scholarly journals Prevalence, antimicrobial susceptibility patterns, serotypes and risk factors for group B streptococcus rectovaginal isolates among pregnant women at Kenyatta National Hospital, Kenya; A cross-sectional study

2020 ◽  
Author(s):  
Jisuvei Clayton Salano ◽  
Osoti Alfred ◽  
Maina Anne Njeri

Abstract Background Estimates of group B streptococcus ( GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS. Methods We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization. Results A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/58 (72.4%) isolates, ampicillin in 32/58 (55.2%) isolates, clindamycin in 14/46 (30.4%) isolates, and vancomycin in 14/58 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization. Conclusion The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.

2019 ◽  
Author(s):  
Jisuvei Clayton Salano ◽  
Osoti Alfred ◽  
Maina Anne Njeri

Abstract Background: Estimates of group B streptococcus (GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS. Methods: We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization. Results: A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/60 (72.4%) isolates, ampicillin in 32/60 (55.2%) isolates, clindamycin in 14/60 (30.4%) isolates, and vancomycin in 14 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization.Conclusion: The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.


2020 ◽  
Author(s):  
Jisuvei Clayton Salano ◽  
Osoti Alfred ◽  
Maina Anne Njeri

Abstract Background Estimates of group B streptococcus ( GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS. Methods We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization. Results A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/58 (72.4%) isolates, ampicillin in 32/58 (55.2%) isolates, clindamycin in 14/46 (30.4%) isolates, and vancomycin in 14/58 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization. Conclusion The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.


2010 ◽  
Vol 41 (4) ◽  
pp. 1047-1055 ◽  
Author(s):  
Didier Silveira Castellano-Filho ◽  
Vânia Lúcia da Silva ◽  
Thiago César Nascimento ◽  
Marcel de Toledo Vieira ◽  
Cláudio Galuppo Diniz

Author(s):  
Leonard Sama ◽  
michel Noubom ◽  
Christelle KENNE ◽  
Thibau Tchouangueu ◽  
omer Ngouateu ◽  
...  

Background: Group B streptococcus (GBS), also name as Streptococcus agalactiae, is a gram-positive bacterium know for it capacity to colonises the vaginal and rectal areas of the mother and is a leading cause of neonatal mortality and morbidity. This study aimed at determining the prevalence, associated risk factors and antimicrobial susceptibility of GBS colonization among pregnant women attending antenatal care at Dschang District Hospital. Methods: This hospital-base cross-sectional study targeted pregnant women population attending hospitals for routine prenatal testing using a multistage sampling method. Pregnant women at 23.46 ± 6.44 weeks gestation completed a questionnaire and vaginal swabs were obtained for GBS analysis. Data were analysed using chi-squared (χ2) test or the Fisher’s exact test when appropriate and the multivariable logistic regression models. Results: The colonisation rate of GBS among pregnant women was 8.69%. Induce abortion (odds ratio [CI] = 3.09, 95% [1.56-6.21]), Spontaneaous abortions (OR= 2.82, 95% CI 1.14-7.29), Stillborn (OR [CI] = 7.75, 95% [2.61-21.71]), Fever (OR [CI] = 0.37, 95% [0.19-0.71]) and anemia (OR [CI] = 0.22, 95% [0.12-0.43]) were found to be influencing factors associated with GBS colonisation. Conclusion: Our findings suggest that none of the studied factors were significantly associated with GBS colonisation. Further longitudinal research is needed to establish the causal relationship and its biological mechanisms. Keys words: Group B Streptococcus, Prevalence, Risk Factors, Antimicrobial Susceptibility, Pregnant Women


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.


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

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Woubishet Girma ◽  
Nadia Yimer ◽  
Tesfaye Kassa ◽  
Elias Yesuf

BACKGROUND: Group B Streptococcus (GBS) is recognized as an important cause of maternal and neonatal morbidity and mortality. Maternal vaginal carriage of GBS (Streptococcus agalactiae) can lead to vertical transmission to the neonate at the time of delivery. However, little is known about its prevalence, predictors and antibiotic susceptibility pattern in Jimma, Ethiopia. This study assessed the prevalence, antimicrobial susceptibility pattern and determinants of GBS recto-vaginal colonization among near-term pregnant women.METHODS: A cross-sectional study was conducted from May to August 2015 at Jimma University Medical Centre in Southwest Ethiopia. Data through questionnaire and GBS isolates from vaginal and rectal swabs were collected. Antimicrobial susceptibility testing was performed.RESULTS: The overall prevalence of GBS colonization among near term pregnant women (35-37 weeks) was 16.3% (22/135). The majority of GBS isolates were sensitive to Ampicillin and Penicillin G with 95.5% and 90.1%, respectively. Erythromycin and clindamycin were resisted by 50% and 40.9% of the isolates, respectively, whereas gentamicin was resisted by all isolates. GBS colonization was significantly associated with a history of preterm delivery (PTD) (AOR: 6.3, 95% CI: 1.42, 28.3) and history of urinary tract infection (UTI) during current pregnancy (AOR: 6.4, 95% CI, 1.95, 21.1).CONCLUSION: Our study indicated that one among six near-term pregnant women had recto-vaginal GBS colonization. In places where universal screening is not feasible, selective screening for factors particularly history of PTD and UTI during current pregnancy may be a reasonable option. Antibiotic susceptibility testing should be performed while using Erythromycin, Clindamycin or Gentamicin. 


