Colonization In Pregnant Women Research Articles

Prevalence of Group B Streptococcus Colonization in Pregnant Women in Iran: A Systematic Review and Meta-Analysis

Introduction: Group B Streptococcus (GBS) or Streptococcus agalactiae is one of the main causes of invasive infections such as meningitis and septicemia in infants. Genital colonization with group B streptococci has been related to increased risk of premature delivery, and premature infants are at greater risk of disease. There is limited information about the prevalence of rectovaginal GBS colonization in pregnant women in Iran. The aim of the present study was investigating the prevalence of group B streptococcus colonization in pregnant women in Iran. Methods: Information of this study was attained by searching on databases including PubMed, Google Scholar, Scopus, Web of Science and SID using relevant keywords and without time limit. Then, the studies containing the inclusion criteria were reviewed. The data were analyzed using Comprehensive MetaAnalysis software (Biostat V3). Heterogeneity between studies was investigated with the I2 index and based on the results of heterogeneity, the random effect model was implemented in order to determine the prevalence of GBS in pregnant women. Results: Out of 231 articles, 15 articles were included in the study. The analysis of 15 studies showed that the prevalence of GBS in Iranian pregnant women was 12.2% (95% CI: 9.9-15.1). Conclusion: In order to prevent the invasive neonatal disease, screening for GBS colonization is recommended for pregnant women in 35–37 weeks of gestation. Regarding the lack of preventive strategies for GBS infections in Iran, national guidelines should be established to guide the obstetricians, midwives, and nurses on the prevention of GBS infections.

Does vaginal bacterial colonization contribute to preterm birth in women with asymptomatic shortened cervix?

PurposeThe aim of this study is to describe the typical microbial spectrum and the influence of distinct vaginal infections on preterm birth in pregnancies affected by cervical incompetence.Methods327 patients were admitted because of asymptomatic shortening of the cervix in the second and third trimester of pregnancy. Clinical data such as age, cervical length, gestational age at admission and at delivery and vaginal microbiologic findings were collected and analyzed.ResultsThe spectrum of germs in the vagina revealed seven different distinct species; the most common bacteria were Ureaplasma spp. and E. coli. In 327 included patients, 217 revealed a bacterial colonization, 110 did not. Most common bacteria in women with preterm birth before 34 weeks were Ureaplasma spp., while E. coli was most common in women undergoing preterm birth after 34 weeks. Nevertheless, the rates of occurrence of these bacterial taxa were not significantly different between who underwent preterm birth to those who did not.ConclusionsThis study gives an overview over the vaginal bacterial colonization in pregnant women with cervical incompetence. The clinical relevance of vaginal bacterial colonization remains unclear.

Prevalence of group B streptococcus colonization in pregnant women and the correspondence of its virulence genes with adverse pregnancy outcome

Prevalence of group B streptococcus colonization in pregnant women and the correspondence of its virulence genes with adverse pregnancy outcome

Perinatal risk factors for neonatal early-onset sepsis: a meta-analysis of observational studies

Objective Early-onset neonatal sepsis (EONS) remains an important cause of neonatal mortality and has many risk factors, therefore, this study aimed to investigate the perinatal risk factors for EONS. Methods We searched CNKI, Wan Fang, VIP, CBM, PubMed, Embase, and Web of Science to compile studies regarding the incidence of neonatal early-onset sepsis, published up to 1 May 2022. To evaluate the quality of the included studies, we used the Newcastle-Ottawa Scale, and the RevMan5.3 software was used for meta-analysis. Results A total of 17 studies were included, with 1987 cases in the case group and 4814 cases in the control group. Meta-analysis showed that perinatal asphyxia or intrauterine distress (OR = 3.00, 95% CI: 2.18–4.13), amniotic fluid meconium contamination (OR = 4.51, 95% CI: 2.31–8.81), group B streptococcal (GBS) colonization in pregnant women (OR = 2.13, 95% CI: 1.48–3.05), chorioamnionitis (OR = 4.58, 95% CI: 2.61–8.05), premature rupture of membranes (OR = 2.63, 95% CI: 2.09–3.30), lower gestational age (OR = 1.31, 95% CI: 1.18–1.44), maternal urinary or reproductive tract infection (OR = 3.61, 95% CI: 2.14–6.11), perinatal fever (OR = 3.59, 95% CI: 2.25–5.71), very low birth weight (OR = 3.79, 95% CI: 2.14–6.73), and vaginal examination ≥3 times (OR = 7.95, 95% CI: 4.04–15.64) were the perinatal risk factors for EONS. Conclusion Perinatal asphyxia or intrauterine distress, meconium contamination in amniotic fluid, GBS colonization in pregnant women, chorioamnionitis, premature rupture of membranes, lower gestational age, maternal urinary tract or reproductive tract infection, perinatal fever, very low birth weight, and vaginal examinations ≥3 times may increase the risk of EONS.

