Prevalence and antibiotic sensitivity of Group B Streptococcus (GBS) infection among antenatal women

Abstract

INTRODUCTIONGroup B Streptococcus infection in pregnant women is a fatal and life-threatening condition as it has a tendency to cause septicemia in neonates.1 It is alarming to know that GBS infection is linked with an increased risk of chorioamnionitis as well as neonatal septicemia. 2,3 GBS is a Gram positive bacteria also known as Streptococcus agalactiae. They are often found in the vagina, rectum, urinary bladder and intestines and isolated from body fluids like CSF, blood, urine and vaginal secretions. They tend to be asymptomatic but can potentially be lethal. 15-45% of all pregnant women are believed to be colonized with GBS and 20-40% of these are colonized during labour. In 1-2% of the pregnant women infected with GBS, the infection can be passed on to the fetus and this can prove to be fatal. Though rare, the neonate usually acquires GBS infection from the mother during labour. Most infants will present with illness shortly after birth and 90% have been found to show clinical signs and symptoms within 24 hours of life. 4,5 To deal with this situation, a routine screening for GBS may be offered to all pregnant women at term gestation. 6 The likelihood of subsequent pregnancies being affected is 38% in women with a history of GBS ABSTRACT Background: Group B Streptococcus (GBS) infection in pregnant women is a major concern as it causes septicemia in neonates which is fatal and potentially life threatening. Objectives of present study were to study the distribution of Group B streptococcus infection among pregnant women at term, to understand if penicillin is still effective as the drug of choice, to determine the alternate drug of choice in women with Group B streptococcus infection if resistant to penicillin and analyze the proportion of Group B Streptococcus infection as a vaginal commensal. Methods: This is a hospital based prospective study comprising of 350 pregnant women at term gestation. Vaginal swabs as well as neonatal nasal swabs following delivery were collected under aseptic precautions and sent for culture and sensitivity. Results: Vaginal swab culture reports of 308 women out of 350 showed a growth. Candida albicans (23.8%), Enterococcus (5.6%), Escherichia coli (4.2%), MRSA (4.2%), Staphylococcus aureus (1.4%) and Group B Streptococcus (1.4%) were the organisms isolated. Penicillin is still the drug of choice for group B Streptococcal infection in antenatal women with Linezolid being the alternate drug of choice. None of the neonatal nasal swabs revealed any growth on culture and sensitivity. Conclusions: This study does not recommend routine screening for Group B Streptococcus in all pregnant women unless they have a positive history in previous pregnancies. Our study also revealed various other organisms which could be responsible for increasing the risk of maternal and neonatal morbidity.