Author(s):  
E. S. Khater ◽  
A. S. Abdel-Motaal

Background: Group B streptococcus is one of the most common causes of severe neonatal infections. Aim: To detect the prevalence of group B. Streptococcus and their antimicrobial susceptibility and to assess the role of PCR as a rapid method of its detection. Place and Duration of the Study: A cross sectional and prospective cohort study was carried out from September 2019 to February 2020 in Gynaecology and Obstetrics OPD and inpatient units in Al- Quwayiyah General hospital, Riyadh, Saudi Arabia Methodology: Paired rectal/vaginal specimens were collected from 540 pregnant females with gestational age 35 or more, Each swab was inoculated into selective medium, Todd Hewitt, One swab is streaked onto blood agar plates incubated in 5% CO2 for 24h at 36ºC. β-hemolytic colonies growth is identified by Gram’s stain, colony morphology and CAMP test. The confirmation and antimicrobial susceptibility were done by Vitek II machine, The second swab was used for PCR to identify atr gene. Results: Out of 540 pregnant women 87 (16.1%) were colonized with GBS isolates. The positive GBS women aged 25 (22-34) and negative GBS women aged 23 (24-35) with no statistical difference. Patients aged more than 35 years old has the higher rate of positive GBS, 46.2%. No significant association detected between GBS and gestational age at delivery, antenatal visits, BMI and gravidity. The GBS strains isolated from pregnant women was 100% susceptible to linezolid and vancomycin followed by ampicillin (93.1%) and tobramicin (83.9%) then gentamicin (81.6%) and levofloxacin(78.2%) and showed least antibiotic susceptibility to erythromycin (26.4%). The PCR was positive in 145 (26.9%). Using culture as gold method, PCR sensitivity was 100% (95% CI: 91.62-100), while specificity was 83.2% (95% CI: 82.61-91.02). Negative and positive predictive values were 100% and 61% respectively. Kappa between the two methods was 0.71, which indicate major agreement. Conclusion: The GBS prevalence among the pregnant females in Al Quwayiyah General Hospital was 16.1%. Detection of GBS using new PCR technique was found to have high sensitivity and faster results, allowing efficient management of GBS and reduction in newborn morbidity and mortality however the cost is high for some laboratories. Further studies should be assessed to be both low cost and accurate rapid screening.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Glynis Oree ◽  
Meleshni Naicker ◽  
Hopolang Clifford Maise ◽  
Partson Tinarwo ◽  
Nathlee Samantha Abbai

Background. Neisseria gonorrhoeae, a sexually transmitted infection, is associated with adverse pregnancy and neonatal outcomes. Emerging resistance towards various antibiotics has been observed globally. However, there is a lack of data on antimicrobial susceptibility patterns in N. gonorrhoeae isolated from pregnant women in our setting. This study fills in this gap in the literature. Methods. The study population included pregnant women, recruited from the antenatal clinic of the King Edward VIII hospital (KEH) in Durban. Endocervical swabs were obtained from 307 women. The swab was placed in Amies Charcoal media for culture assessments. Pure isolates of N. gonorrhoeae were subjected to antimicrobial susceptibility testing using the Etest™ method. The MIC values were assessed in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2019) breakpoints. Results. The prevalence of N. gonorrhoeae by culture was 1.9%. High MIC values to penicillin G (12-64 mg/L) indicating a resistant phenotype were observed for all isolates tested, with 50% of the isolates displaying complete resistance. Isolates with intermediate (1 mg/L) and resistance (1.9-32 mg/L) profiles to tetracycline were observed. Resistance to ciprofloxacin (1.16-3 mg/L) was also observed. Isolates displayed either dual or triple resistance to penicillin G, tetracycline, or ciprofloxacin. All isolates showed susceptibility to spectinomycin (>64 mg/L), azithromycin (1 mg/L), ceftriaxone (>0.125 mg/L), and cefixime (>0.125 mg/L). Conclusion. Despite lack of resistance to ceftriaxone and azithromycin, continuous surveillance for emerging patterns of resistance to these antibiotics is needed since they form part of the treatment guidelines.


Sign in / Sign up

Export Citation Format

Share Document