Incidence of virulence determinants among Streptococcus agalactiae isolated from pregnant women and association with their serotypes

ABSTRACT Colonization of pregnant women by Streptococcus agalactiae (S. agalactiae) is the main reason for intrauterine infection or transmission during parturition. This study investigated the prevalence, antimicrobial susceptibility, serotypes, virulence traits of S. agalactiae in pregnant women across three hospitals in Dakahlia Governorate, Egypt. Isolates were identified by culturing onto Hichrome Sterp B selective medium, latex agglutination and biochemical tests. The antimicrobial susceptibility was determined by Kirby-Bauer disc diffusion method. Capsular serotypes were determined by latex agglutination test. Hemolysin production and biofilm formation were assessed quantitively. Virulence genes were detected by polymerase chain reaction (PCR). Among 290 samples, 31.7% were S. agalactiae. All isolates were sensitive to penicillin G, ampicillin, cefotaxime, and vancomycin, but notably resistant to tetracycline (83.6%), erythromycin (68.4%), and clindamycin (54.3%). Serotype III (26.08%) was most common. Strong biofilm was produced by 72.8% of isolates. High hemolytic activity was seen (80.4%). Prevalent virulence genes included fsbA (97.8%), fbsB (96.7%), and scpB (96.7%). rib and alp4 were frequent surface protein genes (60.8% and 57.6%, respectively). Serotypes were significantly correlated to clindamycin resistance, biofilm production (Ia, III, VI serotypes), hemolytic activity (serotype V), and several virulence genes and surface proteins. Our study found a high prevalence of S. agalactiae isolates in pregnant women with diverse resistance patterns, high virulence indicating potential for increased pathogenicity.

Maternal Colonization Versus Nosocomial Transmission as the Source of Drug-Resistant Bloodstream Infection in an Indian Neonatal Intensive Care Unit: A Prospective Cohort Study.

Drug-resistant gram-negative (GN) pathogens are a common cause of neonatal sepsis in low- and middle-income countries. Identifying GN transmission patterns is vital to inform preventive efforts. We conducted a prospective cohort study, 12 October 2018 to 31 October 2019 to describe the association of maternal and environmental GN colonization with bloodstream infection (BSI) among neonates admitted to a neonatal intensive care unit (NICU) in Western India. We assessed rectal and vaginal colonization in pregnant women presenting for delivery and colonization in neonates and the environment using culture-based methods. We also collected data on BSI for all NICU patients, including neonates born to unenrolled mothers. Organism identification, antibiotic susceptibility testing, and next-generation sequencing (NGS) were performed to compare BSI and related colonization isolates. Among 952 enrolled women who delivered, 257 neonates required NICU admission, and 24 (9.3%) developed BSI. Among mothers of neonates with GN BSI (n = 21), 10 (47.7%) had rectal, 5 (23.8%) had vaginal, and 10 (47.7%) had no colonization with resistant GN organisms. No maternal isolates matched the species and resistance pattern of associated neonatal BSI isolates. Thirty GN BSI were observed among neonates born to unenrolled mothers. Among 37 of 51 BSI with available NGS data, 21 (57%) showed a single nucleotide polymorphism distance of ≤5 to another BSI isolate. Prospective assessment of maternal GN colonization did not demonstrate linkage to neonatal BSI. Organism-relatedness among neonates with BSI suggests nosocomial spread, highlighting the importance of NICU infection prevention and control practices to reduce GN BSI.

