Group B Streptococci Vaginal-Recto Colonization, Vertical Transmission to Newborns, Antimicrobial Susceptibility Profile and Associated Factors in Selected Health Facilities of Bahir Dar City: A Cross-Sectional Study

Abstract

Background Group B streptococci (GBS) is an important pathogen involved in stillbirths, neonatal deaths and neurological defects, and the occurrence of multi-drug resistance (MDR) is an alarming issue. This study determined the prevalence of GBS colonization in pregnant women and newborns, the proportion of vertical transmission, antimicrobial susceptibility profiles of isolates, and the factors associated with colonization and vertical transmission. Methods A cross-sectional study was conducted from March 1, 2021 to June 30, 2021, at selected health facilities of Bahir Dar city. Vaginal-recto swabs from 292 pregnant women and pooled ear, nasal and umbilical swabs from 292 newborns were collected. GBS were identified following standard microbiological protocols. Antimicrobial susceptibility testing was performed using modified Kirby–Bauer disk diffusion method and interpreted by the accepted 2020 CLSI M100 guidelines. Logistic regression analysis was computed. Results Overall, 54 (18.5%) of pregnant women and 22 (7.5%) of newborns had GBS colonization. The proportion of GBS vertical transmission was 22 (40.7%). Group B Streptococcus isolates scored susceptibility to penicillin, ampicillin and vancomycin with 88.9%, 90.7%, and 96.3% for pregnant women and 86.4%, 90.9% and 95.9% for newborns, respectively. A high percentage of non-susceptibility was found for clindamycin and erythromycin with 33.3% and 25.9% for pregnant women and 31.8% and 22.7% from newborns, respectively. Besides, 19 (35.2%) GBS from pregnant women and 8 (36.4%) from newborns were MDR. Group B streptococci colonization was significantly associated with delivery before 37th week of gestation (AOR=2.77, 95% CI 1.14–6.68) and history of stillbirth (AOR=3.13, 95% CI 1.13–8.70). Conclusion Pregnant women vaginal-recto GBS colonization and transmission to newborns connected with MDR are a matter of concerns. Although non-susceptible GBS isolates are obtained, penicillin and vancomycin are relatively effective. The use of clindamycin, erythromycin and ceftriaxone should be guided by antimicrobial susceptibility testing. Genetic analysis is recommended to exactly identify the epidemiology of GBS strains, vertical transmission and antimicrobial resistance at the country level.

Isolation, Antibiotic Susceptibility Profile, and Associated Factors of Group B Streptococcus among Pregnant Women Attending Selected Health Institutions, Hawassa, Ethiopia, 2022

“…In this study, the antibiotic susceptibility pro les of GBS isolates were shown 100% sensitivity to Vancomycin. This is similar to the reports from Yemeni 100% (AL-Subol et al, 2021), Arbaminch 100% (Shiferawu et al, 2019), and Bahir Dar city 96.3% (Leykun et al, 2021). In evidence, to recent studies including the present study Vancomycin is the most potent antibiotic for GBS.…”

“…On the other hand, the prevalence of maternal GBS in this study was less than the study ndings in the Guatemalan, Republic of Central America (17.3%) (Rick et al, 2017), Kenya (20.5%) (Jisuvei et al, 2020), Southern African countries (23.8%) (Gizachew et al, 2019b), Western Cape Region of South Africa (16.6%) (Africa and Kaambo, 2018), Gondar, Ethiopia (25.5%) (Gizachew et al, 2019a), Southwest, Ethiopia (16.3%) (Girma et al, 2020), and Bahir Dar city health facilities (18.5%) (Leykun et al, 2021). However, the variations of maternal GBS colonization in different studies might be due to study populations from different parts of the world, specimen collection site (vigino-rectal swab were more colonized than vaginal swab), sample size, gestational weeks (when gestational weeks increase the colonization rate may also increased), socio-economic status, and geographical areas.…”

A Retrospective National Study on Colonization Rate and Antimicrobial Susceptibility of Streptococcus agalactiae in Pregnant Korean Women, 2018–2020

“…13 Therefore, inducible clindamycin resistance detection should be performed in women with high beta-lactam antibiotic anaphylaxis risk. The multidrug-resistant GBS ratio of 32.2% obtained in this study was higher than the 18.9% reported by Safari, et al 26 and lower than the 35.2% reported by Leykun, et al 25 Most of the clindamycin-resistant GBS strains were also resistant to erythromycin and tetracycline. Accordingly, documentation on the detection of clindamycin resistance, including inducible resistance, should be included in the Korean guidelines for the prevention of perinatal GBS infection.…”

“…Although GBS isolates with reduced penicillin susceptibility have been reported in Korea, Japan, and the United States 23 24 and penicillin non-susceptible GBS isolates have been reported in Ethiopia (11.1%), 25 intravenous penicillin remains the agent of choice for intrapartum antibiotic prophylaxis, with intravenous ampicillin as an acceptable alternative. First-generation cephalosporins (i.e., cefazolin) are recommended for women whose reported penicillin allergy poses a low anaphylaxis risk or is of uncertain severity.…”

Prevalence of Group B Streptococcus Recto-Vaginal Colonization, Vertical Transmission, and Antibiotic Susceptibility Among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

“…The review included studies from regions in Ethiopia, though the majority of the studies were from Addis Ababa and Oromia. Eighteen cross-sectional and one case-control studies (i.e., reported magnitude and total at-risk population) were included in the meta-analysis ( 23 – 25 , 36 , 37 , 39 , 40 , 42 – 51 , 54 , 55 ). The sample size of the included studies ranged from 126 to 1,688.…”