Group B Streptococcus Colonization Rate Research Articles

Relationship of group B streptococcus colonization in late pregnancy with perinatal outcomes

To investigate the relationship of group B streptococcus (GBS) colonization in late pregnancy with perinatal outcome. Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics. A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all P < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all P < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( P < 0.05 or P < 0.01). The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.

Implementation of GBS Self-Swabbing Protocol at the Women's Institute at Banner University Medical Center—Phoenix [21N

INTRODUCTION: To implement a group B streptococcus (GBS) self-swabbing protocol at The Women's Institute and to determine patient satisfaction in self-swabbing. Secondarily, to confirm physician and patient-collected swabs yield similar rates of GBS colonization. METHODS: This is a prospective quality project. Patients were provided the option to self-swab for GBS at their 35 to 37 week visit from January 3 to July 12, 2019. The patient was consented and educated on how to perform the swab. They then completed a short, three question survey to evaluate comfort and satisfaction. A retrospective chart review was performed from September 1, 2018 to July 12, 2019 to determine GBS colonization rates of provider-collected swabs. RESULTS: The rate of GBS colonization in patient-collected swabs was 14/67 (20.9%). Most patients felt comfortable performing the swab (92.5% CI 83.4–97.5%), felt educated in how to perform the swab (98.5% CI 92.0–100.0%), and either preferred to self-swab or had no preference of who performed future swabs (94.0% CI 85.4–98.4%). A retrospective chart review determined the rate of GBS colonization to be 47/238 (19.8%) in provider-collected swabs, which was not significantly different (19.8 vs 20.9, P .86) from patient-collected swabs. CONCLUSION: The rate of GBS colonization between patient and provider-collected swabs was not significantly different, which is consistent with prior studies. Survey results demonstrated patient satisfaction and comfort performing the self-swab. This study supports providing our patients the option of self-swabbing for GBS.

Group B streptococcus colonization, antibiotic susceptibility, and serotype distribution among Saudi pregnant women

BackgroundGroup B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases. This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women.Materials and MethodsIn this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular gene-based multiplex polymerase chain reaction assays.ResultsSixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes.ConclusionThis study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

Group B streptococcus prevalence, serotype distribution and colonization dynamics in Western Australian pregnant women.

Streptococcus agalactiae, or group B streptococcus (GBS), is a leading neonatal pathogen that causes sepsis, meningitis and pneumonia. Globally, strategies have been implemented to address vertical transmission, and in Western Australia (WA), culture-based screening at 35-37 weeks' gestation is part of routine care and guides antibiotic administration. Previous Australian studies have focused on other regions or included low sample-size representatives; we aimed to describe antenatal GBS colonization in WA. A cohort of 814 pregnant women attending antenatal clinics (2015-2017) self-collected vaginal and rectal swabs at ≤22 weeks (n=814) and ≥33 weeks' (n=567) gestation. These were assessed for GBS presence using culture and PCR, and serotyping was conducted using molecular methods. Lifestyle questionnaires and medical data were collected. We observed an overall GBS colonization rate of 24%, with 10.6 % of positive participants transiently colonized. Ethnicity (Aboriginal, Torres Strait Islander and African), maternal age ≥25 years, vitamin use, frequent sexual intercourse (≥5 times/week) and use of sex toys were associated with GBS colonization. The dominant serotypes identified were Ia (27.9%), III (20.9%), II (16.3%), V (15.8%), Ib (8.4%), VI (5.1%), IV (2.8%), NT (1.9), VIII (0.5%) and IX (0.5%) at visit one, with V (18.9%) preceding serotype II (18.2%) at visit two. Serotype VII was not detected. This is the first cohort study to assess GBS colonization in Western Australian pregnant women and will be highly beneficial for guiding clinical practice and future therapeutic options, in particular, the selection of suitable vaccine candidates.

