Association of sexually-transmitted infection and African–American race with Streptococcus agalactiae colonization in pregnancy

Abstract

Background Group B Streptococcus (GBS) remains a significant cause of neonatal infection, but the maternal risk factors for GBS colonization remain poorly defined. We hypothesized that there may be an association between antibiotic exposure during pregnancy and GBS colonization and/or the presence of inducible clindamycin resistance (iCLI-R) in GBS isolates from GBS-colonized pregnant women. Methods A retrospective cohort study was performed at Louisiana State University Health Sciences Center – Shreveport including demographic and clinical data from 1513 pregnant women who were screened for GBS between July 1, 2009 and December 31, 2010. Results Among 526 (34.8%) women who screened positive for GBS, 124 (23.6%) carried GBS strains with iCLI-R (GBS-iCLI-R). While antibiotic exposure, race, sexually-transmitted infection (STI) in pregnancy, GBS colonization in prior pregnancy and BMI were identified as risk factors for GBS colonization in univariate analyses, the only independent risk factors for GBS colonization were African–American race (AOR = 2.142; 95% CI = 2.092–3.861) and STI during pregnancy (AOR = 1.309; 95% CI = 1.035–1.653). Independent risk factors for GBS-iCLI-R among women colonized with GBS were non-African–American race (AOR = 2.13; 95% CI = 1.20–3.78) and younger age (AOR = 0.94; 95% CI = 0.91–0.98). Among GBS-colonized women with an STI in the current pregnancy, the only independent risk factor for iCLI-R was Chlamydia trachomatis infection (AOR = 4.31; 95% CI = 1.78–10.41). Conclusions This study identified novel associations for GBS colonization and colonization with GBS-iCLI-R. Prospective studies will improve our understanding of the epidemiology of GBS colonization during pregnancy and the role of antibiotic exposure in alterations of the maternal microbiome.

Prevalence of early neonatal sepsis and positive maternal culture for group B beta-hemolytic Streptococcus

“…Out of six Latin American countries studied, Nicaragua presented the lowest rate (0.8%), while Uruguay had the highest rate (67.3%) 17 . In a study with 526 pregnant women with positive screening for GBS, black African ethnicity and sexually transmitted diseases were the only independent risk factors for maternal colonization by GBS 19 . Even within the same country, the prevalence of GBS colonization can vary widely.…”

Colonization of pregnant women with group B streptococcus: current view at the problem

“…Capraro с соавт. (2020) отметили, что афроамериканская раса является предрасполагающим фактором риска, а в сочетание с инфекциями, передаваемыми половым путем, взаимосвязь прямолинейная [17]. Установлено, что нарушение соотношения облигатной и факультативной микрофлоры влагалища способствует развитию эндогенной инфекции с разнообразием клинической картины [18].…”

“…Механизм повышенной колонизации СГВ у женщин с ожирением неясен. Однако авторы предполагают, что данная тенденция связана с изменениями микробиоты желудочно-кишечного тракта [19] или сопутствующим сахарным диабетом [17,22].…”

Polymicrobial Interactions Operative during Pathogen Transmission

“…Multispecies biofilms can even be trans-kingdom, with Staphylococcus and Candida (143) and Enterococcus and Candida (144) forming multispecies biofilms. In addition to biofilm-mediated antimicrobial therapy failure, antimicrobial resistance can be transferred from one pathogen to another, particularly in the multispecies biofilm, but also in other cocolonization scenarios, such as Streptococcus agalactiae obtaining antimicrobial resistance from coinfecting sexually transmitted pathogens (145).…”