Carriage and transmission of group B streptococci among STD clinic patients.

Jackson, D H; Hinder, S M; Stringer, J; Easmon, C. S. F.

doi:10.1136/sti.58.5.334

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…5 6 A number of studies have reported an increased rate of carriage in sexually transmitted diseases and GUM clinic attendees. [7][8][9][10][11][12] However, the evidence on sexual transmission is conflicting. A large prospective study among minority women attending community clinics in San Antonio, Texas, 10 found no association between GBS and number of sexual partners, concurrent STI, past history of STI, or condom usage.…”

Section: Discussionmentioning

confidence: 99%

“…In one study in a UK GUM clinic, identical serotypes were found in only three out of 20 couples who were both colonised. 9 However, more recent studies in a GUM setting in the United Kingdom and in college students have supported the concept of sexual transmission. 8 11 The overall period prevalence of GBS detection in routine specimens in our study was 2.1%, which is considerably lower than the 23-42% found in other studies.…”

Section: Discussionmentioning

confidence: 99%

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Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population

Shaw¹,

Mason²,

Scoular³

2003

Sexually Transmitted Infections

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Objectives: The isolation of group B streptococcus (GBS) on routine swabs taken from genitourinary medicine (GUM) clinic attendees is a common finding. The relation of GBS to vulvovaginal symptoms is unclear, creating confusion about management. This case-control study tested the hypothesis that detection of GBS on routine clinical specimens is not causally related to vulvovaginal symptoms in female GUM clinic attendees. Methods: Data were collected on all female GUM clinic attendees who had GBS isolated from anogenital swabs between July 1999 and July 2001. Controls were randomly selected from all new and rebooking female GUM clinic attendees. Controls were group matched for age with cases and were included only if a sexual health screen was performed and the results of this were available. Results: 118 cases and 308 controls were identified during the study period. There was no significant difference between cases and controls in patient demographic or behavioural characteristics, the presence of genital co-infection, or vulvovaginal symptoms. There was no relation between symptoms and quantitative growth of GBS reported by the laboratory in either cervical or urethral swabs. Only nine cases had high vaginal swabs taken, in whom there was a significant association between a heavy growth of GBS and vulvovaginal symptoms (p=0.008). Conclusion: The isolation of GBS from routinely collected genital swabs in female attendees of a GUM clinic is not causally related to vulvovaginal symptoms. We recommend that patients should receive this advice and should not be treated with antibiotic therapy for this indication. G roup B streptococci (GBS) are known to colonise the genital tract in 4-18% of healthy women, 1 and are frequently isolated in genital specimens taken from patients attending genitourinary medicine (GUM) clinics with vulvovaginal symptoms. In women who do not have a well defined alternative explanation for their symptoms, uncertainty often prevails about the aetiological relevance of GBS carriage, particularly the need for treatment and the advice given to patients; consequently, there is much variation in practice. The primary focus of research into GBS infection has been its potential to cause sepsis in the newborn.2 Its causal role in vulvovaginal symptoms has not been well researched.This retrospective case-control study was to designed to test the hypothesis that the detection of GBS on routine clinical specimens is not causally related to vulvovaginal symptoms in female GUM clinic attendees. METHODSCases were defined as all female GUM clinic attendees between 1 July 1999 and 31 July 2001, in whom any anogenital specimen cultured GBS. Controls were group matched for age with all new and rebooking female GUM attendees and were randomly selected from all female attendees over the same time period. Controls were included only if they had a sexual health screen performed and the results of this were available.All new patients attending the GUM service were offered a sexual health screen. All clinical data...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population

Shaw¹,

Mason²,

Scoular³

2003

Sexually Transmitted Infections

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“…Family groups appear to carry the same strain of GBS and this may provide the background for late-onset neonatal sepsis (Weindling et al,198 1). Despite considerable circumstantial evidence, Jackson et al (1982) could not confirm sexual transmission of GBS in a study of 92 couples that employed both serotyping and phage typing.…”