Long-term surveillance of group B Streptococcus strains isolated from infection and colonization in pregnant women and newborns.

Introduction. Group B Streptococcus (GBS) remains the leading cause of bacterial neonatal infections worldwide, despite the spread of recommendations on vaginal screening and antibiotic prophylaxis.Hypothesis/Gap Statement. There is a need to evaluate the potential changes in GBS epidemiology over time following the introduction of such guidelines.Aim. Our aim was to perform a descriptive analysis of the epidemiological characteristics of GBS by conducting a long-term surveillance of strains isolated between 2000 and 2018, using molecular typing methods.Methodology. A total of 121 invasive strains, responsible for maternal infections (20 strains), fetal infections (8 strains) and neonatal infections (93 strains), were included in the study, representing all the invasive isolates during the period; in addition, 384 colonization strains isolated from vaginal or newborn samples were randomly selected. The 505 strains were characterized by capsular polysaccharide (CPS) type multiplex PCR assay and the clonal complex (CC) was assigned using a single nucleotide polymorphism PCR assay. Antibiotic susceptibility was also determined.Results. CPS types III (32.1 % of the strains), Ia (24.6 %) and V (19 %) were the most prevalent. The five main CCs observed were CC1 (26.3 % of the strains), CC17 (22.2 %), CC19 (16.2 %), CC23 (15.8 %) and CC10 (13.9 %). Neonatal invasive GBS diseases were predominantly due to CC17 isolates (46.3 % of the strains), which mainly express CPS type III (87.5 %), with a very high prevalence in late-onset diseases (76.2 %).Conclusion. Between 2000 and 2018, we observed a decrease in the proportion of CC1 strains, which mainly express CPS type V, and an increase in the proportion of CC23 strains, mainly expressing CPS type Ia. Conversely, there was no significant change in the proportion of strains resistant to macrolides, lincosamides or tetracyclines. The two molecular techniques used in our study provide almost as much information as classical serotyping and multilocus sequence typing, but are quicker, easy to perform, and avoid long sequencing and analysis steps.

CRISPR/Cas12a-based assay for the rapid and high-sensitivity detection of Streptococcus agalactiae colonization in pregnant women with premature rupture of membrane

BackgroundStreptococcus agalactiae or group B Streptococcus (GBS) is a leading infectious cause of neonatal morbidity and mortality. It is essential to establish a robust method for the rapid and ultra-sensitive detection of GBS in pregnant women with premature rupture of membrane (PROM).MethodsThis study developed a CRISPR-GBS assay that combined the advantages of the recombinase polymerase amplification (RPA) and CRISPR/Cas12a system for GBS detection. The clinical performance of the CRISPR-GBS assay was assessed using vaginal or cervical swabs that were collected from 179 pregnant women with PROM, compared in parallel to culture-based matrix-assisted laser desorption ionization time-of-flight mass spectrometry (culture-MS) method and real-time quantitative polymerase chain reaction (qPCR) assay.ResultsThe CRISPR-GBS assay can be completed within 35 min and the limit of detection was as low as 5 copies μL−1. Compared with the culture-MS, the CRISPR-GBS assay demonstrated a sensitivity of 96.64% (144/149, 95% confidence interval [CI] 92.39–98.56%) and a specificity of 100% (30/30, 95% CI 88.65–100%). It also had a high concordance rate of 98.88% with the qPCR assay.ConclusionsThe established CRISPR-GBS platform can detect GBS in a rapid, accurate, easy-to-operate, and cost-efficient manner. It offered a promising tool for the intrapartum screening of GBS colonization.

