Maternal colonisation with group B streptococcus and effectiveness of a culture-based protocol to prevent early- onset neonatal sepsis

Abstract

Summary This study was conducted to find out the group B streptococcus colonisation of pregnant women in Kocaeli, Turkey. A culture plus individualised high‐risk‐based antibiotic prophylaxis was compared with high‐risk‐based approach alone. The screening of women was performed via vaginal and anal cultures for group B streptococcus (GBS). The maternal GBS colonisation rate was found to be 6.5%. All colonised women or preterm labours with unavailable culture results until delivery received prophylactic antibiotics. Neonatal colonisation rate and early‐onset neonatal sepsis due to GBS was 1/200. The unscreened 900 women received prophylactic antibiotics due to a risk factor‐based approach. The neonatal colonisation rate was 17/900 (p = 0.1), and the rate of early‐onset neonatal sepsis was 3/900 (p = 0.6). A culture plus individualised high‐risk‐based antibiotic prophylaxis provided an insignificant change in neonatal colonisation and early‐onset neonatal sepsis with GBS when compared with high‐risk‐based approach alone.

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

“…Implementation of this strategy has reduced early-onset neonatal sepsis by 70%. 8 According to the literature, between 6.5% 9 and 43.6% 10 of pregnant women are colonized with S. agalactiae in the vagina or rectum. Maternal colonization rates may differ according to the culture medium and collection site.…”

Colonization of Group B Streptococci In Pregnant Women At Delivery

“…Similarly, no significant associations between being a housewife and GBS colonization was found, consistently with others reported in the literature (10) . Intrapartum prophylaxis is recommended in pregnant women with risk factors (preterm birth act, EMR, PMR, fever>38 o C at delivery, urinary infection due to GBS during pregnancy, and history of GBS related disease in children of pregnant woman) or in women with positive rectovaginal GBS cultures obtained between weeks 35 and 37 of pregnancy in order to prevent perinatal GBS infections (6,8,20) . However, progressively increasing rate of resistance to antibiotics used in intrapartum prophylaxis has become an important issue.…”

“…GBS colonization rate is 11.4% and 24.9% in USA, 12% and 15% in Europe, 21.5% in Middle East and 11.4% and 27.9% in Japan (6,10) . Frequency of GBS in Turkey has been determined as between 1% and 16% in different studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) . When all previous studies are considered, GBS frequency in Turkey is lower than some other countries.…”

“…Microorganisms with positive results in both tests were identified as GBS. [16][17][18][19][20] Isolated GBS strains were confirmed by BBL Crystal Gram Positive (Becton Dickinson, USA) identification kit and antibiotic sensitivity was determined by disk diffusion method. Statistical evaluation of risk factors for cases with GBS positive was performed using chisquare tests in a computer program (EPI-INFO 2000).…”

Strong Correspondence of the Vaginal and Rectal Load of Group B Streptococci in Pregnant Women

“…The vaginal/rectal colonization rate of pregnant women ranges between 6.5% [12] and 43.6% [13] and may vary with characteristics such as age, parity, socio-economic status, geographic location [14], presence of sexually transmitted diseases [15] and sexual behavior [16]. Differences in colonization rates can also be attributed to variation in the culture and detection methods employed, including the media selected and collection sites used [17][18][19].…”