Section: Transmission Of Gbs In Hospital and Communitymentioning

confidence: 96%

“…There is, however, no association between GBS and any particular sexually-transmitted disease. There is a link between GBS and balanitis which deserves further investigation (Jackson et al, 1982).…”

Section: Transmission Of Gbs In Hospital and Communitymentioning

confidence: 98%

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Occasional Review: Group-B Streptococcus--Profile of an Organism

Ross¹

1984

Journal of Medical Microbiology

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Introduction and historical review P. W. Ross Nocard and Mollereau (1 887) were the first to describe the isolation of streptococci from bovine mastitis and these organisms were likely to have been the group-B streptococci (GBS). Many years elapsed, however, before these streptococci featured again in the literature. In 1933, Rebecca Lancefield divided streptococci into groups on the basis of carbohydrate antigens in the cell wall; her classification scheme was based on precipitation reactions of hot-hydrochloric-acid extracts of whole organisms (Lancefield extracts) with antisera raised in rabbits against whole-cell formalinised streptococci. These classical studies clarified the taxonomy of streptococci to a considerable degree because the cultural and biochemical patterns that had been used before 1933 had added little to streptococcal identification. The streptococci that Lancefield described as group B were isolated from bovine and dairy sources. In 1934 she divided GBS into types I, I1 and I11 and in 1938 subdivided type I into Ia and Ib. All the antigens were polysaccharides. Pattison, Matthews and Maxted (1955) added to the serological profile of GBS by describing two protein antigens, R and X. They also stated that GBS from human and bovine sources were not similar and this was corroborated by Butter and de Moor (1967). Wilkinson (1975) discovered a third protein antigen and called it Icp. It is generally referred to as the Ic protein and is usually found in strains with the Ia or Ib polysaccharide. Strains possessing the Ia and Ic antigens are said to belong to type Ic. The Icp antigen may be found in strains with the I1 or the I11 polysaccharide or without a detectable polysaccharide antigen. With serological tests that identify carbohydrate and protein antigens, many combinations of antigens are found-Ia, Ib, Ic, Icp, 11,

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Association of Sexual Activity with Colonization and Vaginal Acquisition of Group B Streptococcus in Nonpregnant Women

Meyn

Moore²,

Hillier³

et al. 2002

American Journal of Epidemiology

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In a longitudinal cohort study of 1,248 nonpregnant young women recruited from three Pittsburgh, Pennsylvania, health clinics in 1998-2000, the authors investigated risk factors associated with vaginal acquisition of group B Streptococcus (GBS). Rectal and vaginal swabs for GBS culture and demographic and behavioral interview data were obtained from the women at enrollment and at three 4-month intervals. Cox proportional hazards models were used to evaluate risk factors for GBS acquisition among the 1,089 women with follow-up data. At enrollment, 365 (29.2%) of the 1,248 study participants were vaginally colonized with GBS. Of 767 women who were GBS-negative at enrollment, 344 (44.9%) acquired vaginal GBS colonization during follow-up. The following factors were independently associated with vaginal acquisition of GBS at the 0.05 significance level: African-American race (hazard ratio (HR) = 1.5, 95% confidence interval (CI): 1.2, 1.9), having multiple sex partners during the past 4 months (HR = 1.7, 95% CI: 1.1, 2.5), having frequent sexual intercourse during the past 4 months (HR = 1.5, 95% CI: 1.1, 2.2), and having sexual intercourse within the 5 days prior to the follow-up visit (HR = 1.6, 95% CI: 1.3, 2.0). These results show that sexual activity is an important risk factor for vaginal acquisition of GBS.

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Carriage and transmission of group B streptococci among STD clinic patients.

Cited by 6 publications

References 8 publications

Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population

Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population

Occasional Review: Group-B Streptococcus--Profile of an Organism

Association of Sexual Activity with Colonization and Vaginal Acquisition of Group B Streptococcus in Nonpregnant Women

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