Risk‐based approach versus culture‐based screening for identification of group B streptococci among women in labor

Khalil, Mohammed Rohi; Uldbjerg, Niels; Thorsen, Poul; Frimodt‐Møller, Niels

doi:10.1002/ijgo.12721

Cited by 11 publications

(12 citation statements)

References 27 publications

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“… Streptococcus agalactiae or group B streptococcus (GBS) is a leading cause of invasive neonatal infections [1]. The bacterium colonizes the gastrointestinal and genital tracts of humans [2, 3] and up to 44 % of women carry GBS in the vagina during pregnancy [4–8]. Most commonly, GBS infections of newborns occur because of an ascending infection in pregnancy or the newborn becomes colonized during passage through the birth canal [2].…”

Section: Introductionmentioning

confidence: 99%

Group B streptococcal infections in infants in Iceland: clinical and microbiological factors

Baeringsdottir

Erlendsdóttir

Björnsdóttir

et al. 2021

Journal of Medical Microbiology

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Introduction. Group B streptococcus (GBS) is a leading cause of invasive neonatal infections. These have been divided into early-onset disease (EOD; <7 days) and late-onset disease (LOD; 7–89 days), with different GBS clonal complexes (CCs) associated with different disease presentations. Hypothesis. Different GBS CCs are associated with timing of infection (EOD or LOD) and clinical presentation (sepsis, meningitis or pneumonia). Aim. To study infant GBS infections in Iceland from 1975 to 2019. Are specific GBS CCs related to disease presentation? Is CC17 overrepresented in infant GBS infections in Iceland? Methodology. All culture-confirmed invasive GBS infections in infants (<90 days) in Iceland from 1975 to 2019 were included. Clinical information was gathered from medical records. Results. A total of 127 invasive GBS infections in infants were diagnosed, but 105 infants were included in the study. Of these, 56 had EOD and 49 had LOD. The incidence of GBS infections declined from 2000 onwards but increased again at the end of the study period. Furthermore, there was a significant increase in LOD over the study period (P=0.0001). The most common presenting symptoms were respiratory difficulties and fever and the most common presentation was sepsis alone. Approximately one-third of the cases were caused by GBS CC17 of serotype III with surface protein RIB and pili PI-1+PI-2b or PI-2b. CC17 was significantly associated with LOD (P<0.001). Conclusion. CC17 is a major cause of GBS infection in infants in Iceland. This clone is associated with LOD, which has been increasing in incidence. Because intrapartum antibiotic prophylaxis only prevents EOD, it is important to continue the development of a GBS vaccine in order to prevent LOD infections.

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Section: Introductionmentioning

confidence: 99%

Group B streptococcal infections in infants in Iceland: clinical and microbiological factors

Baeringsdottir

Erlendsdóttir

Björnsdóttir

et al. 2021

Journal of Medical Microbiology

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“…In the screening-based approach, all pregnant women are offered microbiological screening at 35-37 weeks of gestation and culture-positive women are treated. This approach has been found to be more effective at identifying intrapartum GBS colonization than the risk-based approach but necessitates the treatment of more women and is also a more expensive option [14].…”

Section: Introductionmentioning

confidence: 99%

Group B Streptococcus Colonization in Pregnancy: Prevalence, Determinants and Antibacterial Susceptibility Pattern in Sagamu, Nigeria

Akadri¹,

Osuolale²,

Shorunmu³

et al. 2019

JAMMR

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Aims:To establish the prevalence, determinants and the antibiotic susceptibility pattern of Group B streptococcus in pregnant women in Sagamu, Ogun State, Nigeria. Study Design: Prospective cross-sectional study Place and Duration of Study: The study was carried out at the antenatal clinic at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria, between July 2017 and December 2017. Methodology: The study involved 184 pregnant women attending antenatal clinic. Lower vaginal and rectal swabs were collected under aseptic condition and immediately sent to the laboratory for processing. The samples were assayed for the presence of group B streptococcus using Akadri et al.; JAMMR, 29(10): 1-8, 2019; Article no.JAMMR.49367 2 conventional methods. Information on the socio demographic characteristics and details of delivery were recorded on a data capture sheet. Results: The prevalence of Group B streptococcus was 27.7%. The odds of Group B streptococcus colonization was significantly higher among women of low parity (≤ 2) and binary logistic regression analysis showed that parity was predictive of Group B streptococcus colonization (OR 3.7; 95% CI = 1.03-13.46; P=.045). Younger women (age ≤ 30 years) and women carrying term pregnancies had a non significant trend towards higher odds of Group B streptococcus colonization [(OR= 1.22, 95% CI: 0.6-2.3, P = .54) and (OR=1.6, CI: 0.8-3.2; P = .15) respectively]. The resistance of group B streptococcus isolates to penicillin and ampicillin was 39.2% and 37.3% respectively. Conclusion: The group B streptococcus colonization rate in this study is high. Factors such as low parity, young maternal age and term pregnancies are associated with increased odds of colonization. The emergence of resistance to the commonly prescribed antibiotics calls for reevaluation of the current recommendations regarding the antibiotics prophylaxis. Original Research Article

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“…Carriage studies [ 6 , 9 ] based on rectovaginal swabs from women with risk factors for EOGBS during delivery, showed a carriage rate of 29 %. This is similar to other Danish as well as international studies [ 19 , 20 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that carriage rates with GBS in pregnant women can vary from 10 to 35 % cultured at gestational week 35-37, although this can only be considered as a qualified guess for the rate at birth since GBS colonization may be transient and vary during pregnancy. [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The serotype distribution of Streptococcus agalactiae (GBS) carriage isolates among pregnant women having risk factors for early-onset GBS disease: a comparative study with GBS causing invasive infections during the same period in Denmark

et al. 2021

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Background We describe the serotype distribution of Streptococcus agalactiae (GBS) carriage isolates from women in labor and among GBS isolates causing invasive infections during the same period to see if the distribution of carriage serotypes reflects the GBS serotypes causing invasive diseases including early-onset disease (EOGBS). Methods Data on invasive isolates from 2019 including serotype, erythromycin and clindamycin susceptibility was retrieved from the Danish national reference laboratory, Statens Serum Institut. Carriage isolates were collected from women with risk factors for EOGBS enrolled at delivery at the maternity ward at a Danish University Hospital, first half of 2019. Results Among carriage isolates, the dominant serotype was IX (21 %) followed by serotype III (19 %). The resistance to erythromycin and clindamycin was 21 and 26 %, respectively. Among invasive GBS isolates, no case of EOGBS with serotype IX was detected but the distribution of serotypes were otherwise similar to the GBS carrier strains. The corresponding resistance to erythromycin and clindamycin was 23 and 15 %, respectively. Penicillin resistance was not detected among carriage nor invasive isolates. Conclusions The distribution of serotypes among carriage and invasive GBS reflects the assumption that EOGBS occur following transmission of GBS from mother to newborn, with the exception of serotype IX.

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Risk‐based approach versus culture‐based screening for identification of group B streptococci among women in labor

Cited by 11 publications

References 27 publications

Group B streptococcal infections in infants in Iceland: clinical and microbiological factors

Group B streptococcal infections in infants in Iceland: clinical and microbiological factors

Group B Streptococcus Colonization in Pregnancy: Prevalence, Determinants and Antibacterial Susceptibility Pattern in Sagamu, Nigeria

The serotype distribution of Streptococcus agalactiae (GBS) carriage isolates among pregnant women having risk factors for early-onset GBS disease: a comparative study with GBS causing invasive infections during the same period in Denmark

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