scholarly journals Poor Adherence to the Screening-Based Strategy of Group B Streptococcus Despite Colonization of Pregnant Women in Greece

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.

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


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.


2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Anne-Marie Rick ◽  
Angie Aguilar ◽  
Rosita Cortes ◽  
Remei Gordillo ◽  
Mario Melgar ◽  
...  

Abstract Background Infection causes 1 of every 5 neonatal deaths globally. Group B Streptococcus (GBS) is the most significant pathogen, although little is known about its epidemiology and risk in low-income countries. Methods A cross-sectional study in 2015 at a public hospital in Guatemala City enrolled women ≥35 weeks’ gestation. Vaginal and rectal swabs were processed using Lim broth and GBS CHROMagar then agglutination testing. Risk factors were assessed using multivariate analysis. Vaginal microbiota were profiled by 16S ribosomal ribonucleic acid sequencing in a subset of 94 women. Results Of 896 pregnant women, 155 (17.3%; 95% confidence interval [CI], 14.9–19.9) were GBS colonized. Colonization was associated with history of previous infant with poor outcome (odds ratio [OR], 1.94; 95% CI, 1.15–3.27) and increasing maternal age (OR, 1.05; 95% CI, 1.02–1.09). Multiparity was protective (OR, .39; 95% CI, .21–.72). Four (6%) GBS-exposed infants had early-onset neonatal sepsis. Vaginal microbiome composition was associated with previous antibiotic exposure (P = .003) and previous low birth weight infant (P = .03), but not GBS colonization (P = .72). Several individual taxa differed in abundance between colonized and noncolonized women. Conclusions Group B Streptococcus is prevalent in pregnant women from Guatemala with different risk factors than previously described. Although the vaginal microbiome was not altered significantly in GBS-colonized women, use of antibiotics had an effect on its composition.


Author(s):  
Mohammad Qadi ◽  
Adham AbuTaha ◽  
Ro’ya Al-Shehab ◽  
Salsabil Sulaiman ◽  
Abdallah Hamayel ◽  
...  

Background. Maternal Streptococcus agalactiae (Group B Streptococcus (GBS)) colonization is an important cause of complications in mothers and neonates during gestation and after delivery. The data regarding GBS colonization among pregnant women in Palestine is scarce. The aim of this study is to determine the prevalence of GBS colonization, its associated risk factors, and the antibiotic sensitivity patterns in Nablus, West Bank, Palestine. Methods. A cross-sectional, single center study conducted at Rafidia Governmental Hospital in Nablus, West Bank, Palestine. Samples were collected between November 2019 and January 2020. Vaginal swabs from 200 pregnant women (≥35 weeks of gestation) attending the labor and delivery department were plated directly on CHROMagarTM StrepB (CHROM agar, France) and placed in an incubator at 35–37°C. After 24 and 48 hours, the plates were checked for growth and classified into three categories: growth of GBS with mauve colonies on chromogenic media, no growth, or other growth. The identification of the mauve colonies was confirmed by the CAMP test. Identified GBS isolates were tested for susceptibility to vancomycin, ampicillin, clindamycin, cefotaxime, erythromycin, and levofloxacin using the disc diffusion method. Clinical and demographic information were collected using a questionnaire. Result. The overall prevalence of GBS colonization was 12%. The median age of the study population was 27 years. GBS colonization was significantly associated with age ( p = 0.013 ), history of previous preterm delivery ( p = 0.013 ), and parity ( p = 0.015 ). No association was noted with smoking, previous abortion, previous history of fetal demise, vaginitis, or urinary tract infection. Resistance to ampicillin, vancomycin, cefotaxime, erythromycin, clindamycin, and levofloxacin was found to be 91.7%, 54.2%, 45.8%, 29.2%, 25%, and 8.3%, respectively. Conclusion. The prevalence of vaginal GBS in this study was 12% from Nablus, West Bank. Further research is needed to determine the GBS serotypes common in West Bank and the burden they cause on the health system. Moreover, this study also highlights the need to establish a screening program suited to a developing country with low control on the antibiotic’s prescription protocols.


Author(s):  
Soodabeh Rostami ◽  
Leila Moeineddini ◽  
Fereshteh Ghandehari ◽  
Marzieh Rahim Khorasani ◽  
Parisa Shoaei ◽  
...  

Background and Objectives: Group B streptococcus (GBS) can cause severe and invasive infections in pregnant women, infants, and adults. This study aimed to investigate the risk factors of GBS colonization in pregnant women and determine the macrolide resistance and capsular type of isolates. Materials and Methods: In a cross-sectional study, a total of 200 pregnant women were screened for GBS colonization by phenotypic methods. Antibiotic susceptibility pattern of colonizing isolates and ermB, ermTR, mefA/E genes were detected. Also, molecular capsular types of isolates were distinguished. Results: The overall prevalence of colonization of participates with GBS was 13.5%. Statistical analysis showed that there was no association between risk factors and colonization with GBS. The highest resistance was observed to erythromycin (44.4%) followed by clindamycin (29.6%), penicillin, ampicillin, and ceftriaxone (18.5%), levofloxacin (11.1%), and 29.6% isolates were multidrug-resistant. ermTR and mefA/E genes were detected in 37% and 11.1% isolates; respectively and the ermB gene was not detected. The most common capsular type was type Ib (44.4%) followed by type III (40.7%), type II (11.1), and type Ia (3.7%). Conclusion: In the present study, the prevalence of GBS was in the medium range. Resistance to key antibiotic agents was relatively high. Also, capsular serotype Ib was the predominant serotype, which emphasizes the importance of monitoring the molecular typing of the GBS isolates regularly.


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.


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

2020 ◽  
Author(s):  
Leila Goudarzi ◽  
Mohammad Bagher Khalili ◽  
Mahmood Vakili ◽  
Maryam Sadeh

Consequence of Streptococcus agalactiae, Group B Streptococcus (GBS) relating infant’s diseases are well documented. Although many women carry this bacterium in their vagina, they may transfer to their infant during delivery and may result in different neonatal invasive diseases. The aim of this study was to determine the prevalence of GBS and serotyping the isolated species among un-selective non-pregnant women who attended two gynecology clinics in Tehran. In this cross-sectional study, a total of 560 vaginal samples collected from non-pregnant women. Following inoculation of the specimen on Blood Agar, the standard technology was applied for the final identification of GBS. Detected GBS species were further confirmed using specific PCR directed on dlts gene. Capsular serotyping was done by using the multiplex PCR method. The chi-square method was used for statistical analysis. Fifty (8.9%) out of 560 non-pregnant women were carriers of GBS. The most common types were III (36%), followed by type II (32%), Ia (26%), and Ib (6%), respectively. Results represent that the prevalence rate of GBS in non-pregnant women was reliable and similar to what obtained from pregnant women. In addition, the serotype III was found the most dominant types, as well as other investigations in the Tehran area. Therefore, vaccine designation based on type III is recommended.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032487
Author(s):  
Amer Alshengeti ◽  
Amjad Alharbi ◽  
Shahad Alraddadi ◽  
Abdulsalam Alawfi ◽  
Bushra Aljohani

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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