Maternal Group B Streptococcus colonisation

2017 ◽  
Vol 38 (3) ◽  
pp. 134
Author(s):  
Lucy Furfaro ◽  
Barbara Chang ◽  
Matthew Payne

Streptococcus agalactiae, commonly known as Group B Streptococcus (GBS), is an important neonatal pathogen known to cause sepsis, meningitis and pneumonia. Australian pregnant women undergo screening during pregnancy in an effort to eradicate GBS before delivery where transmission to the neonate can occur. Preventative treatment includes intrapartum antibiotic prophylaxis and results in widespread treatment of the 10–40% of pregnant women colonised. GBS are separated into ten different capsular polysaccharide serotypes and previous studies have suggested associations between specific serotypes and disease. At present, however, minimal data exist on serotype distribution within Western Australian-pregnant women, information that may play an important role in future prophylactic treatment regimens. Our preliminary data, obtained from GBS isolated from vaginal swabs from 191 pregnant women, suggests that GBS serotype distributions in Western Australia are different to other parts of Australasia. In particular, compared to the eastern Australian states and New Zealand, in our cohort, serotype Ib prevalence was 7–17 times lower, II was 2–6 times greater and VI was 2–12 times greater. In addition, serotype IX represented 6.3% of all serotypes. Understanding which serotypes are present in our population will provide valuable data for future targeted treatment regimens such as vaccination and bacteriophage therapy.

2011 ◽  
Vol 5 (08) ◽  
pp. 592-595 ◽  
Author(s):  
Vijayan Sharmila ◽  
Noyal Mariya Joseph ◽  
Thirunavukkarasu Arun Babu ◽  
Latha Chaturvedula ◽  
Sujatha Sistla

Introduction: During the last few decades, group B Streptococcus (GBS) has emerged as an important pathogen. The major reservoirs for GBS are the vagina and the peri-anal regions/rectum, and the colonization of these regions is a risk factor for subsequent infection in pregnant women and newborns. Methodology: A prospective study was performed to determine the prevalence of GBS colonization in the vagina and rectum of pregnant women and the antibiotic susceptibility pattern of the isolates. We also aimed to identify risk factors associated with GBS colonization. The vaginal and rectal swabs were inoculated in Todd-Hewitt broth and later subcultured on blood agar for isolation of GBS. Results: A total of 300 pregnant women were enrolled in the study. GBS strains were isolated from seven out of 300 patients, corresponding to a colonization rate of 2.3%. Of the seven patients carrying GBS, isolates were cultured only from vaginal swabs in two cases (28.6%), only from rectal swabs in two cases (28.6%) from both vaginal and rectal swabs in three cases (42.9%). Heavy colonization was present only in 42.9% (3/7) of antenatal women. None of the seven isolates were resistant to penicillin or clindamycin, while one isolate (14.3%) was resistant to erythromycin and five isolates (71.4%) were resistant to tetracycline. Multigravid women and those with previous spontaneous abortion were more frequently colonized by GBS. Conclusion: The GBS colonization rate in our study was low. No resistance to penicillin or clindamycin was seen, while the majority of the isolates were resistant to tetracycline.


2016 ◽  
Vol 31 (3) ◽  
pp. 74-78
Author(s):  
M. C. Monyama ◽  
J. Y. Bolukaoto ◽  
M. O. Chukwu ◽  
M. R.B. Maloba ◽  
S. R. Moyo ◽  
...  

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.


