A prospective study of group B streptococcal bacteriuria in pregnancy

Wood, Ellen G.; Dillon, Hugh C.

doi:10.1016/0002-9378(81)90226-x

Cited by 116 publications

(53 citation statements)

References 26 publications

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“…Proteus mirabilis was also isolated more frequently in males at this institution, and similar findings have been reported by others (45,46). Streptococcus agalactiae (group B streptococci), an uncommon cause of urinary tract infection, may account for 5% of infections in pregnant females (99 however, there is an increased incidence of infection with this organism in association with urinary tract obstruction, neoplasm, and manipulation (18). Prior to antimicrobial therapy, Staphylococcus aureus was the leading cause of hematogenous infection of the kidney and perinephric abscesses.…”

Section: :1supporting

confidence: 89%

Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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A review of rapid urine screens for detection of bacteriuria and pyuria demonstrates a number of available alternatives to the culture method. Selection of one or more of these systems for routine use is dependent upon the laboratory and the patient population being tested. The laboratory approach to the diagnosis of urinary tract infection should consider the clinical diagnosis of the patient whenever possible. Keeping in mind that quantitative urine cultures alone cannot be used to detect infection in some patient populations unless lower colony counts are considered, a rapid screen may be a more practical approach. It has become accepted that 10(5) CFU/ml can no longer be used as the standard for all patient groups, that pyuria often is important in making the diagnosis of a urinary tract infection, and that most of the rapid screens are more sensitive than the culture method at 10(5) CFU/ml. Presently, no one approach can be recommended for all laboratories and all patient groups. However, each diagnostic laboratory should select one approach which is best for its situation. It is not practical, efficient, or cost effective to define a protocol for each possible clinical condition; however, all should be considered when developing a protocol. This protocol should be compatible with the patient population and communicated to the physicians. Use of a rapid screen should be beneficial to the patient, the physician, and the laboratory.

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Section: :1supporting

confidence: 89%

Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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“…While the overall prevalence of GBS UTI in the adult population remains unclear, GBS bacteriuria during pregnancy occurs at rates of between 1 and 3.5% (4,23,41). Many of these episodes represent ABU (2, 18); however, GBS ABU is considered to be a surrogate for heavy maternal colonization (29,42) and is currently recommended for intrapartum antibiotic chemoprophylaxis (23,34). In addition, up to 7% of pregnancies may be complicated by GBS UTI, and GBS reportedly accounts for approximately 10% of all cases of pyelonephritis during pregnancy (25,28).…”

mentioning

confidence: 99%

“…In addition, up to 7% of pregnancies may be complicated by GBS UTI, and GBS reportedly accounts for approximately 10% of all cases of pyelonephritis during pregnancy (25,28). GBS UTI may also contribute to chorioamnionitis (1), premature onset of labor (24), and an increased risk of vertical transmission of GBS (29,42).…”

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confidence: 99%

Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults

Ulett¹,

Benjamin

Zhuo

et al. 2009

J Clin Microbiol

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Serotypes of group B streptococcus (GBS) that cause urinary tract infection (UTI) are poorly characterized.We conducted a prospective study of GBS UTI in adults to define the clinical and microbiological characteristics of these infections, including which serotypes cause disease. Patients who had GBS cultured from urine over a 1-year period were grouped according to symptoms, bacteriuria, and urinalysis. Demographic data were obtained by reviewing medical records. Isolates were serotyped by latex agglutination and multiplex PCRreverse line blotting (mPCR/RLB). Antibiotic susceptibilities were determined by disc diffusion. GBS was cultured from 387/34,367 consecutive urine samples (1.1%): 62 patients had bacteriuria of >10 7 CFU/liter and at least one UTI symptom; of these patients, 31 had urinary leukocyte esterase and pyuria (others not tested), 50 (81%) had symptoms consistent with cystitis, and 12 (19%) had symptoms of pyelonephritis. Compared with controls (who had GBS isolated without symptoms), a prior history of UTI was an independent risk factor for disease. Increased age was also significantly associated with acute infection. Serotyping results were consistent between latex agglutination and mPCR/RLB for 331/387 (85.5%) isolates; 22 (5.7%) and 7 (1.8%) isolates were nontypeable with antisera and by mPCR/RLB, respectively; and 45/56 (80.4%) isolates with discrepant results were typed by mPCR/RLB as belonging to serotype V. Serotypes V, Ia, and III caused the most UTIs; serotypes II, Ib, and IV were less common. Nontypeable GBS was not associated with UTI. Erythromycin (39.5%) and clindamycin (26.4%) resistance was common. We conclude that a more diverse spectrum of GBS serotypes causes UTI than previously recognized, with the exception of nontypeable GBS.Group B streptococcus (GBS) is a leading cause of infection in newborns, pregnant women, and older persons with chronic medical illness (3,8). In addition to maternal cervicovaginal colonization and neonatal infection that results from the vertical transmission of bacteria from mothers to their infants, GBS can also cause urinary tract infection (UTI). The spectrum of GBS UTI includes asymptomatic bacteriuria (ABU), cystitis, pyelonephritis, urethritis, and urosepsis (6,8,10,20,23,26). GBS ABU is particularly common among pregnant women, although those most at risk for cystitis due to GBS appear to be the elderly and immunocompromised individuals (8,9,25). Despite the uropathogenic nature of GBS, the clinical and microbiological features of GBS UTI, including risk factors for disease and whether there is a tendency for particular GBS serotypes to cause UTI, are poorly understood.Clinically, UTI due to GBS may be indistinguishable from UTI caused by other uropathogens (25). However, a recent study of multiple uropathogens and host characteristics highlighted unique frequencies of host characteristics in UTI groups defined by the causal organism (37). This suggests that the clinical and microbiological features of UTI may differ depending on the infecting...

