Group B streptococcus drug resistance in pregnant women in Iran: a meta-analysis

Background: Group B streptococcus or streptococcus Agalactia is a gram positive beta hemolytic bacteria which is the main factor in neonatal infections. This study aimed at determining the prevalence of GBS in world and clarifying the rate of this infection in Islamic and non-Islamic countries. Methods: We performed a systematic search by using different databases including Medline, Scopus, Science Direct, Psycho-Info ProQuest and Web of Science published up to Feb 2019. We undertook meta-analysis to obtain the pooled estimate of prevalence of GBS colonization in Islamic and non-Islamic countries. Results: Among 3324 papers searched, we identified 245 full texts of prevalence of GBS in pregnancy; 131 were included in final analysis. The estimated mean prevalence of maternal GBS colonization was 15.5% (CI:95% (14.2-17)) worldwide; which was 14% (CI:95% (11-16.8)) in Islamic and 16.3% (CI:95% (14.6-18.1)) in nonIslamic countries and was statistically significant. Moreover, with regards to sampling area, prevalence of GBS colonization was 11.1 in vagina and 18.1 in vagina-rectum. Conclusion: Frequent washing of perineum based on religious instructions in Islamic countries can diminish the rate of GBS colonization in pregnant women.

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Prevalence of maternal Group B Streptococcus rectovaginal colonization among pregnant women in Ethiopia: protocol for a systematic review and meta-analysis

10.21203/rs.3.rs-406725/v1 ◽

2021 ◽

Author(s):

Delayehu Bekele ◽

Dawit Getachew Assefa ◽

Wondimu Gudu ◽

Mekitie Wondafrash ◽

Lemi Belay Tolu

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Vertical Transmission ◽

Meta Analysis ◽

National Level ◽

Group B Streptococcus ◽

Cochrane Library ◽

Resistance Pattern ◽

Reference List ◽

Group B

Abstract Background: Rectovaginal colonization with Group B streptococcus (GBS) during pregnancy is an important risk factor for serious infections including neonatal sepsis, pneumonia, and meningitis. It is also associated with stillbirth and preterm birth. Since globally rates of GBS colonization, as well as rates of vertical transmission to the newborn, differ broadly, having national data is important for implementing strategies to reduce neonatal morbidity and mortality as a result of GBS infection. We propose this systematic review and meta-analysis to describe the prevalence of rectovaginal GBS colonization, rate of vertical transmission, and the antibiotic resistance pattern among third trimester pregnant women in Ethiopia.Methods: A systematic search will be done of PubMed (MEDLINE), EMBASE, CINHAL, and Cochrane Library. In addition, google scholar will be searched, and a reference list of the already identified articles will be checked to find additional eligible articles that were missed during the initial search. Two reviewers will screen all retrieved articles and assess the methodological quality of included studies using the Newcastle-Ottawa Scale (NOS) checklist. Any disagreement between two reviewers will be resolved by a third reviewer. We will extract data using the JBI data extraction tool for the systematic review of prevalence studies. The data analysis will be conducted using Stata Statistical Software: Release 15. We will present pooled estimates of the prevalence of GBS colonization and rates of vertical transmission with a 95% confidence interval.Discussion: This will be the first synthesis of data on GBS during pregnancy at a national level. It will inform decision-makers in determining whether a universal or a risk-based screening strategy is most appropriate, as well as guiding them in adopting an intrapartum antibiotic protocol.Registration: Submitted to PROSPERO on 18/03/2021

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Infection and drug resistance of Streptococcus agalactiae among perinatal pregnant women in Xinjiang

10.21203/rs.3.rs-608405/v1 ◽

2021 ◽

Author(s):

Shuli Guo ◽

Xiandao Luo ◽

Haiying Jia ◽

Xiuhui Pang ◽

Changmin Wang ◽

...