Analysis of screening strategy of group B streptococcus in the third trimester and its influence on pregnancy outcome

Objective: To investigate the screening strategy of group B streptococcus (GBS) in the reproductive tract of women in the third trimester and analyze its impact on pregnancy outcome. Methods: A total of 85 461 pregnant women in 35-37 weeks of gestation from Bao'an Maternity and Child Health Hospital, Jinan University from January 2011 to June 2018 were enrolled. They were divided into 3 periods according to different GBS screening strategies, the unscreened period included 31 384 cases (36.72%), 33 267 cases (38.93%) were included in partial screening period, 20 810 cases (24.35%) were included in screening period. All GBS screening positive pregnant women were given intrapartum antibiotic prophylaxis (IAP). The impact on pregnancy outcomes, and the impact of different GBS collection transport and culture methods on the positive rate of GBS screening were analyzed. Results: (1) The incidence of neonatal early onset GBS disease (EOGBSD) in unscreened period was 0.03% (11/31 773), in partial screening period was 0.02%(6/33 887), and in screening period, the incidence of neonatal EOGBSD decreased to 0, the difference was statistically significant (χ(2)=7.86, P=0.02).(2) The incidence of hematogenous infection of GBS in pregnant women was 0.02%(6/33 887) in partial screening period, and there was none in screening period, there was no significant difference (adjusted χ(2)=3.75, P=0.05). (3) In the screening period, the positive rate of GBS was 14.08%(2 719/19 306), which was significantly higher than the positive rate of GBS in the partial screening period (11.48%, 2 058/17 920; χ(2)=56.12, P=0.00). (4) Antibiotic sensitivity tests of 4 777 GBS strains showed that the antibiotics with higher resistance rate were tetracycline (81.52%, 3 896/4 777), erythromycin (66.59%, 3 181/4 777), and clindamycin (64.31%, 3 072/4 777). The combination of erythromycin, clindamycin and tetracycline was the most common resistant pattern, accounting for 48.80% (2 331/4 777). No penicillin, ceftriaxone or vancomycin resistant strains was found. Conclusions: GBS screening strategy in different regions could combine the local neonatal EOGBSD incidence rate, maternal GBS colonization rate, and the socioeconomic factors to determine whether universal GBS screening or screening for high-risk maternal women. GBS screening positive rate is related to the population, scope of the investigation, the sample collection, delivery and culture methods. The multi-drug resistance rate of GBS is high.

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

Background: As no population-based studies of group B Streptococcus (GBS) colonization rates in late pregnancy (at 35–37 weeks of gestation) have been conducted in China, the incidence of and risk factors for neonatal early-onset GBS disease (GBS-EOD) in China remains poorly understood. Objectives: To determine the GBS colonization rate in late pregnancy and neonatal GBS infection in Xiamen, China, and to assess the effectiveness of intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal GBS-EOD. Methods: A total of 49,908 pregnant women were enrolled between April 1, 2014 and March 31, 2017. Bacterial culture was used to diagnose GBS infection in both pregnant women and neonates. Women with GBS colonization received IAP during parturition or rupture of fetal membranes. Results: The GBS colonization rate was 13.89% (6,933/49,908); 50,772 neonates were born to 49,908 pregnant women, of whom 75 (1.48 per 1,000) were diagnosed with GBS-EOD. The incidence of GBS-EOD among neonates born to GBS-positive mothers (8.77‰; 62/7,068) was 29 times higher than that of neonates born to GBS-negative mothers (0.30‰; 13/43,704). Logistic regression analysis indicated that gestational bacteriuria, GBS disease in infants from previous pregnancies, and chorioamnionitis were risk factors for GBS-EOD (p = 0.007, p = 0.000, and p = 0.018, respectively). IAP effectively protected against neonatal GBS-EOD (p = 0.011). Conclusions: GBS colonization was detected in nearly 14% of late pregnant women. The IAP for reducing GBS-EOD was effective. Therefore, universal screening of maternal GBS and subsequent IAP for those with GBS colonization should be implemented in China.