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“…GBS is isolated from the vaginal tracts of women from all ethnic backgrounds and all stages of life (52,58,61). As an opportunistic pathogen, it rarely causes disease in healthy individuals unless host defense barriers are breached or the individual becomes immunocompromised.…”

Section: Discussionmentioning

confidence: 99%

Serine-Rich Repeat Proteins and Pili Promote Streptococcus agalactiae Colonization of the Vaginal Tract

et al. 2011

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Streptococcus agalactiae (group B streptococcus [GBS]) is a Gram-positive bacterium found in the female rectovaginal tract and is capable of producing severe disease in susceptible hosts, including newborns and pregnant women. The vaginal tract is considered a major reservoir for GBS, and maternal vaginal colonization poses a significant risk to the newborn; however, little is known about the specific bacterial factors that promote GBS colonization and persistence in the female reproductive tract. We have developed in vitro models of GBS interaction with the human female cervicovaginal tract using human vaginal and cervical epithelial cell lines. Analysis of isogenic mutant GBS strains deficient in cell surface organelles such as pili and serine-rich repeat (Srr) proteins shows that these factors contribute to host cell attachment. As Srr proteins are heavily glycosylated, we confirmed that carbohydrate moieties contribute to the effective interaction of Srr-1 with vaginal epithelial cells. Antibody inhibition assays identified keratin 4 as a possible host receptor for Srr-1. Our findings were further substantiated in an in vivo mouse model of GBS vaginal colonization, where mice inoculated with an Srr-1-deficient mutant exhibited decreased GBS vaginal persistence compared to those inoculated with the wild-type (WT) parental strain. Furthermore, competition experiments in mice showed that WT GBS exhibited a significant survival advantage over the ⌬pilA or ⌬srr-1 mutant in the vaginal tract. Our results suggest that these GBS surface proteins contribute to vaginal colonization and may offer new insights into the mechanisms of vaginal niche establishment.Group B streptococcus (GBS) is the leading cause of neonatal meningitis and sepsis in the developed world and also causes serious invasive infections in certain adult populations (54). GBS can be isolated from the rectovaginal tracts of up to 30% of women (16,38), and it can be transmitted to infants during birth through the aspiration of vaginal fluids or cross the placental barrier in utero (7,18). GBS neonatal infection is divided into two categories, early-onset (Ͻ7 days old) and late-onset (7 to 90 days old) disease. Due to the serious nature of GBS infection, pregnant women in the United States are routinely screened for GBS vaginal colonization late in the third trimester of pregnancy; a positive test results in the administration of antibiotics during birth to reduce the risk of GBS transfer to the newborn. Despite this intervention, the incidence of early-onset GBS infection in the United States remains at 1 in 3,000 live births, corresponding to approximately 1,200 infected infants per year (54). There is also evidence that infection rates are much higher among some ethnic groups and in infants delivered at Ͻ37 weeks of gestation (42,43,54,62). Additionally, antibiotic prophylaxis does not prevent late-onset disease.Most women are intermittently asymptomatically colonized by GBS in the genitourinary tract (19); however, colonization poses a significant r...

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A prospective study of group B streptococcal bacteriuria in pregnancy

Cited by 116 publications

References 26 publications

Detection of urinary tract infections by rapid methods

Detection of urinary tract infections by rapid methods

Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults

Serine-Rich Repeat Proteins and Pili Promote Streptococcus agalactiae Colonization of the Vaginal Tract

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