Supplementation of Probiotics in Pregnant Women Targeting Group B Streptococcus Colonization: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to determine if probiotic supplementation in pregnancy reduced maternal Group B streptococcus (GBS) recto-vaginal colonization in pregnant women at 35-37 weeks of gestation. Electronic databases (i.e., PubMed, MEDLINE, ClinicalTrials.gov, ScienceDirect, and the Cochrane Library) were searched from inception up to February 2022. We included RCTs assessing the effects of probiotic supplementation in pregnancy on GBS recto-vaginal colonization. The primary outcome was GBS-positive recto-vaginal cultures performed at 35-37 weeks of gestation. Secondarily, we evaluated obstetric and short-term neonatal outcomes. A total of 132 publications were identified; 9 full-length articles were reviewed to finally include 5 studies. Probiotic supplementation reduced vaginal GBS colonization: the GBS positive culture rate was estimated at 31.9% (96/301) in the intervention group compared to 38.6% (109/282) in the control group (OR = 0.62, 95% CI 0.40-0.94, I2 4.8%, p = 0.38). The treatment started after 30 weeks of gestation and was more effective in reducing GBS colonization (OR 0.41, 95% CI 0.21-0.78, I2 0%, p = 0.55). Probiotic administration during pregnancy, namely in the third trimester, was associated with a reduced GBS recto-vaginal colonization at 35-37 weeks and a safe perinatal profile. Whether this new strategy could reduce the exposition of pregnant women to significant doses of antibiotics in labor needs to be evaluated in other trials.

Prevalence, characterization, antimicrobial susceptibility pattern and factors associated with group B <em>Streptococci</em> (<em>Streptococcus agalactiae</em>) from clinical and non- clinical sources in South-East Nigeria

Many years ago most human infections caused by aerobic Streptococci, were attributed to Lancefield groups A and D or to the so called non-groupable viridans Streptococci. The first human isolates of the group B Streptococci (GBS) were isolated from the vagina of post-partum women. This study is aimed at assessing GBS colonization of some clinical and common non-clinical surfaces. This study utilized a total of 615 samples (300 clinicals and 315 non-clinicals). Samples were from neonates and women who were respectively seen at the Institute of Child Health, of the University of Nigeria Teaching Hospital and Amblim Reference Laboratory in Enugu. The 300 clinical samples were cultured from 119 pregnant and 79 non-pregnant women, 52 neonates and 25 infertile couples (50 individuals; 7 primary and 18 secondary infertility). All samples were cultured on a modified Islam medium and identification carried out using standard bacteriological methods. Characterizations of the GBS isolates were carried out using sodium hippurate reactions, aesculin reactions, Christie, Atkin Muchin – Patterson (CAMP) test and definite hydrolysis on blood agar. The overall GBS isolation of 15.8% was observed in the clinical and non-clinical surfaces assessed. For the clinical subjects, GBS colonization of 11.9%, 7.6%, 9.6% and 17.0% were observed in the pregnant women, non-pregnant women, neonates and couples admitted for infertility. Prevalence of GBS isolation on inflamed cattle udder and milk products were 4.0% and 83.3%, respectively. Gestational period was associated with GBS colonization in pregnant women. All the GBS isolates were susceptible to penicillin and methicillin while all were resistant to streptomycin, tetracycline and sulphafurazole. GBS colonization of vagina was found and this poses a risk for neonatal sepsis.

Colonization of pregnant women with group B streptococcus: current view at the problem

The relevance of the problem of group B streptococcus (GBS) in obstetric practice casts no doubt. Attracting the close attention of leading experts, introducing new solutions and based on practical experience gained, it is still not possible to prevent all cases of neonatal infections associated with GBS. The review article demonstrates the current view of the problem. According to the literature, African-American race in combination with sexually transmitted infections are predisposing risk factors for GBS colonization. A direct relationship between obesity and the percentage of GBS carriers was revealed. GBS-colonized primigravidas have a 50 % increased chance of detecting the pathogen in subsequent pregnancies. Absolute factors for massive GBS colonization of the birth tract include GBS-associated asymptomatic bacteriuria and a history of GBS-colonized children. It is assumed that such virulence factors as hemolytic pigment and hyaluronidase contribute to the GBS pathogenic potential. The protective function in the immune system is performed by Kaschenko–Gofbauer cells, but their role is ambiguous. Early neonatal GBS infection realized in 90 % of newborns that manifested by sepsis, pneumonia and purulent meningitis. Implemented measures to prevent early neonatal GBS infection have a number of disadvantages. False-negative results of culture screening for GBS antigen at gestational age of 35–37 weeks increase a risk of vertical transmission, whereas false-positive results underlie a reason for prescribing irrational intranatal antibiotic prophylaxis. Moreover, antenatal GBS microbiological screening and antibiotic prophylaxis at birth do not prevent the risks of late-onset neonatal GBS infection.

Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry with Time-of-Flight Peak Analysis for Rapid and Accurate Detection of Group B Streptococcus in Pregnant Women.

ABSTRACTSevere infections in neonates caused by Streptococcus agalactiae, Group B Streptococcus (GBS), are often associated with GBS transmission from their mothers during labor or birth. Hence, it is necessary to develop a universal method for screening vaginal–rectal GBS colonization in pregnant women worldwide. A subculture of vaginal–rectal swabs using a selective enrichment broth and an agar plate is conventionally recommended for GBS screening. However, infants born to mothers who are GBS negative on subculture sometimes contract GBS infections. Therefore, we developed another method with high sensitivity for GBS screening. A total of 178 vaginal–rectal swabs from pregnant women were inoculated into the enrichment broth, of which 126 were suspected of containing GBS due to the change in the color of the broth. The subculture results were positive for GBS in 34 (27.0%) swabs. Each broth was then analyzed using matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-TOF MS). Analysis of the TOF peaks specific to GBS revealed 45 (35.7%) swabs as GBS positive. Of the 11 GBS positive samples on TOF peak analysis but negative on subculture, S. agalactiae gene targets were detected through PCR in 4 samples. MALDI detection with analysis of peaks of TOF (MDAPT) can detect GBS directly from cultured broth with high sensitivity. MDAPT can be an alternative method for GBS screening in pregnant women and contribute to the prevention of severe GBS infectious diseases in neonates.IMPORTANCE As previously reported, 10%–30% of pregnant women carry Streptococcus agalactiae, Group B Streptococcus (GBS), in their vagina or rectum, and approximately 50% of them vertically transmit GBS to their neonates during labor or birth. Moreover, 1%–2% of the GBS-transmitted neonates develop severe GBS infectious diseases, which have a mortality rate of 19.2% in a preterm infant and 2.1% in a full-term infant. Hence, universal screening for GBS colonization in pregnant women is conducted worldwide using the subculture procedure; however, infants born to GBS negative mothers sometimes contract GBS infections. Therefore, other laboratory techniques are required for detecting GBS more accurately. The proposed method “MALDI detection with analysis of peaks of TOF (MDAPT)” detects GBS directly from cultured broth with high sensitivity. Therefore, it can be an alternative method for GBS screening in pregnant women, thereby contributing to the prevention of severe GBS infectious diseases in neonates.

Genomic analysis of virulence factors and antimicrobial resistance of group B Streptococcus isolated from pregnant women in northeastern Mexico.