The recurrence risk of group B Streptococcus in consecutive deliveries

Background: Group B streptococcus (GBS) is a significant cause of neonatal morbidity and mortality. GBS maternal colonization status was found to be transient, intermittent, or chronic and screening during each subsequent pregnancy was advised. Recent studies showed that GBS colonization rate was higher among women with history of GBS positive in prior pregnancy.Objective: To establish the cumulative risk of group B streptococcus (GBS) colonization in consecutive subsequent term deliveries as referred to the first delivery GBS colonization status.Study design: A retrospective cohort study, based on a validated computerized database at a tertiary single center between the years 2005–2016. Pregnant women preform vaginal-rectal culture at 35–37 weeks of gestation. We analyzed records of term primiparas women that had records of up to three additional term consecutive deliveries and GBS colonization status.Results: 8641 primiparas met inclusion criteria; 3972 (46.0%), 993 (11.5%), and 243 (2.8%) had second, third, and fourth consecutive deliveries with recorded GBS status respectively. The overall colonization rate for primiparas was 28.4%. The cumulative rates and cumulative risks of repeated GBS positive colonization at the second, third and fourth term consecutive deliveries were 62.0%, 6.93 (95% CI 5.96–8.06), 68.0%, 5.05 (95% CI, 3.67–6.93), and 66.1%, 2.96 (95% CI, 1.54–5.68), respectively. Notably, after a negative GBS colonization in the first, second, and third repeated deliveries, the rate and cumulative risk of GBS positive in each consecutive delivery was significantly lower: 18.2%, 0.14, (95% CI 0.12–0.17), 19.4%, 0.21 (95% CI 0.15–0.28), and 21%, 0.26 (95% CI 0.13–0.51) for the second, third, and fourth consecutive deliveries, respectively.Conclusion: GBS colonization status at the time of first pregnancy is a milestone for the colonization risk in subsequent term deliveries. This risk evaluation may influence the decision-making process for future screening and intrapartum antibiotic prophylaxis for term consecutive deliveries.

Prevalence of Group b Streptococcus, Its Associated Factors and Antimicrobial Susceptibility Pattern Among Pregnant Women Attending Antenatal Care at Arbaminch Hospital, South Ethiopia

Background: Group B Streptococcus colonization of the gastrointestinal and genital tracts of pregnant women usually remains asymptomatic; even if it is the critical determinant of infection in neonates and young infants. It causes early and late onset of invasive Group B Streptococcus (GBS) disease manifesting as septicemia, meningitis and pneumonia. Now it is recognized as an important cause of maternal and neonatal morbidity and mortality in many parts of the world including Ethiopia where the magnitude of the problem has been little studied. Objectives: The aim of this study was to determine the prevalence of GBS colonization, to identify associated risk factors and antimicrobial susceptibility pattern of GBS isolates among pregnant women attending antenatal care at Arbaminch General Hospital, Arbaminch, Ethiopia. Methods: A cross sectional study was conducted from March - July, 2016 among 281 pregnant women on their antenatal care (ANC) visit at Arbaminch General Hospital (AGH). Consented participants’ information was collected using structured questionnaire. Recto-vaginal swab samples were collected by consecutive sampling technique and inoculated directly onto 5% sheep blood agar (SBA) for isolation of GBS. Antimicrobial susceptibility testing was performed according to the clinical and laboratory standard institute (CLSI) guideline, 2014 by disk diffusion method. Data was coded and entered into EPidata version 3.1 and analyzed by SPSS version 21.0. Bivariate and Multivariate logistic regression analysis were used to ascertain the association between explanatory and outcome variable considering p-value <0.05. Result: The colonization rate of GBS among pregnant mothers was 8.5%. The overall recto-vaginal GBS colonization in this study was not significantly associated with any of socio-demographic and obstetric factors. All of the GBS isolates were susceptible to penicillin, ampicillin and vancomycin. Resistance to ciprofloxacin, ceftriaxone, clindamycin, erythromycin, chloramphenicol and gentamycin was found to be 37.5%, 29.2%, 29.2%, 20.8%, 8.3%, and 4.2%, respectively. From a total of twenty four GBS isolates, two showed multidrug resistance. Conclusion and recommendation: This study found that GBS colonization rate was rationally high and most isolates were resistant to the commonly used antibiotics.

Risk‐based approach versus culture‐based screening for identification of group B streptococci among women in labor

To compare a risk-based and culture-based screening approach for identification of group B streptococci (GBS) vaginal colonization using an intrapartum rectovaginal culture as the reference standard. Pregnant women attending the prenatal clinic at Lillebaelt Hospital, Kolding, Denmark, between April 1, 2013, and June 30, 2014, were invited to participate in a prospective observational study. For prepartum culture-based screening, vaginal and rectal culture samples were obtained and, for reference, standard, paired vaginal and rectal culture samples were collected during labor. Risk factors for risk-based screening were previous early-onset GBS, GBS bacteriuria during pregnancy, maternal temperature ≥38.0°C intrapartum, and rupture of membranes for more than 18hours. The intrapartum rectovaginal GBS colonization rate was 30% (32/108) among participants with risk factors and 15% (123/794) among participants without risk factors. Culture-based screening demonstrated a sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio in predicting intrapartum GBS carriage of 78% (95% confidence interval [CI] 71-84), 95% (94-97), 78% (70-84), 95% (94-97), and 17 (12-23), respectively; for risk-based screening, these values were 21% (15-28), 90% (87-92), 30% (22-38), 85% (83-86), and 2(1-3),respectively. Culture-based screening performed considerably better than a risk-based approach in identifying intrapartum GBS colonization.

