P517 Group B Streptococcus (GBS) and Escherichia coli (E. coli) colonization in Lithuanian pregnant women and the impact of colonization on early onset neonatal infections

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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Genomic and phenotypic characterisation of invasive neonatal and colonising group B Streptococcus isolates from Slovenia, 2001–2018

BMC Infectious Diseases ◽

10.1186/s12879-020-05599-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Tina Perme ◽

Daniel Golparian ◽

Maja Bombek Ihan ◽

Andrej Rojnik ◽

Miha Lučovnik ◽

...

Keyword(s):

Pregnant Women ◽

Virulence Factors ◽

Late Onset ◽

Group B Streptococcus ◽

Genomic Diversity ◽

Neonatal Disease ◽

Phenotypic Characterisation ◽

High Prevalence ◽

Group B ◽

The Impact

Abstract Background Group B Streptococcus (GBS) is the leading cause of invasive neonatal disease in the industrialized world. We aimed to genomically and phenotypically characterise invasive GBS isolates in Slovenia from 2001 to 2018 and contemporary colonising GBS isolates from screening cultures in 2018. Methods GBS isolates from 101 patients (invasive isolates) and 70 pregnant women (colonising isolates) were analysed. Basic clinical characteristics of the patients were collected from medical records. Antimicrobial susceptibility and phenotypic capsular serotype were determined. Whole-genome sequencing was performed to assign multilocus sequence types (STs), clonal complexes (CCs), pathogenicity/virulence factors, including capsular genotypes, and genome-based phylogeny. Results Among invasive neonatal disease patients, 42.6% (n = 43) were females, 41.5% (n = 39/94) were from preterm deliveries (< 37 weeks gestation), and 41.6% (n = 42) had early-onset disease (EOD). All isolates were susceptible to benzylpenicillin with low minimum inhibitory concentrations (MICs; ≤0.125 mg/L). Overall, 7 serotypes were identified (Ia, Ib, II-V and VIII); serotype III being the most prevalent (59.6%). Twenty-eight MLST STs were detected that clustered into 6 CCs. CC-17 was the most common CC overall (53.2%), as well as among invasive (67.3%) and non-invasive (32.9%) isolates (p < 0.001). CC-17 was more common among patients with late-onset disease (LOD) (81.4%) compared to EOD (47.6%) (p < 0.001). The prevalence of other CCs was 12.9% (CC-23), 11.1% (CC-12), 10.5% (CC-1), 8.2% (CC-19), and 1.8% (CC-498). Of all isolates, 2.3% were singletons. Conclusions A high prevalence of hypervirulent CC-17 isolates, with low genomic diversity and characteristic profile of pathogenicity/virulence factors, was detected among invasive neonatal and colonising GBS isolates from pregnant women in Slovenia. This is the first genomic characterisation of GBS isolates in Slovenia and provides valuable microbiological and genomic baseline data regarding the invasive and colonising GBS population nationally. Continuous genomic surveillance of GBS infections is crucial to analyse the impact of IND prevention strategies on the population structure of GBS locally, nationally, and internationally.

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The impact of group B streptococcus prophylaxis on late-onset neonatal infections

Journal of Perinatology ◽

10.1038/jp.2012.76 ◽

2012 ◽

Vol 33 (3) ◽

pp. 206-211 ◽

Cited By ~ 10

Author(s):

K L Ecker ◽

P K Donohue ◽

K S Kim ◽

J A Shepard ◽

S W Aucott

Keyword(s):

Late Onset ◽

Group B Streptococcus ◽

Neonatal Infections ◽

Group B ◽

The Impact

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Comparison of early-onset neonatal sepsis caused by Escherichia coli and group B Streptococcus

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.12.031 ◽

2005 ◽

Vol 192 (5) ◽

pp. 1437-1439 ◽

Cited By ~ 22

Author(s):

Kathleen Mayor-Lynn ◽

Víctor Hugo González-Quintero ◽

Mary Jo O'Sullivan ◽

Alan I. Hartstein ◽

Sonia Roger ◽

...