Keyword(s):

Drug Resistance ◽

Pregnant Women ◽

Streptococcus Agalactiae ◽

Group B Streptococcus ◽

Target Site ◽

Macrolide Resistance ◽

Diffusion Method ◽

Resistance Phenotype ◽

Ermb Gene ◽

Group B

Abstract Background: Group B streptococcus (Streptococcus agalactiae) is one of the most common pathogens causing meningitis, bacteremia and pneumonia. The drug resistance mechanisms of group B streptococcus in different countries and regions also show regional differences.Method: The study population was comprised of 1877 pregnant women of 34-38 weeks who underwent prenatal examination in the gynecology and obstetrics outpatient clinic of Xinjiang People's Hospital, between January 1, 2019 and January 31, 2020. Clinic specimens were collected and identified by the API bacteria Rapid Identification card for the downstream group B Streptococcus (Streptococcus agalactiae) isolation. Drug susceptibility of the Streptococcus agalactiae isolated was detected by Kirby-Bauer disk diffusion method. Macrolide–lincosamide–streptogramin B (MLSB) resistance was determined by D test. Real-time quantitative polymerase chain reaction and Gene sequencing was performed for the resistance genes ermA, ermB, mreA, erm (47), mefA/E and Lin B.Results: 149 Streptococcus agalactiae-positive strains were identified by clinical isolation, with a positive rate of 7.94%. Group B Streptococcus showed 100% susceptibility to linezolid, penicillin, vancomycin, meropenem, ampicillin, ceftriaxone, 44.97%, 35.57%, 56.38% and 29.53% susceptibility to levofloxacin, erythromycin, tetracycline and clindamycin, respectively. Among the 149 isolates, 127 strains showed macrolide resistance phenotype. The detection rate of intrinsic resistance phenotype (cMLS) was 40.94% (59/127), active efflux resistance phenotype (MS) 9.45% (12/127), and induced resistance phenotype (iMLS) 22.83% (29/127).Conclusion: The ermB gene-mediated 50s ribosome target site change co-existing with mreA gene for macrolide resistance efflux may play a major role in the mechanism of Streptococcus agalactiae resistance macrolide resistance of in perinatal women in Xinjiang. The change of 50s ribosomal target site mediated by ermB gene may be the main reason for drug cross-resistance.

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Distribution of Streptococcus agalactiae Among Iranian Women from 1992 to 2018: A Systematic Review and Meta-Analysis

Jundishapur Journal of Microbiology ◽

10.5812/jjm.102314 ◽

2020 ◽

Vol 13 (7) ◽

Author(s):

Maryam Sadeh ◽

Amin Salehi-Abargouei ◽

Nastaran Azartoos ◽

Farzaneh Mirzaei ◽

Mohammad Bagher Khalili

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Web Of Science ◽

Meta Analysis ◽

Group B Streptococcus ◽

Random Effects Model ◽

Iranian Women ◽

Context Group ◽

Group B ◽

Colonization Rates

Context: Group B Streptococcus has the capacity of being colonized in the rectovaginal organ of women and causes infections in a mother and her fetus, thereby leading to neonatal diseases. Evidence Acquisition: The aim of this review was to summarize all of the relevant articles published to highlight the prevalence of group B Streptococcus colonization or infection in different regions of Iran. A systematic literature review was conducted by searching PubMed, Scopus, Web of Science (ISI), ScienceDirect, Google Scholar, and domestic databases for papers published in English or Persian from 1992 up to July 2019, concerning the prevalence of group B Streptococcus among Iranian women. All information regarding year, location of cases, frequency, author’s name, date of publication, participants, pregnancy period, sampling, and quality assessment were recorded. Summary effects were derived using the random effects model. Results: Among 61 suitable papers, data revealed that 36,807 cases of pregnant and non-pregnant women had been tested for group B Streptococcus during 1992-2018. Overall, 11.9% of pregnant and 5.3% of non-pregnant women were positive. Further results were as follows: vaginal, recto-vaginal, rectal, and endocervical colonization rates were 12.9%, 9.7%, 18.5%, and 3.7%, respectively. Group B Streptococcus incidence was the highest in Sanandaj (61.5%), and the lowest in Tabriz (1.8%). Conclusions: Although the prevalence distribution in Iran seems to be acceptable, more investigations are needed to represent the real incidence of group B Streptococcus around the country. In addition, a program with a standard lab technique is needed to screen pregnant women for further treatment before birth.

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Prevalence of group B streptococcus colonization in Iranian pregnant women: A systematic review and meta-analysis

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v16i12.3679 ◽

2019 ◽

Vol 16 (12) ◽

pp. 731

Author(s):

Mohammad Hossein YektaKooshali ◽

Masoud Hamidi ◽

Seyed Mohammad Taghi Razavi Tousi ◽

Iraj Nikokar

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Meta Analysis ◽

Group B Streptococcus ◽

Group B

.