Group B Streptococcus (GBS) causes infections in women during pregnancy and puerperium and invasive infections in newborns. The genes lmb, cylE, scpB, and hvgA are involved with increased virulence of GBS, and hypervirulent clones have been identified in different regions. In addition, increasing resistance of GBS to macrolides and lincosamides has been reported, so knowing the patterns of antibiotic resistance may be necessary to prevent and treat GBS infections. This study aimed to identify virulence genes and antibiotic resistance associated with GBS colonization in pregnant women from northeastern Mexico. Pregnant women with 35-37 weeks of gestation underwent recto-vaginal swabbing. One swab was inoculated into Todd-Hewitt broth supplemented with gentamicin and nalidixic acid, a second swab was inoculated into LIM enrichment broth, and a third swab was submerged into a transport medium. All samples were subcultured onto blood agar. After overnight incubation, suggestive colonies with or without hemolysis were analyzed to confirm GBS identification by Gram staining, catalase test, hippurate hydrolysis, CAMP test, and incubation in a chromogenic medium. We used latex agglutination to confirm and serotype GBS isolates. Antibiotic resistance patterns were assessed by Vitek 2 and disk diffusion. Periumbilical, rectal and nasopharyngeal swabs were collected from some newborns of colonized mothers. All colonized women and their newborns were followed up for three months to assess the development of disease attributable to GBS. Draft genomes of all GBS isolates were obtained by whole-genome sequencing. In addition, bioinformatic analysis to identify genes encoding capsular polysaccharides and virulence factors was performed using BRIG, while antibiotic resistance genes were identified using the CARD database. We found 17 GBS colonized women out of 1154 pregnant women (1.47%). None of the six newborns sampled were colonized, and no complications due to GBS were detected in pregnant women or newborns. Three isolates were serotype I, 5 serotype II, 3 serotype III, 4 serotype IV, and 2 serotype V. Ten distinct virulence gene profiles were identified, being scpB, lmb, fbsA, acp, PI-1, PI-2a, cylE the most common (3/14, 21%). The virulence genes identified were scpB, lmb, cylE, PI-1, fbsA, PI-2a, acp, fbsB, PI-2b, and hvgA. We identified resistance to tetracycline in 65% (11/17) of the isolates, intermediate susceptibility to clindamycin in 41% (7/17), and reduced susceptibility to ampicillin in 23.5% (4/17). The tetM gene associated to tetracyclines resistance was found in 79% (11/14) and the mel and mefA genes associated to macrolides resistance in 7% (1/14). The low prevalence of colonization and the non-occurrence of mother-to-child transmission suggest that the intentional search for GBS colonization in this population is not justified. Our results also suggest that risk factors should guide the use of intrapartum antibiotic prophylaxis. The detection of strains with genes coding virulence factors means that clones with pathogenic potential circulates in this region. On the other hand, the identification of decreased susceptibility to antibiotics from different antimicrobial categories shows the importance of adequately knowing the resistance patterns to prevent and to treat GBS perinatal infection.

Evaluation of PCR technique as a rapid screening method for detection of Group B streptococci colonization in pregnant women

BackgroundGroup-B streptococci (GBS) colonization in pregnant women could be a source of serious neonatal infections, such as meningitis and sepsis; therefore, a rapid and accurate method for detection is needed for early prophylaxis. Conventional culture is a common method used for the detection of GBS. However, polymerase-chain reaction (PCR)-based assay may be another method for detection of GBS colonization.ObjectiveTo evaluate the performance of the PCR as a method for detection of GBS (Strept. agalactiae) colonization in the urogenital tract of pregnant women and to detect its prevalence among these women.MethodsThe present study was done at the Department of Clinical Pathology and Department of Obstetrics/Gynecology, Menoufia University Hospitals, during the period from June 2020 to June 2021. In this study, vaginal and perianal swabs were collected from 250 pregnant women, between the 35th and 37th weeks of pregnancy, who attended the Department of Obstetrics and Gynecology for perinatal care. Their ages ranged from 20 to 40 years. GBS was detected by culture VITEK2 and PCR was done.ResultsThe prevalence of colonization in pregnant women with GBS was 20%. The sensitivity and specificity of PCR and culture were 99% and 98%, respectively.ConclusionsPCR technique is a rapid, specific, and sensitive diagnostic tool for GBS detection. So, PCR could be used as a rapid test for the detection of GBS colonization in pregnant women. The sensitivity and specificity of automated culture were 99.8% and 89.2%, respectively, so it is also a rapid and specific method for the detection of GBS colonization.

Group B Streptococcal Infection in Jeddah, Saudi Arabia: Maternal Colonization and Neonatal Infection

The existence of Group B Streptococcus (GBS) in the rectovaginal area during pregnancy and labor is linked to disease and even death in neonates. However, the extent of GBS colonization in pregnant women in Saudi Arabia has not been fully established. The goal of this study was to ascertain the prevalence of Group B Streptococcus (GBS) colonization in pregnant women in Saudi Arabia, where GBS screening is not routinely conducted. This retrospective study involved 1201 Saudi women at ≥28 weeks

Prevalence of Group B Streptococcus Colonization in Pregnant Women at a University Hospital in Korea.

