Group B streptococcal colonization in a developing country: its association with sexually transmitted disease and socioeconomic factors.

Abstract

Abstract. Group B Streptococcus (GBS) is an important infectious organism in pregnant women and their neonates. Although excellent data are available from the developing world, little epidemiologic information is available from Latin America. To evaluate the prevalence of GBS colonization in a developing country, a prospective study was performed in Lima, Peru. We found a relatively low prevalence of GBS colonization of 6.0% in parturient women and 10.6% in nonpregnant women. No association of GBS colonization was made with previously identified risk factors such as age, parity, or birth control practices. We did find a positive association between GBS colonization and chlamydial carriage (P Ͻ 0.05). We also report an even distribution of GBS serotypes: Ia/c ϭ 35%, IIc ϭ 18%, III ϭ 29%, and V ϭ 18%. Our study provides evidence for a low prevalence of GBS maternal carriage in this urban Latin American population.Group B Streptococcus (GBS) is a cause of significant morbidity and mortality in certain populations of pregnant women and their neonates throughout the world. The attack rate for neonatal invasive disease, both early and late onset, is between 1.7 and 3.3 per 1,000 live births in the United States 1,2 and 0.2-0.6 per 1,000 live births in Europe, 3 Canada, 4 and Israel. 5 Case-fatality rates for the early-onset disease in the United States that range from 5% to 20% illustrate the seriousness of the infection. 6 A recent large multicenter study, the Vaginal Infections and Prematurity Study, detailed the association between heavy group B Streptococcal colonization and the delivery of a preterm, low-birth weight infant. 7 The infants born to the heavily colonized women were also at substantially increased risk of neonatal sepsis. Although excellent data are available from the developed world, there is little information on GBS invasive disease in the developing world. To our knowledge, only three maternal carriage studies have been performed in Latin America. [8][9][10] As the treatment of GBS by both chemoprophylaxis and vaccine becomes more refined, more GBS data is critical for effective public health planning. We performed a prospective study in Lima, Peru to evaluate the prevalence of GBS colonization in a developing country and its association with sexually transmitted disease. PATIENTS, MATERIALS, AND METHODSStudy design. This prospective study took place in Lima, Peru from August through October 1991. A parturient group of 151 women was chosen sequentially at La Maternidad de Lima, a large inner-city maternity hospital. Nonpregnant women were sampled sequentially in two clinical settings: 1) 60 women presenting to the family planning clinic at Loayza Hospital for a routine annual examination and birth control; and 2) 63 prostitutes presenting for their monthly clinic visit. Although the latter group was chosen for its high-risk sexual practices, these women are examined monthly, screened, and treated for sexually transmitted disease.Informed consent was obtained from all participants and human ethica...

Prevalence of and Factors Associated with Reproductive Tract Infections among Pregnant Women in Ten Communes in Nghe An Province, Vietnam

“…16 With regard to the group B streptococcal infection, a study from Peru reported a prevalence of 6%; and another study in the United States reported an even higher 18.6%. 17,18 Although the prevalence of the two infections in Nghe An Province was relatively low when compared with the ones reported in the aforementioned studies, these two are known as strong risk factors for preterm delivery and neonatal infection. 19,20 The reviews by the Cochrane Collaboration and the WHO recommend that high-risk women with a history of preterm delivery be screened for bacterial vaginosis.…”

Prevalência da colonização pelo estreptococo do grupo B em gestantes atendidas em ambulatório de pré-natal

“…Não houve, conforme os resultados obtidos, em concordância com a maioria das pesquisas, como correlacionar DST e colonização pelo EGB 10,21 . No sentido inverso, estão os achados de maior prevalência em mulheres com freqüência maior de relações sexuais por semana e mais de um parceiro sexual, inclusive com resultados estatisticamente significativos quando estas duas variá-veis foram comparadas em relação ao restante da amostra, como já foi citado anteriormente, indicando a promiscuidade como um fator importante na colonização.…”

Group B Streptococcus detection in pregnant women via culture and PCR methods

“…In previous studies, the prevalence indexes for GBS in Brazil (14.6% to 32.6%) [13][14][15][16][17] were similar to those in countries that have adopted universal laboratory screening and maternal intrapartum antibiotic prophylaxis (10% to 30%); however, these values could potentially vary greatly by geographic location, sociodemographic and clinical characteristics, and the detection technique employed.…”

“…This colonization is a dynamic condition and represents the main risk factor for early neonatal infection. Notably, the international literature reports maternal GBS colonization rates of 6.5-36.0% in Europe 6,7 , 10.0-30.0% in North America 2,8 , 16.5-31.6% in African countries 9 , and 1.4-36.7% in South America, including Brazil [10][11][12][13] , Chile 14 , Peru 15 , and Argentina 16 .…”