VAGINAL CARRIAGE RATE OF GROUP B STREPTOCOCCUS IN PREGNANT WOMEN AND ITS TRANSMISSION TO NEONATES

Bushra Yasmin Chaudhry, Naeem Akhtar, Abbas Hayat Balouch

Abstract


Background: Maternal vaginal colonisation with Group B Streptococcus (GBS, Streptococcus
agalactiae) at the time of delivery can cause vertical transmission to the neonate. GBS is the leading
cause of sepsis, meningitis and pneumonia in the infants. Asymptomatic colonisation of the vagina with
GBS varies with the geographical location. Methods: This was a cross-sectional study conducted in
2009 at Benazir Bhutto Hospital, Rawalpindi, Pakistan. Lower vaginal swabs were obtained from 200
pregnant women at the time of admission in the Gynaecology and Obstetrics Department for term,
normal vaginal delivery and swabs from the skin of abdomen and ear canals of their respective neonates
immediately after delivery were collected. Swabs were inoculated on blood agar and incubated
aerobically and on Group B Streptococcus agar (GBS agar) and incubated anaerobically in an anaerobic
jar. Identification of GBS was made on the basis of colonial morphology (β-haemolytic colonies on
blood agar and orange pigmented colonies on GBS agar), Gram stain, catalase test and conformation was
done by means of latex agglutination tests. Results: A GBS carriage rate of 8.5% among pregnant
women before delivery and an acquisition rate of 53% on the abdominal skin and 18% in the ear canals
by the neonates of colonised mothers were found. Conclusions: GBS colonisation in pregnant women
and its transmission to the neonates is present in our population so GBS infections in the prenatal and
neonatal period might not be uncommon in Pakistan, so routine screening should be carried out.
Keywords: Group B Streptococcus, vaginal carriage rate, pregnant women, transmission to neonates

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References


Yun HC, Hamza H, Berkowitz LB, Khattak F. Bacterial infections

and pregnancy. BMJ 2007;335:655–72.

Natarajan G, Johnson YR, Zhang F, Chen KM, Worsham MJ.

Real-Time Polymerase Chain Reaction for the rapid detection of

group B streptococcal colonization in neonates. Pediatrics

;118:14–22.

Regan JA, Klebanoff MA, Nugent RP, Eschenbach DA.

Colonization with group B Streptococcus in pregnancy and

adverse outcome. Am J Obstet Gynecol l996;174:1354–60.

Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH,

Lefkowitz LB, et al. Group B streptococcal disease in the era of

intrapartum antibiotic prophylaxis. N Engl J Med 2000;342:15–20.

Prevention of perinatal group B streptococcal disease: a public

perspective. MMWR Morb Mortal Wkly Rep 1996;45:1–24.

Zangwill KM, Schuchat A, Wenger JD. Group B streptococcal

disease in the United States 1990: Report from a multistate active

surveillance system. Mor Mortal Wkly Rep CDC Surveill Summ

;41:25–32.

Al-Sweih N, Maiyegun S, Diejomaoh M, Rotimi V, Khodakhast

F, Hassan N, et al. Streptococcus agalactiae (Group B

Streptococci) carriage in late pregnancy in Kuwait. Med Princ

Pract 2004;13:10–4.

El Beitune P, Duarte G, Maffei CM. Colonization by

Streptococcus agalactiae during pregnancy: maternal and

perinatal prognosis. Braz J Infect 2005;9:4.

Stoll, Barbara J, Schuchat, Anne. Maternal carriage of group B

streptococci in developing countries. Pediatr Infect Dis J

;17:499–503.

Noble MA, Bent JM, West AB. Detection and identification of

group B streptococci by use of pigment production. J Clin Pathol

;36:350–2.

Picard FJ, Bergeron MG. Laboratory detection of group B

Streptococcus for prevention of perinatal disease. Eur J Clin

Microbiol Infect Dis 2004;23:665–71.

Schuchat A. Group B Streptococcus. Lancet 1999;353:51–6.

Schrag SJ, Zell ER, Lynfield R, Roome A, Arnold KE, Craig AS,

et al. A population-based comparison of strategies to prevent

early-onset group B streptococcal disease in neonates. N Engl J

Med 2002;347:233–9.

Rallu F, Barriga P, Scrivo C, Laferrière VM, Laferrière C.

