Risk Factors Associated with Group B Streptococcus Colonization and Their Effect on Pregnancy Outcome

Lekala, Lucia Matsiane; Mavenyengwa, Rooyen T.; Moyo, Sylvester R.; Lebelo, Sogolo Lucky; Bolukaoto, John Y.; Chukwu, Martina Onyedi; Monyama, Maropeng Charles; Nchabeleng, Maphoshane; Tshepuwane, Tshimane Charles; Monokoane, S.

doi:10.11648/j.jgo.20150306.14

Cited by 7 publications

(9 citation statements)

References 42 publications

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“…Our result is also similar with various studies conducted in different parts of the world that ranged from 20.9% in Ethiopia, Zimbabwe and Palestine [3, 20, 21] to 28.7% in Poland [22]. However, it is lower than a report South Africa (48.2%) [6]. Our study showed higher prevalence of maternal colonization with GBS than the adjusted worldwide estimates of colonization (18%) with lower prevalence in sub-regions like Southern Asia (12.5% and Eastern Asia (11%) [4]; in India, 2.3% [7] and 20% in Democratic Republic of the Congo [23].…”

Section: Discussionsupporting

confidence: 92%

“…A review of 390 articles from 85 countries with a total of 299,924 pregnant women showed that the adjusted estimate for maternal GBS colonization worldwide was 18% with regional variation like lower prevalence in Southern Asia (12.5% and Eastern Asia 11%) [4]. The maternal colonization prevalence among the African studies was also reported as 12% in Kenya [5] to 48.2% in South Africa [6]. It is ranged from 2.3% in India [7] to 40.8% in Italy [8].…”

Section: Introductionmentioning

confidence: 99%

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Streptococcus agalactiae from Ethiopian pregnant women; prevalence, associated factors and antimicrobial resistance: alarming for prophylaxis

Gizachew

Tiruneh

Moges

et al. 2019

Ann Clin Microbiol Antimicrob

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BackgroundMaternal Streptococcus agalactiae (Group B Streptococcus, GBS) colonization rates and its antibiotic resistance patterns provide important information useful in guiding prevention strategies. There is a paucity of evidence about GBS in the Amhara National Regional State, Ethiopia.ObjectiveTo determine colonization prevalence, associated risk factors, and antibiotics resistance including inducible clindamycin resistance patterns of GBS among Ethiopian pregnant women.MethodsA prospective cross-sectional study was conducted from 1st December 2016 to 30th November 2017 at the University of Gondar Referral hospital delivery ward. Combined recto-vaginal swabs were collected from 385 pregnant women and analyzed at the University of Gondar Bacteriology Laboratory by using LIM broth and 5% defibrinated sheep blood agar culture methods. Isolates were identified by using colony morphology, gram reaction, hemolysis, and CAMP test. Antibiotic susceptibility test was done using the disc diffusion method. Double disc diffusion method was used to identify inducible clindamycin resistance isolates. Data were analyzed by SPSS version 20 software. p ≤ 0.05 was considered as statistically significant.ResultsThe overall prevalence of maternal GBS colonization was 25.5% (95% CI 21–29.5%). Experiencing meconium stained amniotic fluid (AOR = 3.018, 95% CI 1.225, 7.437), and longer duration of premature rupture of membrane (AOR = 1.897, 95% CI 1.014, 3.417) were statistically significant to maternal colonization. Furthermore, GBS resistant to 0 (8.2%), 1 (25.5%) and 3 (39.8%) or more antibiotics were identified. A D-test showed 15.2% inducible clindamycin resistant GBS. Constitutive macrolide lincosamide–streptograminB, L-, and M-phenotypes were also detected.ConclusionsMaternal GBS colonization rate in this study was higher compared to the previous reports in Ethiopia. This much prevalence and antibiotics resistance results are the clue to which attention shall be given to this bacterium during management of pregnant women and the newborns.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Streptococcus agalactiae from Ethiopian pregnant women; prevalence, associated factors and antimicrobial resistance: alarming for prophylaxis