Group B Streptococcus Serotypes in Pregnant Women From the Western Cape Region of South Africa.

Background: Maternal colonization of Group B streptococci (GBS) during pregnancy is an important risk factor for neonatal morbidity and mortality. The aim of this study was to determine the prevalence and serotype distribution of GBS isolated from a cohort of pregnant women in the Western Cape, South Africa.Methods: Two ano-vaginal swabs were collected from 301 women at 28–37 weeks of gestation. Participants were recruited from four different antenatal clinics in the Western Cape, South Africa. GBS were detected by culture and PCR and serotypes confirmed by latex agglutination tests. Antibiotic sensitivity was performed using disc diffusion.Results: The GBS colonization rate was 16.6%. Serotype distribution revealed serotype V as the predominant serotype (66.67%) followed by serotype III (21.05%). Serotypes Ia, II, IV, and IX constituted 1.75% each and 3 GBS isolates were non-typeable. Serotype V demonstrated resistance to most of the antibiotics tested, while serotype III demonstrated better susceptibility, except for tetracycline. No significant differences were observed for GBS colonization or serotype distribution according to HIV status.Conclusion: Predominating serotypes differed from those previously reported from other regions in South Africa. Global surveillance of serotype distribution plays an important role in informing vaccine development and antibiotic prophylaxis.

Group B streptococcal colonization in mothers and infants in western China: prevalences and risk factors

BackgroundThe epidemiology of maternal and infant Group B streptococcus (GBS) colonization is poorly understood in China. The aim of this study is to explore the prevalence and risk factors associated with maternal and infant GBS colonization in Western China.MethodsFrom January 2017 to June 2017, a prospective study was conducted to estimate the maternal and infant GBS colonization rate by maternal rectovaginal and infant nasopharynx, ear canal and umbilical swab culture. Patient demographics, clinical characteristics and outcomes were collected. Chi-square and logistic regression analyses were used to examine the risk factors associated with GBS colonization of mothers and infants.ResultsThe GBS colonization rate in mothers and infants was 6.1 and 0.7%, respectively. The vertical transmission rate was 7.6%. The early onset GBS infection rate was 0.58 per 1000 live births and mortality was 0.29 per 1000 live births. Age younger than 40 years (p = 0.040) and minority ethnic status (p = 0.049) were associated with higher GBS colonization rate in pregnant women. Positive GBS status in the mother prior to delivery (p < 0.001) as well as longer duration of membrane rupture (≥12 h) (p < 0.001) and longer labor (≥4 h) (p < 0.001) were all significant risk factors for GBS colonization in infants. Compared to infants without GBS colonization, infants colonized with GBS were more likely to have had a temperature of ≥38 °C (p < 0.001), developed early onset infection (EOD) (p < 0.001), and been prescribed antibiotics (p < 0.001). Furthermore, infants with GBS were more likely to have been admitted to neonatal intensive unit (NICU) (p < 0.001) with a longer hospital length of stay (LOS) (p < 0.001).ConclusionsMaternal GBS colonization, longer duration of membrane rupture and labor were all major risk factors associated with GBS colonization in Chinese infants. Infant GBS colonization was associated with increased risk of EOD and NICU admission as well as longer LOS.

Comparison of Culture and PCR Methods for Diagnosis of Group B &lt;i&gt;Streptococcus&lt;/i&gt; in Women

Group B Streptococcus (GBS), as a risk factor for newborns, is one of the most important causes of meningitis and septicaemia in newborns, intrauterine infections in women and colonization in the vaginal region in late gestation. We evaluate GBS prevalence and infection among pregnant women through culture and PCR methods, and then compare these methods. To this end, vaginal and urine swabs were separately collected from 246 women at the Women’s Hospital of Sari, Iran. Next, the samples were enriched in selective culture media Todd–Hewitt broth for 24 h at 37°C, recognized using blood agar media, and finally were amplified STREP gene by PCR technique. The indicated that the frequency of GBS in samples collected from urine and vaginal cultures and PCR method was positive. In addition, no significant relationship was found among the positive results of culture, maternal age, gestational age, a history of abortion and infection. With regard to the cultivation method as a standard technique, the sensitivity of PCR test was 100% and specificity was 96%. Moreover, it was found that the colonization rate of GBS in women was significant in Sari. Therefore, PCR is recommended as a reliable and rapid method for detection of GBS.

