Relationship between vaginal group B streptococcus colonization in the early stage of pregnancy and preterm birth: a retrospective cohort study

Preterm delivery is one of the biggest contributors to neonatal death because the organ systems in premature babies are not yet fully developed. The cause of preterm labor is multifactorial, one of which is complex inflammation due to Group B Streptococcus (GBS) bacterial infection. Maternal serum procalcitonin is a prohormone involved in the inflammatory process, and specifically as a marker of bacterial infection. This study time to determine the relationship between vaginal GBS bacterial infection and high maternal serum procalcitonin levels in preterm labor. This study used a cross-sectional method. Samples were 31 pregnant women who came to the Obstetrics ER at Sanglah Hospital Denpasar with a diagnosis of preterm delivery that met the inclusion criteria. Vaginal mucus samples were examined at the Clinical Microbiology Laboratory of Sanglah Hospital and procalcitonin samples were examined at the Clinical Pathology Laboratory of Sanglah Hospital. Descriptive and analytical analysis was performed on the data obtained. There were 7 positive GBS results (22.5%) and 24 negative GBS results (77.5%). The results of high procalcitonin obtained 12 (38.7%) while the normal 19 (61.3%). In the Chi-Square test, the PR value was 3.4 (95% CI: 1.61-7.30) with p value = 0.004. Therefore, it can be concluded that there is a relationship between GBS infection and serum procalcitonin levels, where positive GBS infection is a risk factor that increases the occurrence of high serum procalcitonin levels in preterm labor.

Section: Discussionmentioning

confidence: 99%

Correlation Between B Group Streptococcus Infection in Vagina and Maternal Serum Procalcitonin Level with Preterm Delivery

Suwardewa

Sanjaya

Suardika

et al. 2022

EJMED

“…Vaginal colonization of GBS is associated with preterm births [4] and its detection is clinically relevant for decision-making regarding the administration of intrapartum antibiotics [7]. According to the American College of Obstetricians and Gynecologists, screening for GBS in the third trimester or near term is recommended in all women.…”

Section: Discussionmentioning

confidence: 99%

“…Every year, premature rupture of membranes (PROM), preterm births, chorioamnionitis, postpartum endometritis, urinary tract infections and post-caesarean febrile illness occur in 1 in 10 pregnancies due to GBS infection in mothers. In newborns and young infants, sepsis, meningitis and pneumonia are also commonly associated with maternal GBS infection [4–7]. Thus, prenatal detection of GBS in vaginal swabs is recommended because GBS-positive women are eligible candidates for prophylactic intrapartum antibiotics.…”

Section: Introductionmentioning

confidence: 99%

False-positive detection of Group B Streptococcus (GBS) in chromogenic media (Strep B Carrot Broth) due to presence of Enterococcus faecalis in High Vaginal swabs

Husein

Journal of Medical Microbiology

et al. 2022

Introduction. Vaginal colonization of Group B Streptococcus (GBS) is associated with preterm births and neonatal sepsis. Thus routine screening of GBS in prenatal care is recommended. Hypothesis. Chromogenic media (carrot broth) aids in specific and rapid detection of GBS. Aim. To investigate the efficiency of Strep B Carrot Broth for detection of GBS in high vaginal swabs from pregnant women. Methods. In this study 201 vaginal swab samples were collected from pregnant women. Swabs were inoculated in chromogenic media (Strep B Carrot Broth). The positive and negative cultures were inoculated on blood agar and crome agar plates. The colonies were subjected to 16S rRNA sequencing and gene-specific PCR for confirmation. The Christie Atkins Munch Peterson (CAMP) and bile esculin agar (BEA) tests were used for biochemical confirmation. PCR was performed on genomic DNA isolated from uncultured vaginal swabs. Results. It was found that 20/201 (9.9 %) vaginal swab samples were positive in the Strep B Carrot Broth and 17/20 (85 %) and 19/20 (95 %) of these samples yielded colonies on blood agar and crome agar, respectively. Of the 181 carrot broth-negative samples, 1 (0.5 %) and 38 (20.9 %) yielded colonies on blood agar and crome agar plates, respectively. However, 16 s rRNA sequencing revealed that none of the 20 carrot broth-positive cultures were GBS and had sequence similarities to Enterococcus faecalis . This was also confirmed by using gene-specific PCR and BEA positivity. Furthermore, E. faecalis was detected by PCR in DNA isolated from 57 uncultured vaginal swabs samples, GBS could only be detected by PCR in four samples. Conclusion. Carrot broth-based culture can lead to false-positive detection due to the presence of E. faecalis . Thus GBS-positive results in carrot broth must be confirmed by the other molecular and biochemical tests before making a final diagnosis.

“…Vaginal colonization of GBS is associated with preterm births (Tano et al, 2021, Surve et al, 2016 and its detection is clinically relevant for decision making towards the administration of intrapartum antibiotics (Edwards et al, 2019). According to the American College of Obstetricians and Gynaecologists, screening of GBS in the third trimester or near term is recommended in all women.…”

Section: Discussionmentioning

confidence: 99%

“…Every year, due to GBS infection 1 in 10 pregnancies, premature rupture of membranes (PROM), preterm births, chorioamnionitis, postpartum endometritis, urinary tract infections and post-caesarean febrile illness occurred in mother. In newborn and young infant's sepsis, meningitis, and pneumonia is also commonly associated with maternal GBS infection (Assefa et al, 2018, Edwards et al, 2019, Tano et al, 2021. Thus, prenatal detection of GBS in vaginal swabs is recommended because GBS-positive women are eligible candidates for prophylactic intrapartum antibiotic.…”

Section: Introductionmentioning

confidence: 99%

False-positive detection of Group B Streptococcus (GBS) in chromogenic media due to presence of Enterococcus faecalis in High Vaginal Swabs

Husein

et al. 2021

Preprint

Vaginal colonization of Group B Streptococcus (GBS) is associated with preterm births and neonatal sepsis. Thus, routine screening of GBS in prenatal care is recommended. Chromogenic media are useful in rapid and sensitive screening for GBS. herein, we evaluated the performance of Carrot broth for the detection of GBS in vaginal swabs of pregnant women. In all 20/201 (9.9%) vaginal swab samples were positive in the carrot broth. 17/20 (85%) and 19/20 (95%) samples yielded colonies on Blood agar and Crome agar respectively. However, 16s rRNA sequencing revealed that none of the carrot broth positive cultures had sequence similarities to the Enterococcus faecalis and not GBS. Furthermore, Enterococcus faecalis was detected by PCR in DNA isolated from the corresponding uncultured vaginal swabs samples, while GBS could be detected by PCR only in 4 samples. Thus carrot broth-based culture can lead to false-positive detection due to the presence of Enterococcus faecalis.