Gizachew

Tiruneh

Moges

et al. 2019

Ann Clin Microbiol Antimicrob

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“…This is because vaginal GBS colonization results in ascending infection and inflammation, chorioamnionitis and preterm PROM and finally preterm delivery. 5 This is in agreement with a study from Jimma, Ethiopia, 5 South Africa 16 and India. 15 …”

Section: Discussionsupporting

confidence: 91%

“…This was consistent with the estimated adjusted global prevalence of maternal GBS colonization (18%) 30 and previous reports from Africa (15.7–23.6%), 22–24 , 31 , 38 , 39 Jordan (19.5%) 14 and the USA (21.6%). 40 However, it was lower in comparison to reports from South Africa (48.2%), 16 Gambia (33.7%), 41 the United Kingdom (29.4%) 42 and USA (35%). 12 But the present finding is higher compared to the 7.2 −13.7% prior reports from other parts of Ethiopia, 18 , 25 , 43 , 44 and 6.1% in China.…”

Section: Discussionmentioning

confidence: 59%

“…Earlier reports in the United States of America (USA), 12 Asia 13–15 and Africa, 16–18 archived 20% to 35%, 7.8% to 13.65% and 7.2% to 48.2% of GBS colonization in pregnant women, respectively. Moreover, 11.2%, (6.7% and 7.6%) and 45% to 63.3% of vertical transmission of GBS have been found in German, 19 Asia 20 , 21 and Ethiopia, 22–25 respectively.…”

Section: Introductionmentioning

confidence: 99%

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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

Leykun¹,

Genet²,

Mulu³

2021

IDR

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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.

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Group B Streptococcal Colonization among Pregnant Women and Neonates in a Tertiary Care Hospital in South India

Warrier

Joy

et al. 2022

Indian J Pediatr

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Objectives To assess the prevalence of maternal and neonatal group B Streptococcal colonization, incidence of neonatal systemic illness, and antibiotic sensitivity of isolates. Methods This prospective cohort study was conducted in a South Indian tertiary care hospital. Rectovaginal swabs from pregnant mothers at 36 0/7 –37 6/7 wk gestation and throat and rectal swabs from their neonates at 48 h of age were collected. Presence of group B Streptococcus (GBS) was identified by broth enrichment step, and traditional microbiologic methods and antibiotic sensitivity of isolates was noted. All mothers received intrapartum antibiotic prophylaxis (IAP). Culture-positive sepsis, clinical sepsis, pneumonia, meningitis, and urinary tract infection were defined as neonatal systemic illness. Neonates of colonized mothers were followed at 3 mo for late-onset sepsis. Results Of the 310 mothers, 40 were GBS colonized (prevalence: 12.9%; 95% CI 9.2%, 17.6%). None of the neonates were colonized. Maternal GBS colonization was significantly associated with premature rupture of membrane (RR - 2.93, 95% CI - 1.66–5.16) and neonatal systemic illness (RR - 2.78, 95% CI - 1.39–5.54). Positive correlation was noted between duration of IAP ≤ 4 h and neonatal illness and between maternal GBS colonization and Apgar at 1 min ≤ 4. Clindamycin resistance was noted in 20%. All neonates remained well at 3 mo follow-up. Conclusion High maternal colonization alerts the need for GBS screening in India. Clindamycin resistance among GBS isolates questions its effectiveness as alternative therapy in penicillin allergy.

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Risk Factors Associated with Group B Streptococcus Colonization and Their Effect on Pregnancy Outcome

Cited by 7 publications

References 42 publications

Streptococcus agalactiae from Ethiopian pregnant women; prevalence, associated factors and antimicrobial resistance: alarming for prophylaxis

Streptococcus agalactiae from Ethiopian pregnant women; prevalence, associated factors and antimicrobial resistance: alarming for prophylaxis

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

Group B Streptococcal Colonization among Pregnant Women and Neonates in a Tertiary Care Hospital in South India

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