Prevalence of group B streptococcus colonization in pregnant women in a tertiary care center in Korea.

ObjectiveThe purpose of this study was to evaluate the group B streptococcus (GBS) colonization rate in pregnant Korean women using selective culture media for GBS and to identify obstetrical complications and GBS-induced early-onset neonatal sepsis.MethodsWe evaluated 1,014 pregnant women who delivered at Busan Paik Hospital between January 2015 and December 2016. GBS colonization was assessed using chromID Strepto B agar. We evaluated GBS colonization in pregnant women, as well as the obstetrical complication and GBS-induced neonatal sepsis rates.ResultsThe total GBS colonization rate was 11.6% (117/1,014). No significant increase was observed in the rate of pregnancy-related complications between the GBS-positive and the GBS-negative groups. Among the 134 neonates born to colonized mothers, early neonatal sepsis was reported in 2 neonates (1.5%); however, these were cases of non-GBS-induced sepsis.ConclusionThe GBS colonization rate (using selective culture media) in this study involving pregnant Korean women showed a higher colonization rate than that previously reported in Korea. Therefore, based on this study, we recommend GBS screening and the administration of intrapartum antibiotic prophylaxis in pregnant Korean women.

841: Select microbes present in early 2nd trimester in the cervicovaginal space are associated with subsequent Group B Strep colonization

Microbial communities at different sites influence both health and disease. The cervicovaginal (CV) microbiota have documented associations with sexually transmitted infection acquisition and spontaneous preterm birth. While colonization with Group B Streptococcus (GBS) is prevalent, it remains a significant risk factor for neonatal morbidity. There are no data on how CV microbial communities might influence colonization with GBS. Therefore, the objective of this study was to determine if the CV microbiota is associated with GBS colonization (GBS-C) in pregnant women. A 3 year prospective cohort study of women with singleton pregnancies was utilized (“M&M,” n=1,943). We performed a nested case-control study of 394 GBS- and 158 GBS+ women with 16s rRNA gene analysis of CV specimens collected at 16-20 weeks. Women were considered GBS-C if they were treated with antibiotics for GBS+ in labor. Nine bacteria were selected for analysis based on prior associations with adverse pregnancy outcomes. Odds of GBS colonization (GBS-C) by quartile of relative abundance was estimated with logistic regression adjusting for race and intercourse ≤ 24hrs of visit. The overall rate of GBS+ was 27.3%. GBS+ women were more likely to have had intercourse within 24 hours of the biospecimen collection but otherwise the cases and controls were similar (Table 1). At 16-20 weeks, increasing levels of Sneathia sanguinegens were associated with an increasing rate of GBS+ (0= 14.6%, Q1= 27.1%, Q2= 28.2%, Q3=34.7%, Q4=34.2%), which remained significant after adjustment with odds ranging from Q1 aOR: 2.49 (95% CI 1.16-5.37) up to Q4 aOR: 3.50 (95% CI 1.62-7.54). GBS+ rates also increased with Gardnerella vaginalis levels from 20.3% at Q1 to 31.9% at Q4, which was significant after adjustment: Q2: aOR 1.78 [1.01-3.13], Q3: aOR 1.82 [1.01-3.27], Q4: aOR 1.96 [1.10-3.48]. Certain bacteria present early in the 2nd trimester in the CV space are associated with increased rates of GBS colonization. Microbial communities at various biological sites can be modified without the use of antibiotics. As such, future research should investigate if GBS colonization may be prevented by modifying the CV microbiota, thus limiting, if not preventing, the use of antibiotics during labor without compromising neonatal risk. (NRO14784 ME)

The impact of prenatal group B streptococcus screening as a national health policy in Taiwan

