevention and control strategies.
Highlights
In pregnant women Streptococcus agalactiae (GBS) can be transmitted to newborn causing severe infections
In 2007 and 2008, in Misiones Province and Argentina, Laws XVII - N° 59 and 26,369 were passed, that adhere to the mandatory search for Group B Streptococcus (GBS) in pregnant women, and, detected maternal colonization, to the implementation of intrapartum antibiotic prophylaxis (IPP) [3, 4]
Written informed consent was obtained from each patient and confidential medical data according to study protocol: C10 ‘Prevalence of vaginal and rectal colonization of Streptococcus Beta-hemolytic group B (GBS or S. agalactiae) in pregnant women of 35-37 weeks of gestation’
Summary
In pregnant women Streptococcus agalactiae (GBS) can be transmitted to newborn causing severe infections. It is classified into 10 serotypes (Ia, Ib, II-IX). S. agalactiae, Group B Streptococcus (GBS), is one of the main causes of morbidity and mortality in neonates and severe infections in pregnant women and in nonpregnant adults especially among patients with underlying medical conditions, such as Diabetes Mellitus or immunosuppression [1]. S. agalactiae produces severe infections such as septicemia, pneumonia and meningitis [5] It is an important cause of infection in pregnant and puerperal women producing chorioamnionitis, postpartum endometritis, post-cesarean surgical wound infection and urinary tract infection [6, 7]
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