Screening and genotyping of group B streptococcus in pregnant and non-pregnant women in Turkey.

Feyza Alp,Hatice Turk Dagi,Aybike Tazegul Pekin,Ugur Arslan,Duygu Findik,Setenay Arzu Yilmaz

doi:10.3855/jidc.6190

Feyza Alp, Hatice Turk Dagi + Show 4 more

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https://doi.org/10.3855/jidc.6190

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Abstract

The purpose of this study was to investigate group B streptococcus (GBS) colonization, to compare the methods, to determine the relationship between GBS carriage and risk factors, and to genotype the GBS isolates. Recto-vaginal swab specimens were obtained from 500 women, and a questionnaire was administered to each to assess their risk factors for GBS carriage. A culture, GBS antigen test, and polymerase chain reaction (PCR) were performed on all samples. Antibiotic susceptibility testing was performed, and the clonal relationship was determined by pulsed-field gel electrophoresis (PFGE) on all viable isolates. Of the 500 women, sixty-eight (13.6%) women were GBS carriers, of whom 9.8% were pregnant and 16.5% not. There was a significant difference between GBS carriage and history of premature rupture of membrane (PROM). GBS was isolated from 65 (13%) samples. GBS was positive in 70 (14%) samples by antigen test and in 62 (12.4%) by PCR. Sixty-eight of the 70 positive antigen tests were confirmed by PCR or culture. Fifty-five isolates were resistant to tetracycline, 16 to erythromycin and clindamycin, and 13 to levofloxacin. Thirteen different pulsotypes and 17 sporadic strains were determined by PFGE. GBS carriage rate in non-pregnant women was higher than in pregnant women. The GBS antigen test was more sensitive than culture and PCR. GBS isolates did not originate from a single clone and contained sporadic strains. There was a significant difference between GBS carriage and history of PROM. Epidemiologic data obtained in this study will help future studies.

Highlights

The purpose of this study was to investigate group B streptococcus (GBS) colonization, to compare the methods, to determine the relationship between GBS carriage and risk factors, and to genotype the GBS isolates
GBS colonization was determined in 5 of 13 (38.5%) women who had a history of premature rupture of membrane (PROM) in previous births and in 55 (11.3%) of 487 women who had no history of PROM
Our results showed that there was no statistically significant difference between GBS antigen test and culture, but there was a significant difference between the GBS antigen test and polymerase chain reaction (PCR)

Summary

Introduction

The purpose of this study was to investigate group B streptococcus (GBS) colonization, to compare the methods, to determine the relationship between GBS carriage and risk factors, and to genotype the GBS isolates. A culture, GBS antigen test, and polymerase chain reaction (PCR) were performed on all samples. GBS was positive in 70 (14%) samples by antigen test and in 62 (12.4%) by PCR. The colonization of GBS in the urogenital or gastrointestinal system of the mother is the most important risk factor for the development of invasive newborn disease [2]. The Centers for Disease Control (CDC) recommends screening all pregnant women at 35–37 weeks of gestation and providing intra-partum antibiotic prophylaxis to pregnant women with recto-vaginal colonization, women who previously delivered infants with invasive GBS infection, those identified as having GBS bacteriuria in any trimester of pregnancy, and those with unknown GBS status at the onset of labor but who have risk factors, for the prevention of early-onset neonatal GBS disease [5]

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