ObjectiveThere was no national data on group B streptococcus (GBS) infections in Taiwan. Until 2012, when prenatal GBS screening was introduced to obstetric practices as a national health policy aimed at reducing neonatal GBS infections. The purpose of this study was to examine the impact of this national health policy on the incidence of maternal GBS colonization and neonatal GBS infection rate. Relatedly, the clinical characteristics of neonatal GBS infection were investigated to determine the correlations between the incidence of maternal GBS colonization and the neonatal GBS infection rate. Materials and methodsThis population-based nationwide study used data for 2012–2013 from the National Health Insurance Research Database of Taiwan. A total of 789 newly diagnosed pregnant women with genital GBS infection were recruited. ResultsThe maternal GBS screening rate was 93.2%. The maternal colonization rate of GBS was around 8.2%, and the incidence of neonatal GBS infection was 22.6%. The data indicate that no sepsis was developed in any of the cases, while fever was found in 3 cases (3/179, 1.7%) and UTI was found in 1 case (1/179, 0.6%). ConclusionsWe conclude that a policy calling for universal maternal rectovaginal cultures for GBS with intrapartum antibiotic prophylaxis is a good national policy for reducing morbidity due to GBS infections in neonates in Taiwan.

Group B Streptococcal infection in neonates and colonization in pregnant women: An epidemiological retrospective analysis.

Group B Streptococcus (GBS) infection is one of the major causes of neonatal morbidity and mortality. Universal GBS screening with intrapartum antibiotic prophylaxis (IAP) in pregnant women were initiated in 2012 in Taiwan. This study aimed to analyze the most recent maternal GBS colonization rate and the changes in neonatal GBS infection rate from 2011 to 2016. All pregnant women and their live born neonates between January 2011 and June 2016 were retrospectively reviewed. Whether GBS screening was done, screening results, presence of risk factors, the use of antibiotics, and neonatal outcome were analyzed. In addition, hospitalized neonates diagnosed with GBS infections were retrieved for comparison of early onset disease (EOD) (<7 days) and late onset disease (LOD) (≥7 days). A total of 9535 women delivered babies during the study period. The maternal GBS screening rate was 71.0% and the colonization rate was 22.6%. The overall neonatal invasive GBS infection rate was 0.81 per 1000 live births and the vertical transmission rate was 1.2%. After 2012, the invasive neonatal GBS infection rate declined from 1.1-1.6‰ to 0.6-0.7‰ in 2014 and thereafter, the GBS EOD incidence rate declined from 2.8‰ to 0.0-0.6‰, but the LOD incidence rate remained approximately 0.7‰. Infants with EOD had strong association with obstetric risk factors. Taiwan's universal GBS screening with IAP program reduced the incidence rate of neonatal GBS EOD to be lower than 1‰ after 2012. Pediatricians still should pay attention to infants with GBS LOD since its incidence rate remained unchanged.

Group B streptococcus colonization and HIV in pregnancy: A cohort study in Nigeria.

Group B streptococcus (GBS) is a leading cause of maternal and neonatal infectious morbidity. HIV is prevalent among pregnant women in Nigeria. To determine the rates of anogenital GBS colonization in our institution and compare GBS colonization rates between HIV positive and negative pregnant women. A cross-sectional comparative study was conducted over 6 months. Patients were separated according to their HIV status: positive and negative. GBS colonization was assessed by vaginal and anal swabs collected at 35-37 weeks of gestation and cultured in Todd-Hewitt broth, followed by a confirmatory test. Socio-demographic characteristics and CD4 count were extracted from patient medical records. Secondary outcomes were identification of risk factors for GBS colonization, antibiotic sensitivity, and any association between CD4 count and GBS colonization. Appropriate statistical analysis was done. A total of 200 patients attended the clinic; 67 HIV positive and 133 negative. Analyzed samples were 198; the overall prevalence of GBS was 18.2%. No significant difference in GBS colonization was noted between HIV positive (19.4% [13]) and negative patients (17.6% [23/131]). Most GBS isolates were susceptible to ampicillin (87%) and penicillin (81%). A high body mass index (BMI) was independently associated with GBS colonization (OR = 1.25, 95% CI: 1.04-1.51). No association was observed between CD4 counts and GBS colonization. A high prevalence of GBS colonization was observed in our institution. Colonization rates were independent of the HIV status but associated with a high BMI in HIV positive women.