Keyword(s):

Escherichia Coli ◽

Neonatal Sepsis ◽

Early Onset ◽

Group B Streptococcus ◽

Group B

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Group B Streptococcus serotypes associated with different clinical syndromes: Asymptomatic carriage in pregnant women, intrauterine fetal death, and early onset disease in the newborn

PLoS ONE ◽

10.1371/journal.pone.0244450 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244450

Author(s):

Yulia Schindler ◽

Galia Rahav ◽

Israel Nissan ◽

Liora Madar-Shapiro ◽

Julia Abtibol ◽

...

Keyword(s):

Pregnant Women ◽

Early Onset ◽

Fetal Death ◽

Group B Streptococcus ◽

Intrauterine Fetal Death ◽

Carriage Rate ◽

Asymptomatic Carriage ◽

Clinical Syndromes ◽

Group B ◽

Dominant Serotype

Objectives To study Group B Streptococcus (GBS) isolates associated with different clinical syndromes: asymptomatic carriage in pregnant women, intrauterine fetal death (IUFD), and early onset disease (EOD) in the newborn. Methods GBS isolates were collected from asymptomatic pregnant women admitted for labor, IUFD cases, and neonates with EOD. Serotypes and antibiotic susceptibilities were determined. Multilocus sequence typing (MLST) was performed to assess genetic epidemiology. Results GBS carriage rate was 26.1% (280/1074). The dominant serotype among asymptomatic pregnant women was VI [98/240 women (40.8%)], followed by serotypes III, V and IV in 42/240 (17.5%), 30/240 (12.5%) and 28/240 (11.7%) women, respectively. The dominant serotype in IUFD cases was serotype VI [10/13 (76.9%)]. In contrast the prevalent serotype among EOD cases was III [16/19 (84.2%)]. ST-1 was associated with IUFD [7/13 (53.8%)], ST-17 was associated with serotype III and EOD in the newborn 14/19 (73.7%)]. Erythromycin and clindamycin resistance reached 36.8%, 7.7% and 20.0%among EOD, vaginal carriage and IUFD, respectively. Conclusions Serotypes VI and ST-1 were dominant among asymptomatic pregnant women and in IUFD cases while EOD was associated with serotype III and ST-17. Invasive mechanisms thus may differ between IUFD and EOD in the newborn and virulence may be related to capsule serotype. Resistance rates to erythromycin and clindamycin were high in EOD cases.

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Prevalence of Group B Streptococcus in Vagina and Rectum of Pregnant Women of Islamic & Non-Islamic Countries: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v50i5.6106 ◽

2021 ◽

Author(s):

Fatemeh Abbasalizadeh ◽

Sajjad Pourasghary ◽

Maryam Shirizadeh ◽

Sanaz Mousavi ◽

Morteza Ghojazadeh ◽

...

Keyword(s):

Pregnant Women ◽

Web Of Science ◽

Meta Analysis ◽

Group B Streptococcus ◽

Final Analysis ◽

Sampling Area ◽

Neonatal Infections ◽

Islamic Countries ◽

Group B ◽

Main Factor

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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Ampicillin susceptibilities of vaginal and placental isolates of group B streptococcus and Escherichia coli obtained between 1992 and 1994.

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.41.5.1173 ◽

1997 ◽

Vol 41 (5) ◽

pp. 1173-1174 ◽

Cited By ~ 9

Author(s):

L A Meyn ◽

S L Hillier

Keyword(s):

Escherichia Coli ◽

Group B Streptococcus ◽

E Coli ◽

Group B

Vaginal group B streptococcus (GBS) and Escherichia coli isolates were tested for their susceptibilities to ampicillin. All 414 GBS isolates tested were susceptible to ampicillin; the MIC at which 90% of the isolates were inhibited (MIC90) was 0.125 microg/ml, and the range was 0.06 to 0.25 microg/ml. The MIC50 for the 342 E. coli isolates tested was 4.0 microg/ml, and 27% were resistant to ampicillin.