2013 ◽  
Vol 5 (01) ◽  
pp. 42-45 ◽  
Author(s):  
Kavitha P Konikkara ◽  
Shrikala Baliga ◽  
Suchitra M Shenoy ◽  
B Bharati

ABSTRACT Aims: Group B Streptococcus (GBS) is one of the most common causes of neonatal sepsis throughout the world. Reports of vaginal colonization of GBS in India are few and variable. A study was conducted on pregnant women in a tertiary care hospital to compare various methods for isolation of GBS, to study the prevalence of GBS in pregnant women in third trimester, and to determine risk factors for GBS colonization. Settings and Design: Observational descriptive study. Materials and Methods: High vaginal swabs from 150 pregnant women in their third trimester were used to compare three methods for isolation of GBS viz. direct culture on 5% Sheep Blood agar, direct culture on selective Columbia Blood Agar and culture in LIM enrichment broth with subsequent culture on 5% Sheep Blood agar. A history of associated risk factors was also taken. Statistical Analysis Used: Statistical analysis was performed by Chi–square test. Results: Isolation was best from LIM enrichment broth with subsequent culture on 5% Sheep Blood Agar. Prevalence of GBS colonization by using culture method was 12.67%. Most frequently associated risk factor was intrapartum fever (42.11%). Conclusions: Standard Culture Method using LIM enrichment should be adopted as standard practice for isolation of GBS from vaginal swabs.


Author(s):  
Yu-Jin Jung ◽  
Bich-Tram Huynh ◽  
Abdoulaye Seck ◽  
Raymond Bercion ◽  
Fatoumata Diene Sarr ◽  
...  

Maternal group B Streptococcus (GBS) colonization is a major risk factor for neonatal GBS infection. However, data on GBS are scarce in low- and middle-income countries. Using sociodemographic data and vaginal swabs collected from an international cohort of mothers and newborns, this study aimed to estimate the prevalence of GBS colonization among pregnant women in Madagascar ( n = 1,603) and Senegal ( n = 616). The prevalence was 5.0% (95% CI, 3.9–6.1) and 16.1% (95% CI, 13.1–19.0) in Madagascar and Senegal, respectively. No factors among sociodemographic characteristics, living conditions, and obstetric history were found to be associated independently with GBS colonization in both countries. This community-based study provides one of the first estimates of maternal GBS colonization among pregnant women from Madagascar and Senegal.


2019 ◽  
Vol 23 (67) ◽  
pp. 1-40 ◽  
Author(s):  
Clara Carreras-Abad ◽  
Madeleine Cochet ◽  
Tom Hall ◽  
Laxmee Ramkhelawon ◽  
Asma Khalil ◽  
...  

Background Group B streptococcus is the leading cause of infection in infants. Currently, intrapartum antibiotic prophylaxis is the major strategy to prevent invasive group B streptococcus disease. However, intrapartum antibiotic prophylaxis does not prevent maternal sepsis, premature births, stillbirths or late-onset disease. Maternal vaccination may offer an alternative strategy. Multivalent polysaccharide protein conjugate vaccine development is under way and a serocorrelate of protection is needed to expedite vaccine licensure. Objectives The ultimate aim of this work is to determine the correlate of protection against the major group B streptococcus disease-causing serotypes in infants in the UK. The aim of this feasibility study is to test key operational aspects of the study design. Design Prospective cohort study of pregnant women and their infants in a 6-month period (1 July to 31 December 2018). Setting Five secondary and tertiary hospitals from London and South England. National iGBS disease surveillance was conducted in all trusts in England and Wales. Participants Pregnant women aged ≥ 18 years who were delivering at one of the selected hospitals and who provided consent during the study period. There were no exclusion criteria. Interventions No interventions were performed. Main outcome measures (1) To test the feasibility of collecting serum at delivery from a large cohort of pregnant women. (2) To test the key operational aspects for a proposed large serocorrelates study. (3) To test the feasibility of collecting samples from those with invasive group B streptococcus. Results A total of 1823 women were recruited during the study period. Overall, 85% of serum samples were collected at three sites collecting only cord blood. At the two sites collecting maternal, cord and infant blood samples, the collection rate was 60%. A total of 614 women were screened for group B streptococcus with a colonisation rate of 22% (serotype distribution: 30% III, 25% Ia, 16% II, 14% Ib, 14% V and 1% IV). A blood sample was collected from 34 infants who were born to colonised women. Maternal and infant blood and the bacterial isolates for 15 newborns who developed invasive group B streptococcal disease during the study period were collected (serotype distribution: 29% III, 29% II, 21% Ia, 7% Ib, 7% IV and 7% V). Limitations Recruitment and sample collection were dependent on the presence of research midwives rather than the whole clinical team. In addition, individualised consent limited the number of women who could be approached each day, and site set-up for the national surveillance study and the limited time period of this feasibility study limited recruitment of all eligible participants. Conclusions We have verified the feasibility of collecting and processing rectovaginal swabs and blood samples in pregnant women, as well as samples from those with invasive group B streptococcal disease. We have made recommendations for the recruitment of cases within the proposed GBS3 study and for controls both within GBS3 and as an extension of this feasibility study. Future work A large case–control study comparing specific immunoglobulin G levels in mothers whose infants develop invasive group B streptococcal disease with those in colonised mothers whose infants do not develop invasive group B streptococcal disease is recommended. Trial registration Current Controlled Trials ISRCTN49326091; IRAS project identification number 246149/REC reference number 18/WM/0147. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 67. See the NIHR Journals Library website for further project information.


