Screening Strategies for Group B Streptococcus in the Third Trimester of Pregnancy

Abstract Background: For pregnant women who develop complications during the third trimester of pregnancy, or who have not given birth naturally after more than 41 weeks of pregnancy, artificial induction of labor is needed in order to obtain a healthy outcome for both the mother and the child. The 2014 edition of the Guidelines for Promoting Cervical Maturation and Delivery in Late Pregnancy point out that the use of COOK cervical ripening balloons to mechanically dilate the cervix can be used in the third trimester to promote cervical ripening and labor induction [1]. The disadvantage is the risk of infection, premature rupture of membranes, and umbilical cord prolapse [2]. The safety of balloon induction for pregnant women colonized by group B streptococcus (GBS) is currently lacking in multi-center clinical research data. This article will study the safety of COOK double balloon induction in pregnant women colonized by GBS.Methods: A total of 1,681 pregnant women who used COOK double balloons for cervical ripening in Changsha Maternity and Child Health Hospital from September 2018 to September 2020 were selected as the research subjects, from which 125 cases with colonization of group B streptococcus in the reproductive tract were selected as the observation group. Pregnant women without group B streptococcus colonization (N = 1556) served as the control group. This study compares the two groups’ delivery methods, postpartum complications, and neonatal conditions. Results: The rate of transition to cesarean section in the observation group was slightly higher, and the difference was statistically significant (p = 0.049). The rate of postpartum hemorrhage was higher than that of the control group (p < 0.05). Although chorioamnionitis increased compared to the control group, the difference was not significant (p > 0.05). The comparison of newborn birth indicators between the two groups showed no statistically significant difference (p > 0.05). Conclusion: When pregnant women with colonization of group B streptococcus of the genital tract use the COOK double balloon to promote cervical ripening, the success rate of labor induction is high. Use of the balloon does not increase the cesarean section rate and the incidence of chorioamnionitis, nor does it increase the risk of neonatal infection. However, the risk of postpartum hemorrhage increases, and it is necessary to take active measures to reduce this risk.

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Antenatal group B streptococcus detection in pregnant women: culture or PCR?

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10367 ◽

2018 ◽

Vol 12 (08) ◽

pp. 631-635 ◽

Cited By ~ 2

Author(s):

Gerasimos Gerolymatos ◽

Paraskevi Karlovasiti ◽

Argiri Sianou ◽

Emmanuel Logothetis ◽

George Kaparos ◽

...

Keyword(s):

Pregnant Women ◽

Antimicrobial Prophylaxis ◽

Screening Method ◽

Group B Streptococcus ◽

Culture Method ◽

First Trimester ◽

Colonization Rate ◽

Third Trimester ◽

The Third ◽

Group B

Introduction: Group B streptococcus (GBS) is an important cause of neonatal infections. Maternal GBS colonization screening and intrapartum antimicrobial prophylaxis of colonized women can prevent neonatal diseases. The aim of this study was to assess the prevalence of GBS colonization in pregnant and non-pregnant women and to compare the performance of a polymerase chain reaction (PCR) assay with the established as gold standard technique, culture method, used for the detection of this microorganism. Methodology: Vaginal and rectal samples collected from 857 pregnant and 370 non-pregnant women were examined through cultures, while the samples collected from 452 pregnant women between 35 and 37 weeks of gestation were assayed by culture and PCR method targeting the cfb gene. Results: GBS colonization was present in both pregnant and non-pregnant women. The colonization rate was similar in non-pregnant and first trimester pregnant women and then increased from first to the third trimester of pregnancy. GBS cultures for vaginal and rectal samples were positive in 13.2% and 14.3% in non-pregnant women, while in pregnant women 13.2% and 13.7% in the first trimester, and 15.0% and 16.5% in the second trimester, respectively. In third trimester pregnant women, compared to culture method, PCR identified a significantly increased number of GBS positive vaginal (18.4% vs 22.6%, p = 0.0006) and rectal (18.1% vs 21.2%, p = 0.01) samples. Conclusions: GBS colonization rate was higher in the third trimester. PCR proved to be a rapid and useful GBS screening method allowing a shorter detection time, while identifying more colonized women than culture.

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Knowledge, attitude and current practices of pregnant women towards group B streptococcus screening: cross-sectional study, Al-Madinah, Saudi Arabia

BMJ Open ◽

10.1136/bmjopen-2019-032487 ◽

2020 ◽

Vol 10 (2) ◽

pp. e032487

Author(s):

Amer Alshengeti ◽

Amjad Alharbi ◽

Shahad Alraddadi ◽

Abdulsalam Alawfi ◽

Bushra Aljohani

Keyword(s):

Saudi Arabia ◽

Pregnant Women ◽

Group B Streptococcus ◽

Knowledge Score ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Screening Strategies ◽

Group B ◽

Universal Culture

AimsGroup B streptococcus (GBS) is one of the most frequent bacterial pathogens causing invasive infections in neonates. It can be transmitted from colonised mother to neonates around delivery. Screening strategies for GBS during pregnancy include either universal culture-based or risk-based screening. The present study aimed to assess the knowledge, attitude and current practices of pregnant women towards GBS screening in Al-Madinah City, Saudi Arabia.MethodsA hospital-based cross-sectional study was conducted at Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia, from May to July 2018. Participants were recruited from postnatal wards. Participants were interviewed using a previously published validated survey that was divided into the following domains: demographic data, knowledge, experience and attitude towards different GBS screening strategies.ResultsA total of 377 out of 450 women (response rate 83.7%) were enrolled. The results showed that the overall mean knowledge score of the pregnant women towards GBS screening was 59.8%. Majority of the women (66.8%) were not aware of the GBS bacterium, while 86.5% of them had never been informed of GBS risk assessment during their pregnancies. The mean knowledge score among women who were aware of GBS (62.8%) was significantly higher than that among women who were not (58.4%) (p=0.015). However, majority of the pregnant women (61.8%) showed preference for universal culture-based GBS screening strategy over risk-based strategy.ConclusionThe study results have concluded that the level of awareness and knowledge about GBS among pregnant women were relatively poor; however, majority of the pregnant women prefer universal culture-based screening.

