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

Bekele, Habtamu; Debella, Adera; Getachew, Tamirat; Balis, Bikila; Tamiru, Dawit; Eyeberu, Addis; Tiruye, Getahun; Kure, Mohammed Abdurke; Habte, Sisay; Eshetu, Bajrond; Regassa, Lemma Demissie; Mesfin, Sinetibeb; Alemu, Adisu; Dessie, Yadeta; Shiferaw, Kasiye

doi:10.3389/fpubh.2022.851434

Cited by 4 publications

(4 citation statements)

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“…In our study, the prevalence of GBS among pregnant women was 11.9%. This finding is comparable with studies conducted in Ethiopia [ 13 – 17 ], Brazil [ 18 ], Japan [ 19 ], and Germany [ 20 ]; but it is lower than studies done in Tanzania [ 21 ] and Zimbabwe [ 22 ]. However, it is higher than studies done in Cameroon [ 23 ], Mozambique [ 24 ], and China [ 25 ].…”

Section: Resultssupporting

confidence: 83%

“…The proportion of vertical transmission of GBS from pregnant mother to newborn in our study was 45.8%, which is within the range of global reports of 40–70% [ 27 ]. However, it is higher than studies conducted in Ethiopia [ 17 , 28 ] and Bangladesh [ 29 ]. These variations might be due to variations in geographic location, methodological variation, and service availability.…”

Section: Resultsmentioning

confidence: 67%

“…However, it is higher than studies done in Cameroon [ 23 ], Mozambique [ 24 ], and China [ 25 ]. The difference in prevalence may be due to geographical differences, sample size, and methodological variations [ 17 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Clindamycin resistance is comparable with reports from Tanzania [ 21 ], Brazil [ 35 ], and Kuwait [ 36 ]. The widespread use of these antibiotics to prevent early onset GBS disease has raised concern about the development of antibiotic resistance among GBS isolates [ 17 , 37 ]. The drug resistance level underlines the need of carrying out antimicrobial susceptibility testing before prescription of antibiotics.…”

Section: Resultsmentioning

confidence: 99%

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Vertical Transmission, Risk Factors, and Antimicrobial Resistance Patterns of Group B Streptococcus among Mothers and Their Neonates in Southern Ethiopia

Dadi

Sime

Seid

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Group B Streptococcus (GBS) contributes to maternal and neonatal morbidity and mortality by increasing intrauterine infection or vertical transmission at the time of birth. Despite many efforts to reduce the potential risk of vertical transmission, GBS remains the main cause of serious disease (neonatal sepsis, meningitis, and/or pneumonia) in vulnerable newborns during the first week of life. This study aimed to assess vertical transmission, risk factors, and antimicrobial resistance patterns of GBS among pregnant women and their neonates. Methods. A facility-based cross-sectional study was conducted among mothers and their neonates from February to May 2021. A total of 201 pregnant women with their neonates participated in this study. A well-designed questionnaire was used to collect sociodemographic and clinical data. A vaginal swab from mother before delivery and neonatal nasal and ear canal swab samples were taken as soon as after delivery within 30 minutes. Vaginal swabs, neonatal ear canal, and nasal swabs were placed into Todd–Hewitt broth and incubated at 37°C for 18–24 hours at 35–37°C in 5% CO2 conditions and then subcultured on 5% sheep blood agar for 18–48 hours. Presumptive identification of GBS was made by morphology, Gram stain, catalase, and hemolytic activity on sheep blood agar plates. CAMP and bacitracin susceptibility tests were used as confirmatory tests for GBS. Data were analyzed using SPSS version 21. P value ≤0.05 was considered statistically significant. Results. Vertical transmission rates of GBS (mother to neonates) were 11.9%. The prevalence of GBS among pregnant women and newborns was 24/201 (11.9%) (95% CI = 7.5–16.9) and 11/201 (5.5%) (95% CI = 2.5–9.0), respectively. The history of prolonged rupture of membranes (AOR = 3.5, CI = 2.2–18.8) and urinary tract infection (AOR = 2.9, CI = 1.7–16.3) were associated factors for maternal GBS colonization. Gestational age of <37 weeks ( p = 0.008 ), low birth weight of <2.5 kg ( p = 0.001 ), and maternal history of vaginal discharge ( p = 0.048 ) were associated factors for neonatal GBS colonization. Low antibiotic resistance was observed for erythromycin 8.6%, clindamycin 5.7%, and chloramphenicol 2.9%. Conclusion. In this study, high vertical transmission (mother to neonates) rate was observed. The prevalence of vaginal GBS colonization of women at delivery was 11.9% and significantly associated with the history of prolonged rupture of membranes and urinary tract infections. Gestational age of <37 weeks, low birth weight of <2.5 kg, and maternal history of vaginal discharge were associated with neonatal GBS colonization. Hence, there is a need for antenatal culture-based GBS screening, risk factor-based interventions, and regular follow-up of drug resistance patterns for proper treatment and management of GBS.

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