Pathogens ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 43
Author(s):  
Anna Dobrut ◽  
Monika Brzychczy-Włoch

Streptococcus agalactiae (Group B Streptococcus, GBS) is an opportunistic pathogen, which asymptomatically colonizes the gastrointestinal and genitourinary tract of up to one third of healthy adults. Nevertheless, GBS carriage in pregnant women may lead to several health issues in newborns causing life threatening infection, such as sepsis, pneumonia or meningitis. Recommended GBS screening in pregnant women significantly reduced morbidity and mortality in infants. Nevertheless, intrapartum antibiotic prophylaxis, recommended following the detection of carriage or in case of lack of a carriage test result for pregnant women who demonstrate certain risk factors, led to the expansion of the adverse phenomenon of bacterial resistance to antibiotics. In our paper, we reviewed some immunogenic GBS proteins, i.e., Alp family proteins, β protein, Lmb, Sip, BibA, FsbA, ScpB, enolase, elongation factor Tu, IMPDH, and GroEL, which possess features characteristic of good candidates for immunodiagnostic assays for GBS carriage detection, such as immunoreactivity and specificity. We assume that they can be used as an alternative diagnostic method to the presently recommended bacteriological cultivation and MALDI.


Author(s):  
Nishita Shettian ◽  
Shetty Theertha Shankar ◽  
Manjunath Kamath Ammembal

Background: Group B Streptococcus (GBS) infection in pregnant women is a major concern as it causes septicemia in neonates which is fatal and potentially life threatening. Objectives of present study were to study the distribution of Group B streptococcus infection among pregnant women at term, to understand if penicillin is still effective as the drug of choice, to determine the alternate drug of choice in women with Group B streptococcus infection if resistant to penicillin and analyze the proportion of Group B Streptococcus infection as a vaginal commensal.Methods: This is a hospital based prospective study comprising of 350 pregnant women at term gestation. Vaginal swabs as well as neonatal nasal swabs following delivery were collected under aseptic precautions and sent for culture and sensitivity.Results: Vaginal swab culture reports of 308 women out of 350 showed a growth. Candida albicans (23.8%), Enterococcus (5.6%), Escherichia coli (4.2%), MRSA (4.2%), Staphylococcus aureus (1.4%) and Group B Streptococcus (1.4%) were the organisms isolated. Penicillin is still the drug of choice for group B Streptococcal infection in antenatal women with Linezolid being the alternate drug of choice. None of the neonatal nasal swabs revealed any growth on culture and sensitivity.Conclusions: This study does not recommend routine screening for Group B Streptococcus in all pregnant women unless they have a positive history in previous pregnancies. Our study also revealed various other organisms which could be responsible for increasing the risk of maternal and neonatal morbidity.