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Screening for group B Streptococcus in pregnant women: a systematic review and meta-analysis

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000600026 ◽

2011 ◽

Vol 19 (6) ◽

pp. 1470-1478 ◽

Cited By ~ 10

Author(s):

Mônica Taminato ◽

Dayana Fram ◽

Maria Regina Torloni ◽

Angélica Gonçalves Silva Belasco ◽

Humberto Saconato ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Neonatal Sepsis ◽

Universal Screening ◽

Screening Program ◽

Meta Analysis ◽

Group B Streptococcus ◽

Public Health Problem ◽

Cochrane Library ◽

Group B

Infection with Group B Streptococcus (GBS) is considered an important public health problem. It is associated with: Neonatal sepsis, meningitis, pneumonia, neonatal death, septic abortion, chorioamnionitis, endometritis and other perinatal infections. The aim of this study was to determine the best screening strategy for GBS in pregnant women. For this a systematic review and meta-analysis were carried out in the Nursing Department of the Federal University of São Paulo, Cochrane Center, Brazil. Sources used were, EMBASE, LILACS, Medline, list of references, personal communication and the Cochrane library. The criterion for the selection of the studies was; studies which analyze some type of screening for GBS in pregnant women. Independent of the comparator, all analyses were in favor of a universal screening program for reducing the incidence of neonatal sepsis. The evidence obtained in this study suggests that the strategy of universal screening of pregnant women associated with the use of prophylactic antibiotics is safe and effective.

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Biomarkers for a histological chorioamnionitis diagnosis in pregnant women with or without group B streptococcus infection: a case-control study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03731-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jie Ren ◽

Zhe Qiang ◽

Yuan-yuan Li ◽

Jun-na Zhang

Keyword(s):

Cord Blood ◽

Pregnant Women ◽

Peripheral Blood ◽

Group B Streptococcus ◽

Diagnostic Value ◽

Adverse Outcomes ◽

Intercellular Adhesion Molecule ◽

Tnf Α ◽

Group B ◽

The Impact

Abstract Background Chorioamnionitis may cause serious perinatal and neonatal adverse outcomes, and group B streptococcus (GBS) is one of the most common bacteria isolated from human chorioamnionitis. The present study analyzed the impact of GBS infection and histological chorioamnionitis (HCA) on pregnancy outcomes and the diagnostic value of various biomarkers. Methods Pregnant women were grouped according to GBS infection and HCA detection. Perinatal and neonatal adverse outcomes were recorded with a follow-up period of 6 weeks. The white blood cell count (WBC), neutrophil ratio, and C-reactive protein (CRP) level from peripheral blood and soluble intercellular adhesion molecule-1 (sICAM-1), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α) levels from cord blood were assessed. Results A total of 371 pregnant women were included. Pregnant women with GBS infection or HCA had a higher risk of pathological jaundice and premature rupture of membranes and higher levels of sICAM-1, IL-8, and TNF-α in umbilical cord blood. Univariate and multivariate regression analysis revealed that sICMA-1, IL-8, TNF-α, WBC, and CRP were significantly related to an increased HCA risk. For all included pregnant women, TNF-α had the largest receiver operating characteristic (ROC) area (area: 0.841; 95% CI: 0.778–0.904) of the biomarkers analyzed. TNF-α still had the largest area under the ROC curve (area: 0.898; 95% CI: 0.814–0.982) for non-GBS-infected pregnant women, who also exhibited a higher neutrophil ratio (area: 0.815; 95% CI: 0.645–0.985) and WBC (area: 0.849; 95% CI: 0.72–0.978), but all biomarkers had lower value in the diagnosis of HCA in GBS-infected pregnant women. Conclusion GBS infection and HCA correlated with several perinatal and neonatal adverse outcomes. TNF-α in cord blood and WBCs in peripheral blood had diagnostic value for HCA in non-GBS-infected pregnant women but not GBS-infected pregnant women.

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Poor Adherence to the Screening-Based Strategy of Group B Streptococcus Despite Colonization of Pregnant Women in Greece

Pathogens ◽

10.3390/pathogens10040418 ◽

2021 ◽

Vol 10 (4) ◽

pp. 418

Author(s):

Maria Maroudia Berikopoulou ◽

Aikaterini Pana ◽

Theodota Liakopoulou-Tsitsipi ◽

Nikos F. Vlahos ◽

Vasiliki Papaevangelou ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Pregnant Women ◽

Late Onset ◽

Group B Streptococcus ◽

Culture Collection ◽

Carrier Status ◽

Cross Sectional ◽

Screening Guidelines ◽

Group B

Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks’ gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients’ records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures (p = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.

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