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Intrauterine Coxsackie Virus, Group B Type 1, Infection: Viral Cultivation from Amniotic Fluid in the Third Trimester

American Journal of Perinatology ◽

10.1055/s-2007-994407 ◽

1995 ◽

Vol 12 (02) ◽

pp. 78-79 ◽

Cited By ~ 14

Author(s):

Beatrice Strong ◽

Stephen Young

Keyword(s):

Amniotic Fluid ◽

Coxsackie Virus ◽

Third Trimester ◽

The Third ◽

Virus Group ◽

Group B

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Oral probiotics to reduce vaginal group B streptococcal colonization in late pregnancy

Scientific Reports ◽

10.1038/s41598-020-76896-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Alex Farr ◽

Valentina Sustr ◽

Herbert Kiss ◽

Ingo Rosicky ◽

Alexandra Graf ◽

...

Keyword(s):

Placebo Group ◽

Preterm Birth ◽

Primary Endpoint ◽

Rectal Swab ◽

Late Pregnancy ◽

Third Trimester ◽

The Third ◽

Group B ◽

Study Inclusion

AbstractThis study aimed to evaluate the potential of oral probiotics to eradicate vaginal GBS colonization during the third trimester of pregnancy. We screened 1058 women for GBS colonization at 33–37 gestational weeks using a combination of vaginal-to-rectal swab and culture-based methods. Women who tested GBS positive were randomized to either the verum group, receiving a dietary probiotic supplement of four viable strains of Lactobacillus twice-daily for 14 days, or to the placebo group. Women underwent follow-up smears, whereat GBS colonization upon follow-up was considered the primary endpoint. We found that 215 women (20.3%) were positive for GBS upon screening, of which 82 (38.1%) were eligible for study inclusion; 41 (50%) of these were randomized to the verum and placebo groups each. After treatment, 21/33 (63.6%) members of the verum group, and 21/27 (77.8%) of the placebo group were still GBS positive (p = 0.24). Four (9.8%) women in the verum group and one (2.4%) in the placebo group experienced preterm birth (p = 0.20); smokers showed significantly higher rates of preterm birth (p = 0.03). Hence, the findings did not support the hypothesis that oral probiotics can eradicate GBS during pregnancy, although we observed a trend toward reduced GBS persistence after probiotic intake.

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Comparison of Various Culture Methods for Isolation of Group B Streptococcus from Intrapartum Vaginal Colonization

Journal of Laboratory Physicians ◽

10.4103/0974-2727.115938 ◽

2013 ◽

Vol 5 (01) ◽

pp. 42-45 ◽

Cited By ~ 2

Author(s):

Kavitha P Konikkara ◽

Shrikala Baliga ◽

Suchitra M Shenoy ◽

B Bharati

Keyword(s):

Pregnant Women ◽

Group B Streptococcus ◽

Culture Method ◽

Sheep Blood Agar ◽

Blood Agar ◽

Third Trimester ◽

Sheep Blood ◽

Vaginal Colonization ◽

Vaginal Swabs ◽

Group B

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.

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Distinctive Features of Surface-Anchored Proteins of Streptococcus agalactiae Strains from Zimbabwe Revealed by PCR and Dot Blotting

Clinical and Vaccine Immunology ◽

10.1128/cvi.00112-08 ◽

2008 ◽

Vol 15 (9) ◽

pp. 1420-1424 ◽

Cited By ~ 9

Author(s):

Rooyen T. Mavenyengwa ◽

Johan A. Maeland ◽

Sylvester R. Moyo

Keyword(s):

Potential Role ◽

Capsular Polysaccharide ◽

Group B Streptococcus ◽

Potential Importance ◽

Protein Markers ◽

Distinctive Features ◽

The Third ◽

Group B ◽

Type V ◽

Dot Blotting

ABSTRACTThe distribution of capsular polysaccharide (CPS) types and subtypes (serovariants) among 121 group B streptococcus (GBS) strains from Zimbabwe was examined. PCR was used for the detection of both CPS types and the surface-anchored and strain-variable proteins Cα, Cβ, Alp1, Alp2, Alp3, R4/Rib, and Alp4. The R3 protein was detected by an antibody-based method using monoclonal anti-R3 antibody in dot blotting. The CPS types detected, Ia (15.7% of strains), Ib (11.6%), II (8.3%), III (38.8%), V (24.0%), and nontypeable (1.7%), were essentially as expected on the basis of data from Western countries. The type V strains showed distinctive features with respect to protein markers in that Alp3 was detected in only 6.9% of the isolates while R3 occurred in 75.9% and R4/Rib occurred in 37.9% of the isolates. R3 occurred nearly always in combination with one of the alpha-like (Alp) proteins, and it was the third most common of the proteins studied. These results show that type V GBS strains from Zimbabwe differed from type V strains from other geographical areas and also emphasize the importance of the R3 protein in GBS serotyping and its potential importance in the immunobiology of GBS, including a potential role in a future GBS vaccine.

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