Feasibility of Oral Prenatal Probiotics against Maternal Group B Streptococcus Vaginal and Rectal Colonization

Hanson, Lisa; VandeVusse, Leona; Duster, Megan; Warrack, Simone; Safdar, Nasia

doi:10.1111/1552-6909.12308

Cited by 41 publications

(48 citation statements)

References 28 publications

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“…62 Additionally, the prenatal probiotic supplementation to reduce GBS colonization has been recommended as a safe strategy, but there are not enough clinical trials to support this practice. 63,64 For example, Hanson et al 63 observed that pregnant women that were administered with oral probiotic (from the 28th week of pregnancy) had lower GBS vaginal load at 36 weeks.…”

Section: Discussionmentioning

confidence: 99%

Immunomodulation of Lactobacillus reuteri CRL1324 on Group B Streptococcus Vaginal Colonization in a Murine Experimental Model

Gregorio

Tomás

Nader‐Macías

2015

American J Rep Immunol

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Section: Discussionmentioning

confidence: 99%

Immunomodulation of Lactobacillus reuteri CRL1324 on Group B Streptococcus Vaginal Colonization in a Murine Experimental Model

Gregorio

Tomás

Nader‐Macías

2015

American J Rep Immunol

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“…Several clinical studies have observed an inverse correlation between levels of Lactobacillus species and GBS in the human vaginal tract (15,16). Even so, preliminary human studies with Lactobacillus probiotic treatments (16,17), as well as murine models (5), have failed to show significant reduction of GBS vaginal colonization. While this paper was being reviewed, a recent study was published that showed reduction of GBS vaginal load in mice, but only if Lactobacillus was given prior to GBS colonization (18).…”

Section: Discussionmentioning

confidence: 99%

Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization

Patras

Wescombe²,

Rösler

et al. 2015

Infect Immun

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c Streptococcus agalactiae (group B streptococcus [GBS]) colonizes the rectovaginal tract in 20% to 30% of women and during pregnancy can be transmitted to the newborn, causing severe invasive disease. Current routine screening and antibiotic prophylaxis have fallen short of complete prevention of GBS transmission, and GBS remains a leading cause of neonatal infection. We have investigated the ability of Streptococcus salivarius, a predominant member of the native human oral microbiota, to control GBS colonization. Comparison of the antibacterial activities of multiple S. salivarius strains by use of a deferred-antagonism test showed that S. salivarius strain K12 exhibited the broadest spectrum of activity against GBS. K12 effectively inhibited all GBS strains tested, including disease-implicated isolates from newborns and colonizing isolates from the vaginal tract of pregnant women. Inhibition was dependent on the presence of megaplasmid pSsal-K12, which encodes the bacteriocins salivaricin A and salivaricin B; however, in coculture experiments, GBS growth was impeded by K12 independently of the megaplasmid. We also demonstrated that K12 adheres to and invades human vaginal epithelial cells at levels comparable to GBS. Inhibitory activity of K12 was examined in vivo using a mouse model of GBS vaginal colonization. Mice colonized with GBS were treated vaginally with K12. K12 administration significantly reduced GBS vaginal colonization in comparison to nontreated controls, and this effect was partially dependent on the K12 megaplasmid. Our results suggest that K12 may have potential as a preventative therapy to control GBS vaginal colonization and thereby prevent its transmission to the neonate during pregnancy. S treptococcus agalactiae (group B streptococcus [GBS]) is aGram-positive organism that is currently the leading infectious agent responsible for neonatal morbidity and mortality in the United States (1). The primary risk factor for newborn disease is maternal GBS colonization within the gastrointestinal or vaginal tract (1). GBS colonization of the vaginal tract during pregnancy may be constant, intermittent, or transient in nature among individual women (2). In lieu of an effective vaccine, the current recommendations from the Centers for Disease Control and Prevention include late-gestational screening and intrapartum antibiotic prophylaxis (IAP) for GBS-positive mothers, which has resulted in reduced early-onset GBS disease and infant colonization (1). However, IAP with ampicillin for GBS-positive mothers has been determined an independent risk factor for ampicillin-resistant Escherichia coli early-onset sepsis (3) and has recently been shown to reduce beneficial Bifidobacterium spp. in week-old newborn intestinal flora (4). There are likely to be other unrecognized negative effects of antibiotic exposure on long-term gut health, which prompts development of alternative prophylactic strategies. Several studies have proposed the use of probiotic strains to control GBS and have observed inhibitory acti...

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“…Erste Studien, z. B. durch Verabreichung von Probiotika an die Schwangeren, die mütterliche Darmflora zu beeinflussen, befinden sich auf dem Weg [67]. Eine Impfung der Frauen gegen GBS, die für Schwangere und Neugeborene zweifelsohne die beste Lösung darstellen würde, befindet sich nach wie vor im Stadium der Entwicklung [68,69].…”

Section: Fazit Ausblickunclassified

Prophylaxe der Neugeborenensepsis – frühe Form – durch Streptokokken der Gruppe B. Leitlinie des BVF, BVDfK, der DGGG, DGHM, DGPI, DGPM und GNPI. (S2k-Level, AWMF-Registernummer 024/020, März 2016)

Franz¹,

Härtel²,

Herting³

et al. 2017

Z Geburtshilfe Neonatol

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Feasibility of Oral Prenatal Probiotics against Maternal Group B Streptococcus Vaginal and Rectal Colonization

Abstract: Prenatal probiotic therapy has the potential to reduce GBS colonization. The potential of the probiotic intervention appears to be linked to daily adherence. A controlled clinical trial with a larger, adequately powered sample is feasible and justified.

Cited by 41 publications

References 28 publications

Immunomodulation of Lactobacillus reuteri CRL1324 on Group B Streptococcus Vaginal Colonization in a Murine Experimental Model

Immunomodulation of Lactobacillus reuteri CRL1324 on Group B Streptococcus Vaginal Colonization in a Murine Experimental Model

Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization

Prophylaxe der Neugeborenensepsis – frühe Form – durch Streptokokken der Gruppe B. Leitlinie des BVF, BVDfK, der DGGG, DGHM, DGPI, DGPM und GNPI. (S2k-Level, AWMF-Registernummer 024/020, März 2016)

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