scholarly journals Prevalence, Risk Factors, and Serotype Distribution of Group B Streptococcus Colonization in HIV-Infected Pregnant Women Living in Belgium: A Prospective Cohort Study

2018 ◽  
Vol 5 (12) ◽  
Author(s):  
Nicolas Dauby ◽  
Catherine Adler ◽  
Veronique Y Miendje Deyi ◽  
Rosalie Sacheli ◽  
Laurent Busson ◽  
...  

Abstract Background Group B streptococcus (GBS) infection is a leading cause of severe neonatal infection. Maternal GBS carriage during pregnancy is the main risk factor for both early-onset and late-onset GBS disease. High incidence of GBS infection has been reported in HIV-exposed but -uninfected infants (HEU). We aimed to determine the prevalence, characteristics, and risk factors for GBS colonization in HIV-infected and HIV-uninfected pregnant women living in Belgium. Methods Between January 1, 2011, and December 31, 2013, HIV-infected (n = 125) and -uninfected (n = 120) pregnant women had recto-vaginal swabs at 35–37 weeks of gestation and at delivery for GBS detection. Demographic, obstetrical, and HIV infection–related data were prospectively collected. GBS capsular serotyping was performed on a limited number of samples (33 from HIV-infected and 16 from HIV-uninfected pregnant women). Results There was no significant difference in the GBS colonization rate between HIV-infected and -uninfected pregnant women (29.6% vs 24.2%, respectively). HIV-infected women were more frequently colonized by serotype III (36.4% vs 12.5%), and the majority of serotype III strains belonged to the hypervirulent clone ST-17. Exclusively trivalent vaccine serotypes (Ia, Ib, and III) were found in 57.6% and 75% of HIV-infected and -uninfected women, respectively, whereas the hexavalent vaccine serotypes (Ia, Ib, II, III, IV, and V) were found in 97% and 100%, respectively. Conclusions HIV-infected and -uninfected pregnant women living in Belgium have a similar GBS colonization rate. A trend to a higher colonization rate with serotype III was found in HIV-infected women, and those serotype III strains belong predominantly to the hypervirulent clone ST17.

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 418
Author(s):  
Maria Maroudia Berikopoulou ◽  
Aikaterini Pana ◽  
Theodota Liakopoulou-Tsitsipi ◽  
Nikos F. Vlahos ◽  
Vasiliki Papaevangelou ◽  
...  

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.


2016 ◽  
Vol 10 (03) ◽  
pp. 222-226 ◽  
Author(s):  
Feyza Alp ◽  
Duygu Findik ◽  
Hatice Turk Dagi ◽  
Ugur Arslan ◽  
Aybike Tazegul Pekin ◽  
...  

Introduction: The purpose of this study was to investigate group B streptococcus (GBS) colonization, to compare the methods, to determine the relationship between GBS carriage and risk factors, and to genotype the GBS isolates. Methodology: Recto-vaginal swab specimens were obtained from 500 women, and a questionnaire was administered to each to assess their risk factors for GBS carriage. A culture, GBS antigen test, and polymerase chain reaction (PCR) were performed on all samples. Antibiotic susceptibility testing was performed, and the clonal relationship was determined by pulsed-field gel electrophoresis (PFGE) on all viable isolates. Results: Of the 500 women, sixty-eight (13.6%) women were GBS carriers, of whom 9.8% were pregnant and 16.5% not. There was a significant difference between GBS carriage and history of premature rupture of membrane (PROM). GBS was isolated from 65 (13%) samples. GBS was positive in 70 (14%) samples by antigen test and in 62 (12.4%) by PCR. Sixty-eight of the 70 positive antigen tests were confirmed by PCR or culture. Fifty-five isolates were resistant to tetracycline, 16 to erythromycin and clindamycin, and 13 to levofloxacin. Thirteen different pulsotypes and 17 sporadic strains were determined by PFGE. Conclusions: GBS carriage rate in non-pregnant women was higher than in pregnant women. The GBS antigen test was more sensitive than culture and PCR. GBS isolates did not originate from a single clone and contained sporadic strains. There was a significant difference between GBS carriage and history of PROM. Epidemiologic data obtained in this study will help future studies.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tina Perme ◽  
Daniel Golparian ◽  
Maja Bombek Ihan ◽  
Andrej Rojnik ◽  
Miha Lučovnik ◽  
...  

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.


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.


10.19082/4399 ◽  
2017 ◽  
Vol 9 (5) ◽  
pp. 4399-4404 ◽  
Author(s):  
Roksana Darabi ◽  
Sima Tadi ◽  
Mitra Mohit ◽  
Erfan Sadeghi ◽  
Gita Hatamizadeh ◽  
...  

2000 ◽  
Vol 46 (10) ◽  
pp. 1583-1587 ◽  
Author(s):  
Marcello Assumma ◽  
Fabrizio Signore ◽  
Lucia Pacifico ◽  
Naila Rossi ◽  
John F Osborn ◽  
...  

Abstract Background: The reported sensitivities and specificities of procalcitonin (PCT) concentrations for the diagnosis of neonatal infection vary widely. A postnatal increase of PCT has been observed in healthy term newborns with a peak at ≈24 h of age, and many questions remain regarding maternal and perinatal factors that may influence the normal PCT kinetics during the immediate postnatal period. Methods: We prospectively investigated the association between the serum PCT values obtained from 121 mothers at delivery and serum PCT in their healthy, term offspring at birth as well as at 24 and 48 h of age. We also analyzed whether obstetric and perinatal factors would alter maternal and neonatal PCT response. Results: PCT concentrations in the babies at birth were significantly higher than in the mothers (P &lt;0.0001), with even larger differences at 24 and 48 h of age. None of the variables identified from maternal and perinatal histories had a significant effect on maternal PCT response. In the healthy neonate, the variables that significantly affected the concentration of PCT at birth were the mothers’ PCT (P &lt;0.01), maternal group B streptococcus colonization (P &lt;0.05), and rupture of membranes ≥18 h (P &lt;0.01). The coefficient of linear correlation between the mother’s PCT concentration and that of the baby at birth was 0.32 (P &lt;0.01). The only variable that significantly altered the PCT concentration at both 24 (P &lt;0.01) and 48 (P &lt;0.01) h of age was rupture of membranes ≥18 h. Nonetheless, the PCT response observed during the 48-h period after birth among healthy babies born to mothers with risk factors for infection was well below that reported previously among age-matched neonates with sepsis. Conclusions: The postnatal increase of PCT observed in the healthy neonate with peak values at 24 h of age most likely represents endogenous synthesis. In estimating the sensitivities and specificities of PCT for diagnosis of sepsis throughout the initial 48 h of life, it is important to consider the normal PCT kinetics and the pattern(s) of PCT response in the healthy neonate.


Author(s):  
Kirsty Le Doare ◽  
Christine E. Jones ◽  
Paul T. Heath

Group B Streptococcus (GBS) is a leading cause of early neonatal infection and neonatal mortality, with long-term adverse neurodevelopmental outcomes in up to 50% of survivors of GBS meningitis. GBS has a likely underappreciated role in causing preterm birth and stillbirth. GBS colonizes the vagina and gastrointestinal tract of the pregnant woman, and transmission to the infant occurs during or just before delivery. Although the majority of these infants do not develop invasive disease, maternal colonization is a prerequisite for early onset disease (0–6 days of life, most commonly associated with sepsis and respiratory distress) and a significant risk factor for late onset disease (7–89 days of life, most commonly associated with sepsis and meningitis). The introduction of intrapartum antibiotic prophylaxis has resulted in significant declines in the incidence of early onset disease but provides no protection against late onset disease.


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