Prevention of early onset group B streptococcal disease by universal antenatal culture-based screening in all public hospitals in Hong Kong

Objectives: To determine the prevalence of maternal colonization with group B streptococcus (GBS), and early onset GBS disease (EOGBSD) after implementation of universal screening.Methods: This was a three-year retrospective cohort study on universal antenatal rectovaginal culture-based screening and intrapartum antimicrobial prophylaxis (IAP) to colonized women in the public sector in Hong Kong. Routinely collected data including maternal colonization and EOGBSD were retrieved.Results: Of 113,989 GBS screening performed, 21.8% were positive. The colonization rate was higher in the public hospitals (higher risk) than in the Maternal and Child Health Centers (lower risk) (23.7% vs 18.1%, p < .001), while their false negative rates were not greater than expected. Majority of eligible women opted for screening, and colonized women received IAP. There were 29 cases of EOGBSD with clinical signs and a positive blood or cerebrospinal fluid culture. Compared to clinical risk-based screening, EOGBSD incidence decreased after universal screening (1 vs 0.24 per 1000 births, p < .001). Although EOGBSD occurred at a higher rate in preterm than term infants, 86.7% occurred in the latter, and were associated with a false negative screening result (41.3%), lack of screening (20.7%) or unavailability of a colonization result at labour (13.8%).Conclusions: Maternal GBS colonization rate was higher than previously reported, and varied with different risk populations. EOGBSD reduced after universal screening.

Group B streptococcus detection in China: comparison of different screening methods and different sampling sites

Objectives: To evaluate the use of real-time polymerase chain reaction (RT-PCR) and bacterial culture methods to detect group B streptococcus (GBS) in Chinese pregnant women in the third trimester; to separately assess the prevalence of rectal and vaginal GBS colonization ; and to determine the antimicrobial susceptibility pattern of the isolates. Methodology: Samples were collected from 505 women at 35 and 37 weeks gestation at the Peking Union Medical College Hospital. Bacterial culture and RT-PCR were performed. Antimicrobial susceptibility to commonly used antibiotics was also analyzed. Results: The overall GBS colonization rate was 7.5%. The colonization rate, sensitivity, and negative predictive value of the bacterial culture method were 2.8%, 36.8%, and 95.1%, respectively, and these values were 7.3%, 97.4%, and 99.8%, respectively, for PCR (p<0.001). The GBS colonization rate of the rectum (6.7%) was higher than that of the vagina (2.8%) (p=0.005). Antimicrobial susceptibility testing showed that 100% were sensitive to penicillin, cephalosporin and vancomycin. Conclusions: RT-PCR was found to be a rapid and sensitive test for the detection of GBS colonization in Chinese pregnant women. Rectal swabbing was also important for detecting GBS colonization. β-lactams are the first-line antibiotics used for the treatment of GBS. J Microbiol Infect Dis 2016;6(4): 179-183 Group B streptococcus, Real-time polymerase chain reaction, Sampling sites,

Group B streptococcus colonisation in pregnant women at Dr. George Mukhari Hospital, South Africa

The aim of the study was to estimate group B streptococcus (GBS) colonisation in pregnant mothers using selective enrichment broth and solid media for culturing GBS. Vaginal and rectal swabs were collected from 413 pregnant women for GBS culture at recruitment stage. Direct plating and enrichment broth culture methods were compared by using the same swab samples. The swabs were cultured on colistin nalidixic agar (CNA) plate and incubated at 37°C and examined after 18-24 h. The samples which were culture negative on a CNA agar plate were then inoculated into a Todd-Hewitt enrichment broth to recover any GBS present that was not recovered on the solid agar. With the CNA agar plate, the samples were cultured separately to enable identification of colonised sites such as vaginal sites or rectal sites. Rectal and vaginal swabs were inoculated into Todd-Hewitt enrichment broth at the same time in the same tube. The GBS colonisation rate in pregnant women was 30.9% (128/413). The CNA agar plate recovered 45.3% (58/128) of the GBS isolates, whereas 54.7% (70/128) isolates were recovered from Todd-Hewitt broth. Pregnant women of various ages were found to be at risk of GBS colonisation. The colonisation rate was however highest among women of 25–29 age groups as compared with other age groups. Detection of group B streptococcus improved when both rectal and vaginal swabs were collected for laboratory analysis. The simultaneous use of Todd-Hewitt broth and CNA plate also improved the yield of group B streptococcus.