Group B Streptococcus (GBS) colonization in pregnant women is a risk factor for causing infection in neonates; therefore, GBS screening tests are performed on them. Culture methods and molecular diagnostics are mainly performed for GBS detection; however, culture methods differ in the detection rate for GBS depending on the procedure of culture. The authors intended to confirm the difference in GBS colonization rate in the conventional culture method, enrichment culture method, and molecular genetic test as screening tests for GBS. Duplicate vagino-rectal swabs were collected from 371 pregnant women between the 35th and 37th week of gestation; one was used for conventional culture method and the other was frozen at -80℃, followed by enrichment culture method and molecular genetic test. The prevalence of GBS colonization identified by conventional culture, enrichment culture, and molecular genetic test was 4.35% (17/391), 8.95% (35/391), and 22.25% (87/391), respectively. The detection rate by enrichment culture method was 2.06 times higher (17/391 vs. 35/391) than that by conventional culture method. It was identified that there was a significant difference in the detection rates of GBS between the two methods (p < 0.001). The detection rate identified in molecular genetic test was much higher at 22.25% (87/391). The concordance rate of the results from three detection methods for GBS was 80.05% (313/391). All pregnant women colonized with GBS were given intrapartum antibiotic prophylaxis using cefazolin and their neonates were confirmed not to be infected with GBS. Prevalence of GBS colonization in pregnant women is shown to vary depending on detection method. Particularly, it differs greatly depending on the use of enrichment media in the culture method. Therefore, it is necessary that the microbiological laboratory implements the culture method with supplementary procedures such as selective or enrichment media in order to improve the detection rate of GBS.

Prevalence, Antimicrobial Susceptibility Pattern and Factors Associated with GBS Colonization in Pregnant Women at the Regional Hospital Bamenda (RHB)

Introduction: Maternal asymptomatic colonization with GBS (Group-B Streptococcus) has become a major cause of sepsis, meningitis and encephalopathy in neonates alongside premature births, stillbirths and post-natal infections. Routine screening of pregnant women for GBS carriage and antimicrobial susceptibility are therefore necessary. This study was aimed at evaluating the prevalence, antimicrobial susceptibility pattern and factors associated with GBS colonization in pregnant women at the Regional Hospital Bamenda (RHB). Materials and Methods: Vaginal and rectal swab samples were collected from 121 pregnant women in the 3rd trimester at the RHB from December 2017 to May 2018. Sociodemographic, obstetric and neonatal history and some clinical parameters were obtained through a questionnaire approach. Cultures for the isolation and identification of GBS from the samples were done and grouping as well as susceptibility testing of GBS isolates was done. Results: The colonisation rates were 5.8% (7), 1.7% (2) and 5.8% (7) for rectal, vaginal and concomitant recto-vaginal carriage. GBS was isolated in the vagina/rectum of 16 participants (13.2% prevalence). Of the 16 GBS strains used for in vitro susceptibility test, no resistance to ampicillin, oxacillin, amoxicillin-clavulanate, ceftriaxone, erythromycin, imipenem, aztreonam and clindamycin was recorded. 6.3% (1) of the strains had intermediate susceptibility to ampicillin and amoxicillin-clavulanic acid. Of the isolates examined, 37.5% (6), and 12.5% (2) were respectively sensitive to gentamycin and levofloxacin. Maternal overweight, HIV positive status, history of PROM and spontaneous abortion, presence of Gardnerella vaginalis and Candida albicans had a high rate of GBS colonization but only HIV positive status had a statistical significance (p = 0.01). Other microbes isolated were Gardnerella vaginalis (55.4%, 67), Candida albicans (40.5%, 49), and Candida spp (12.4%, 15). Conclusion: GBS prevalence was 13.2%. GBS had decreased susceptibility to some antibiotics. Only HIV positive status was significantly associated with GBS colonization.