2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Ayesha Bahez ◽  
Mohammed Imad Al-Deen Mustafa Mahmud ◽  
Hairul Aini Hamzah ◽  
Hanan Hamimi Wahid

INTRODUCTION: Group B streptococcus (GBS) is a leading cause of maternally-acquired invasive infections in neonates. Nowadays maternal immunization is of utmost demand for prevention of these infections. We undertook capsular serotyping and virulence factor genes identification for local GBS isolates as a pilot study, to identify potential candidates to propagate vaccine development. MATERIALS AND METHODS: This is a descriptive lab -based study to determine GBS serotypes and presence of genes coding virulence factors bca and rib in isolates obtained from symptomatic pregnant women in Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia. Sixty-two GBS isolates from high vaginal swabs were collected. Latex agglutination test was performed to determine GBS serotypes. Real-time PCR was done to determine the presence of virulence genes. RESULTS: Of the 62 GBS isolates, 77.4% were serologically typeable, and 22.6% were non -typeable. Serotypes Ia and Ib (16.1% each) were the most common capsular types, followed by II, V, and VII (9.7% each), III (8.1%), VI (6.5%), and VIII (1.6 %). Furthermore, 67.7% of the isolates harboured the rib gene while 98.4% possessed the bca gene. CONCLUSION: The five known prevalent serotypes worldwide, do not match the CPS distribution in symptomatic pregnant women in Kuantan. However, the frequency of virulence genes rib and bca is high among our isolates, which if confirmed by further bigger and wider studies makes the proteinaceous vaccine, N-terminal domains of Rib and AlpC a suitable candidate for GBS prevention in this geographical area.


Author(s):  
Moyurakhi Gogoi ◽  
Manuj K Das ◽  
Jayanta Kumar Das ◽  
Nabanita Barman ◽  
Pankaj Das ◽  
...  

Introduction: Maternal genitalia colonising bacteria i.e., Group B Streptococcus (GBS) well known as Streptococcus agalactiaeis responsible for serious health complications in newborns like sepsis, meningitis and pneumonitis. Centre for Disease Control and Prevention (CDC) recommends a thorough culture based screening in 35-37 weeks gestation mothers for further therapeutic steps. Previously no study was carried out on the occurrence of GBS among pregnant mothers in Assam with phylogenetic analysis. Aim: To bring the scenario of GBS infection in antepartum women by targeting the capsular serotypes with their antibiogram profile and to bring the phylogenetic relationship of the prevailing GBS isolates found in Dibrugarh district, Assam, India. Materials and Methods: This was a hospital based observational study which was carried out in District Urban Health Centre, Assam, India. Lower vaginal swabs without using speculum were collected from the enrolled late trimester pregnant women. Socio-demographic data were collected with their consent. Out of the total enrolled participants (n=345), GBS was isolated in 52 samples. These were inspected by culture techniques and further confirmed using molecular methods. Serotyping was carried out by employing multiplex PCR. Antibiotic susceptibility test was conducted as per Clinical and Laboratory Standards Institute (CLSI) guidelines and phylogenetic tree was reconstructed. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 16.0. Results: This study showed a GBS carriage rate of 15.1% in the colonising participating women. No significant association with any of the demographic and clinical factors was found. Serotype Ia (42.1%) was the ruling one followed by VI (31.6%), II (15.8%) and VII (10.5%). While 36.7% of the GBS isolates were grouped into not typeable. Serotypes Ia showed resistant towards cefotaxime, erythromycin and clindamycin and serotype II towards vancomycin. Phylogenetic evaluation showed the presence of four distinct clusters viz., I, II, III and IV with unique evolutionary trends in human GBS population in the study site. Conclusion: So far in Assam, this study reports for the first time on GBS prevailing rate in late trimester mothers which may be helpful in declining the rate of adverse neonatal outcomes with on time maternal therapeutic administration by real time monitoring of antibiogram profiling. This study also paves a way of designing Capsular Polysaccharide (CPS) based vaccines for immunising the expectant mothers to prevent adverse outcomes of the newborns.


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