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Early-onset neonatal infections in Australia and New Zealand, 2002–2012

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-314671 ◽

2018 ◽

Vol 104 (3) ◽

pp. F248-F252 ◽

Cited By ~ 14

Author(s):

Tarun Singh ◽

Elizabeth H Barnes ◽

David Isaacs

Keyword(s):

New Zealand ◽

Incidence Rate ◽

Early Onset ◽

Group B Streptococcus ◽

E Coli ◽

Live Births ◽

Early Onset Sepsis ◽

Group B ◽

Almost All ◽

Over Time

BackgroundThe epidemiology of early-onset neonatal sepsis (EONS) varies over time, and requires regular surveillance.ObjectiveTo analyse data on EONS in Australia and New Zealand.MethodsRetrospective analysis of data collected longitudinally from multiple neonatal units from 2002 to 2012.ResultsOf 386 423 live births, 454 infants had EONS. The incidence rate of EONS was 1.20 per 1000 live births in 2002 and 0.83 in 2012, decreasing by 4% per year (95% CI 1% to 7%, p=0.007). Group B streptococcus (GBS) (37%) and Escherichia coli (25%) were the most prevalent organisms. The early-onset GBS (EOGBS) incidence rate was 0.43/1000 live births, with no evidence of change over time (p=0.3). Of EOGBS-infected babies, 62% were born at term compared with 8% with early-onset E. coli sepsis, p<0.0001. The mortality of E. coli early-onset sepsis (EOS) (25%) was higher than GBS (11%), but this difference in mortality was no longer significant after adjusting for gestation and birth weight. Mortality from EOS fell significantly over the study period (17% per year, 95% CI 10 to 24, p<0.0001).ConclusionsGBS was the most common cause of early sepsis, but the incidence was lower than prior to the introduction of intrapartum antibiotic prophylaxis, and remained steady over time. The mortality of early-onset E. coli sepsis was significantly higher than GBS sepsis, but this may have been because almost all babies with E. coli were born preterm, rather than a difference in virulence.

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Streptococcus agalactiae colonization and screening approach in high-risk pregnant women in southern Brazil

The Journal of Infection in Developing Countries ◽

10.3855/jidc.12025 ◽

2020 ◽

Vol 14 (04) ◽

pp. 332-340

Author(s):

Jeane Zanini da Rocha ◽

Jéssica Feltraco ◽

Vanessa Radin ◽

Carla Vitola Gonçalves ◽

Pedro Eduardo Almeida da Silva ◽

...

Keyword(s):

High Risk ◽

Pregnant Women ◽

Low Cost ◽

Group B Streptococcus ◽

Neonatal Morbidity ◽

Neonatal Infection ◽

Diagnostic Methods ◽

Antenatal Screening ◽

Group B ◽

The Impact

Introduction: Considering that Group B Streptococcus (GBS) persists as an important cause of neonatal morbidity and mortality, the objective of this study was to evaluate the frequency of maternal colonization by GBS, comparing the culture by the Granada broth with the GeneXpert real-time PCR diagnostic methods and the impact of chemoprophylaxis in high-risk pregnant women. Methodology: A prospective cohort of 110 pregnant women hospitalized for gestational complications was formed and recruited following interview and collection of rectovaginal swabs. Results: The frequency of maternal colonization was 28.2% and statistically associated with Capurro> 37 weeks (p = 0.030) and neonatal infection (p = 0.008). Chemoprophylaxis was offered to 80% of those colonized. Among the pregnant women treated, a fivefold reduction in the rate of prematurity and rate of neonatal infection was observed. The sensitivity was 76.6% and 86.6% in culture and PCR, respectively, with an optimal index of agreement between the methods (K = 0.877). Grenade culture was considered an easy and low-cost method, while GeneXpert presented higher cost and error rate of 10%. However, 23.3% of the pregnant women were diagnosed exclusively by GeneXpert and the results were obtained in two hours. Conclusions: This study showed a significant prevalence of maternal colonization for GBS and that both culture and molecular methods had peculiarities that allow different applicability, with the culture being feasible for antenatal screening and in the hospital for high-risk pregnant women with no sign of imminent delivery and GeneXpert being prioritized for situations of preterm birth.

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