Sensitivities of antigen detection and PCR assays greatly increased

compared to that of the standard culture method for screening for

group B Streptococcus carriage in pregnant women. Journal of

Clinical Microbiology 2006;44:725–8.

Busetti M, D’Agaro P, Campello C. Group B Streptococcus

prevalence in pregnant women from North-Eastern Italy:

advantages of a screening strategy based on direct plating plus

broth enrichment. Journal of Clinical Pathology 2007;60:1140–3.

Rahim F, Jan A, Mohummad J, Iqbal H. Pattern and outcome of

admissions to neonatal unit of Khyber Teaching Hospital,

Peshawar. Pak J Med Sci 2007;23:249–53.

Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A.. Prevention of

perinatal group B streptococcal disease. Revised guidelines from

CDC. MMWR Recomm Rep 2002;51:1–22.

Dyke MK, Phares CR, Lynfield R, Thomas AR, Arnold KE,

Craig AS, et al. Evaluation of universal antenatal screening for

group B Streptococcus. N Engl J Med 2009;360:2626–36.

Logsdon BA, Casto DT. Prevention of group B Streptococcus

infection in neonates. Ann Pharmacother 1997;31:897–906.

J Ayub Med Coll Abbottabad 2010;22(4)

http://www.ayubmed.edu.pk/JAMC/PAST/22-4/Bushra.pdf

Orrett FA. Colonization with group B streptococci in pregnancy

and outcome of infected neonates in Trinidad. Pediatr Int

;45:319–23.

Savoia D, Gottimer C, Crocilla C, Zucca M. Streptococcus

agalactiae in pregnant women: phenotypic and genotypic

characters. J Infect 2008;56:120–5.

Annotation. Prevention of early onset group B streptococcal

infection: screen, treat, or observe? Arch Dis Child Fetal Neonatal

Ed 1998;79:F81–2.

Dermer P, Lee C, Eggert J, Few B. A history of neonatal group B

Streptococcus with its related morbidity and mortality rates in the

United States. J Pediatr Nurs 2004;19:357–63.

Ancona RJ, Ferrieri P, Williams PP. Maternal factors that enhance

the acquisition of group B streptococci by newborn infants. J Med

Microbiol 1980;3:273–80.

Votava M, Tejkalová M, Drábková M, Unzeitig V, Braveny I.

Use of GBS media for rapid detection of group B streptococci in

vaginal and rectal swabs from women in labor. Eur J Clin

Microbiol Infect Dis 2001;20:120–2.

Gilbert R. Prenatal screening for group B streptococcal infection:

gaps in the evidence. International J of Epidemiol 2003;33:2–8.

Akhtar T, Zia S, Khatoon J. Group B Streptococcus carriage rate

of pregnant women and newborn infants. Pakistan J Med Res

;23:12–5.

Hafeez A, Ali S, Abbasi SA. Normal vaginal flora in pregnant

women. J Pakistan Ins Med 1997;7:437–40.

NomuraI ML, Passini R Júnior, Oliveira UM. Selective versus

non-selective culture medium for group B Streptococcus detection

in pregnancies complicated by preterm labor or preterm-premature

rupture of membranes. Braz J Infect Dis 2006;10:242–6.

Mani V, Jadhav M, Sivadasan K, Thangavelu CP, Rachel M,

Prabha J. Maternal and neonatal colonization with group B

Streptococcus and neonatal outcome. Indian Pediatr

;21:357–63.

El-Kersh TA, Al-Nuaim LA, Kharfy TA, Al-Shammary FJ, AlSaleh SS, Al-Zamel FA. Detection of genital colonization of

group B streptococci during late pregnancy. Saudi Med J

;23:56–61.

Namavar Jahromi B, Poorarian S, Poorbarfehee S. The prevalence

and adverse effects of group B streptococcal colonization during

pregnancy.Arch Iran Med 2008;11:654–7.

Ayata A, Guvenc H, Felek S, Aygun AD, Kocabay K, Bektas S.

Maternal carriage and neonatal colonization of group B

streptococci in labour are uncommon in Turkey. Pediatr Perinatal

Epidemiol 1994;8:188–92.

Benitz W.E., Gould J.B., Druzin M.L. Risk factors for early-onset

group B streptococcal sepsis: estimation of odds ratios by critical

literature review. Pediatrics 1999;103:77.

Baker CJ. Early onset Group B streptococcal disease. J Paediatr

;93:124–5.


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