Detection of Streptococcus agalactiae colonization in pregnant women by using combined swab cultures: cross-sectional prevalence study

Abstract

CONTEXT AND OBJECTIVE: Maternal Streptococcus agalactiae colonization and early-onset neonatal sepsis have aroused interest in the worldwide literature. Streptococcal neonatal disease is associated with significant morbidity and mortality in the perinatal period, especially among premature neonates. The aim of this study was to assess the prevalence of maternal streptococcal colonization by using combined swab cultures, compared with swab collection from a single site. RESULTS:The prevalence of streptococcal colonization was 25.4%. Among the patients with positive cultures, 28.1% had this at only one collection site, 24.2% simultaneously at two sites and 47.5% at all three sites. Associating the swabs from two collection sites significantly increased streptococcal isolation, compared with a single swab (P < 0.05), except for perianal (rectal) collection. Use of combined swabs from three collection sites showed statistically higher isolation rates. CONCLUSION:In combined swab cultures collected from three collection sites, the prevalence of maternal Streptococcus agalactiae colonization was higher than in swabs collected from a single site. RESUMOCONTEXTO E OBJETIVO: Colonização materna por Streptococcus agalactiae e sepse neonatal de início precoce têm despertado interesse na literatura mundial. A doença estreptocócica neonatal está associada com significantes índices de morbidade e mortalidade perinatal, principalmente nos recém-nascidos prematuros. O objetivo deste estudo foi avaliar a prevalência de colonização estreptocócica materna por meio da coleta de swabs combinados, comparada com coleta de swab num único local. RESULTADOS: A prevalência de colonização estreptocócica foi de 25,4%. Dentre as pacientes com cultura positiva, 28,1% tiveram positividade em apenas um local de coleta, 24,2% em dois locais simultaneamente e 47,5% nos três locais avaliados. Associação de swabs de dois locais de coleta aumentou significativamente o isolamento estreptocócico, comparado a único swab (P < 0,05), exceto para coleta perianal. (retal) Utilização de swabs combinados de três locais de coleta mostrou taxas de isolamento estatisticamente superiores. TIPO DE ESTUDO E LOCAL:CONCLUSÃO: Na cultura de swabs combinados de três locais de coleta houve maior prevalência de colonização materna por Streptococcus agalactiae, comparada com coleta de swabs em um único local.

Group B Streptococcus Colonization in Pregnancy

“…According to the CLSI guidelines of 2013, all β haemolytic streptococci with penicillin MIC of ≤0.12 µg/ml can be considered as sensitive. 12 Nineteen (63.3%) isolates were sensitive to erythromycin while eight (26.7%) were of intermediate sensitivity and three (10%) were resistant. Of the total GBS, 19 (63.3%) were resistant to clindamycin.…”

PREVALÊNCIA DA COLONIZAÇÃO POR Streptococcus agalactiae EM GESTANTES ATENDIDAS NA REDE PÚBLICA DE SAÚDE DE SANTO ÂNGELO – RS

“…9,10 Em outros países esse percentual se mantém, como por exemplo, em uma pesquisa realizada na Etiópia, em 2010, a taxa de colonização foi de 20,9%. 11 Já no Irã e na Suíça, a prevalência foi de 22,8% e 21%, respectivamente.…”

The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women

“…Maternal streptococcal colonization is associated with urinary tract infection, premature rupture of membrane (PROM), preterm labor, intrauterine fetal death and complications such as chorioamnionitis and endometritis (2). Pregnant women who are carriers of GBS have 50–60% potential capacity for vertical transmission of the microorganism, through which 1–2% of their newborns develop invasive GBS infection (1, 3), with 5–20% mortality rate and serious complications, especially among premature neonates (4, 5). Ethnicity, African origin, maternal age, parity, marital status, socio-economic status, education, occupation, geographic location, smoking, presence of sexually transmitted disease, sexual behavior, and high body mass index have been reported to influence the prevalence of colonization (2, 3, 6).…”

“…Ethnicity, African origin, maternal age, parity, marital status, socio-economic status, education, occupation, geographic location, smoking, presence of sexually transmitted disease, sexual behavior, and high body mass index have been reported to influence the prevalence of colonization (2, 3, 6). The Centers for Disease Control and Prevention (CDC) currently recommend screening of all pregnant women for GBS between 35–37 weeks of gestation (2, 5, 7). Based on recommended guidelines, intra-partum administration of antibiotics in high risk groups like premature deliveries (before 37 weeks), PROM longer than 18 hours, fever higher than 38°c (8), previous history of infant with GBS infection and also in women with positive screening test of GBS, lowers the risk of neonatal GBS infection (1, 8–10).…”