Group B streptococcal carriage, antimicrobial susceptibility, and virulence related genes among pregnant women in Alexandria, Egypt

Abstract

2018) Group B streptococcal carriage, antimicrobial susceptibility, and virulence related genes among pregnant women in Alexandria, a b s t r a c t Background and aim: Group B Streptococcus (GBS) has emerged as a leading cause of illness and death among neonates. The study was conducted to estimate the prevalence of recto-vaginal carriage of GBS among pregnant women at 35-37 weeks, gestation, to describe GBS antimicrobial susceptibility profile and to investigate selected virulence genes by PCR. Subjects and methods: Two-hundred pregnant women at 35-37 weeks of gestation attending antenatal clinic at Al-Shatby University Hospital were enrolled in the study. Both vaginal and rectal swabs were collected from each subject. Swabs were inoculated onto CHROMagar TM StrepB and sheep blood agar plates. All GBS isolates were subjected to antimicrobial susceptibility testing using disc diffusion. Disc approximation test was performed to detect erythromycin resistance phenotype (MLSB). GBS virulence genes scpB, bac, bca, and rib were identified by PCR. Results: Among the 200 pregnant women, 53 (26.5%) were identified as GBS carriers. All carriers had vaginal colonization (100%), four (7.5%) had combined recto-vaginal colonization. None of the carriers had rectal colonization alone. All isolates (100%) were susceptible to penicillin, ampicillin, ceftriaxone, cefotaxime, cefepime, vancomycin, and linezolid. On the other hand, 43.4%, 28.3%, 22.6%, and 15% of isolates were resistant to levofloxacin, azithromycin, erythromycin, and clindamycin respectively. Out of 12 erythromycin resistant isolates, six isolates had constitutive while two had inducible MLSB resistance. scpB was identified in 100%, rib in 79.2%, and bac in 35.8% of GBS isolates. None of the isolates possessed the bca gene. Conclusion: Introduction of GBS screening in Egyptian pregnant women is recommended. Penicillin or ampicillin is still the antibiotic of choice for intrapartum prophylaxis. Ó 2017 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Antimicrobial Resistance Profile and Associated Factors of Group B Streptococci Colonization among Pregnant Women Attending Antenatal Clinics in Jigjiga, Southeast Ethiopia

“…We reported better sensitivity of GBS for chloramphenicol and azithromycin at 96.6% and 89.2%, respectively. This result is concurring with other findings reported in Egypt [ 50 ] and similar studies in Ethiopia [ 52 , 53 ]. Vancomycin was also one of the commonly utilized drugs for patients who poorly responded for clindamycin and for the cases with a risk of high anaphylaxis.…”

“…Clindamycin and erythromycin could also be considered for patients who are allergic to penicillin once AST is performed [ 5 ]. Our finding is comparable with the studies conducted in Switzerland (8.2%) [ 49 ], Iran, Tehran (14.6%) [ 26 ], Egypt (22.6%) [ 50 ], Kenya (30.4%) [ 51 ], and Ethiopia (17.6–26.8%) [ 48 , 52 ].…”

<p>Diagnostic performance of direct latex agglutination, post-enrichment latex agglutination and culture methods in screening of group B streptococci in late pregnancy: a comparative study</p>

“…Resistance to erythromycin was 21.3% and to clindamycin 12.8%. This was similar to the results declared by Sadeka et al10 in Egypt, where all isolates (100%) were susceptible to penicillin, ampicillin, ceftriaxone, cefotaxime, cefepime, vancomycin, and linezolid while 22.6%, and 15% of isolated GBS were resistant to erythromycin and clindamycin, respectively. In Ethiopia, all isolated GBS were sensitive to penicillin, ampicillin, vancomycin, and gentamicin.…”

“…The maternal carriage rate of GBS was (23.5%) is in agreement with results obtained by two other studies in Egypt; in Alexandria the rate was found to be 26.5%10 and in Ismalia 25.3% 5. Also, the international prevalence rate of GBS carriage was found to be 24%, 20.7%, 18.4% in Kuwait, Lebanon, and Saudi Arabia, respectively 1,11.…”

“…This was in line with many reasonable studies 4,9. In contrast, other studies have found most GBS were isolated from pregnant females at the 37th week of gestation and whose age range was 20–30 years 10…”