Evaluation of PCR technique as a rapid screening method for detection of group B streptococci colonization in pregnant women

Evaluation of PCR technique as a rapid screening method for detection of group B streptococci colonization in pregnant women

Prevalence and Risk Factors of Group B Streptococcus Colonization in Pregnant Women: A Pilot Study in Palestine.

Background Maternal Streptococcus agalactiae (Group B Streptococcus (GBS)) colonization is an important cause of complications in mothers and neonates during gestation and after delivery. The data regarding GBS colonization among pregnant women in Palestine is scarce. The aim of this study is to determine the prevalence of GBS colonization, its associated risk factors, and the antibiotic sensitivity patterns in Nablus, West Bank, Palestine. Methods A cross-sectional, single center study conducted at Rafidia Governmental Hospital in Nablus, West Bank, Palestine. Samples were collected between November 2019 and January 2020. Vaginal swabs from 200 pregnant women (≥35 weeks of gestation) attending the labor and delivery department were plated directly on CHROMagarTM StrepB (CHROM agar, France) and placed in an incubator at 35–37°C. After 24 and 48 hours, the plates were checked for growth and classified into three categories: growth of GBS with mauve colonies on chromogenic media, no growth, or other growth. The identification of the mauve colonies was confirmed by the CAMP test. Identified GBS isolates were tested for susceptibility to vancomycin, ampicillin, clindamycin, cefotaxime, erythromycin, and levofloxacin using the disc diffusion method. Clinical and demographic information were collected using a questionnaire. Result The overall prevalence of GBS colonization was 12%. The median age of the study population was 27 years. GBS colonization was significantly associated with age (p=0.013), history of previous preterm delivery (p=0.013), and parity (p=0.015). No association was noted with smoking, previous abortion, previous history of fetal demise, vaginitis, or urinary tract infection. Resistance to ampicillin, vancomycin, cefotaxime, erythromycin, clindamycin, and levofloxacin was found to be 91.7%, 54.2%, 45.8%, 29.2%, 25%, and 8.3%, respectively. Conclusion The prevalence of vaginal GBS in this study was 12% from Nablus, West Bank. Further research is needed to determine the GBS serotypes common in West Bank and the burden they cause on the health system. Moreover, this study also highlights the need to establish a screening program suited to a developing country with low control on the antibiotic's prescription protocols.

Group B Streptococcus vaginal colonization in pregnant women living with HIV infection: prevalence and antibiotic susceptibility at HIV referral centers in Lagos, Nigeria

Objectives Group B Streptococcus (GBS) colonization of the genital tract is often asymptomatic yet associated with increased risks of maternal and neonatal morbidity especially amongst women living with HIV infection. The objectives of this study were to determine the prevalence of GBS colonization of the genital tract in women living with HIV infection and antibiotic susceptibility of GBS in the genital tract. Method This cross-sectional study recruited 244 pregnant women (122 women living with HIV infection and 122 HIV-uninfected women) between 35 and 37 weeks of gestation. GBS colonization was determined by collecting lower vaginal and anal swabs at recruitment. Swabs were cultured in Todd Hewitt’s broth and confirmed by Christie, Atkins, and Munch-Peterson (CAMP) test. Most recent CD4 count and viral load estimates were retrieved from the women’s records. Maternal and neonatal outcomes and antibiotic susceptibility were assessed. Statistical analysis was performed at 95% confidence interval at a statistical significance of p < .005 Results The prevalence of GBS colonization of the genital tract in all participants was 3.3%; GBS was isolated in 4 (3.3%) of 122 pregnant women living with HIV. No woman with a GBS-colonized genital tract developed puerperal sepsis and no neonatal infection occurred in neonates born to GBS-positive women, irrespective of HIV infection status. In women living with HIV, GBS isolate was resistant to Ampicillin (100%), Ceftriaxone (100%), Vancomycin (100%), yet partially sensitive to Ciprofloxacin (50%). Conclusion Pregnant women living with HIV do not have an increased risk of genital GBS colonization. Vaginal GBS colonization was not associated with an adverse perinatal outcome. Antibiotic use for GBS colonization should be based on sensitivity pattern and not empiric.