Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia

Luhidan, Lama Al; Madani, Areej; Albanyan, Esam A.; Saif, Saif Al; Nasef, Minosh; Aljohani, Sameera; Madkhali, Azzah; Shaalan, Mohamed; Al-Alola, Sulaiman A.

doi:10.1097/inf.0000000000002269

Cited by 13 publications

(10 citation statements)

References 15 publications

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“…Moreover, GBS has been established as a leading cause of neonatal invasive infections globally (1,3,6), including in Saudi Arabia, where a recent study reported an overall incidence of GBS cases to be 0.51/1,000 live births; 69.1% had early onset disease and 30.9% had late onset disease [32]. Among them, urinary tract infection was the most common (47.3%), followed by sepsis (43.6%), meningitis (5.5%), and pneumonia (1.8%) with a mortality rate of 3.6%.…”

Section: Group B Streptococcus In Saudi Pregnant Womenmentioning

confidence: 99%

Group B streptococcus colonization, antibiotic susceptibility, and serotype distribution among Saudi pregnant women

Khan

Faiz

et al. 2020

Infect Chemother

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Background: Group B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases. This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women. Materials and Methods: In this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular genebased multiplex polymerase chain reaction assays. Results: Sixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes. Conclusion: This study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

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Section: Group B Streptococcus In Saudi Pregnant Womenmentioning

confidence: 99%

Group B streptococcus colonization, antibiotic susceptibility, and serotype distribution among Saudi pregnant women

Khan

Faiz

et al. 2020

Infect Chemother

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“…In addition, Streptococcus agalactiae is the most frequently isolated bacteria from cerebrospinal fluid in newborns (less than 28 days), which is consistent with the related research that Streptococcus agalactiae (GBS) disease is caused by ascending infection of settled mothers or transmission during vaginal delivery, 12 and related research shows that the disease is more common in newborns whose mothers are not screened by GBS, and Intrapartum antibiotic prophylaxis (IAP) is an effective intervention measure to reduce the incidence of earlyonset disease (EOD). [13][14][15] Therefore, at present, the preventive measures of Streptococcus agalactiae should include prenatal GBS screening for women and antibiotic prophylaxis before and after delivery. [16][17][18] Children or newborns with infection can be treated with antibiotics such as linezolid and vancomycin, and avoid using erythromycin, clindamycin, and tetracycline because Streptococcus agalactiae has a high resistance to them.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics and Drug Resistance Analysis of Cerebrospinal Fluid Microbial Infections in Wenzhou Area

Zhou¹,

Kuang²,

Huang³

et al. 2021

IDR

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Objective Central nervous system infections (CNSI) are serious diseases that endanger human health. Identifying pathogens and their susceptibility to antibiotics, and promptly using antibiotics under this guidance is essential for treatment. The purpose of this study is to investigate the pathogen characteristics of CNSI patients, which can help clinicians choose appropriate empiric antibiotic . Methods We retrospectively collected data on CNSI patients with cerebrospinal fluid (CSF) culture positive from 2012 to 2020, including demographic characteristics, laboratory data, pathogenic bacteria, and antimicrobial susceptibility test results. Results A total of 166 patients with 168 isolates out of 8188 patients were available for data analysis. Among the isolates, Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 59.5%, 36.3%, and 4.2%, respectively. Among newborns, children under 12, and patients over 12, the most isolated strains were Streptococcus agalactiae (24/46, 52.2%), Streptococcus pneumoniae (21/68, 30.9%) and Staphylococcus epidermidis (10/54, 18.5%), respectively. Streptococcus agalactiae is more sensitive to linezolid and vancomycin. Streptococcus pneumoniae is more sensitive to vancomycin. Staphylococcus epidermidis is more sensitive to clindamycin and rifampicin. The sugar content in the CSF of Gram-negative bacteria of children ≤12 years old was significantly lower than that of Gram-positive bacteria (P<0.05). Conclusion We comprehensively studied the etiological characteristics and antimicrobial resistance patterns of positive cerebrospinal fluid cultures in Wenzhou City, Zhejiang Province from 2012 to 2020, which can provide valuable strategies for preventing pathogens and improving evidence-based treatment.

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“…Importantly, like Rao et al, they observed that discontinuation of universal antenatal screening was significantly associated with an increase in EOGBS incidence. 19 While Africa has the highest burden of EOGBS infection in the world, there are continuing challenges in implementing intrapartum prophylaxis, both using risk-based or screening-based strategies due to limited resources. 20 It is clear that only vaccines can provide a realistic solution for prevention of GBS related infant mortality in most parts of Africa.…”

Section: Efficacy Of Screening-versus Risk-based Strategy: Which Of Tmentioning

confidence: 99%

“…Importantly, like Rao et al , they observed that discontinuation of universal antenatal screening was significantly associated with an increase in EOGBS incidence. 19 …”

Section: Efficacy Of Screening- Versus Risk-based Strategy: Which Of mentioning

confidence: 99%

To screen or not to screen women for Group B Streptococcus (Streptococcus agalactiae) to prevent early onset sepsis in newborns: recent advances in the unresolved debate

Rao

Khanna²

2020

Therapeutic Advances in Infection

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Streptococcus agalactiae, also known as Group B streptococcus (GBS) is the commonest cause of early onset sepsis in newborns in developed high-income countries. Intrapartum antimicrobial (antibiotic) prophylaxis (IAP) is recognized to be highly effective in preventing early onset Group B sepsis (EOGBS) in newborns. The key controversy is about the strategy that should be used to identify mothers who should receive IAP. There are two strategies that are followed in developed countries: screening-based or risk-factor-based identification of women requiring IAP. The debate regarding which of the two approaches is better has intensified in the recent years with concerns about antimicrobial resistance, effect on newborn’s microbiome and other adverse effects. In this review, we have discussed some of the key research papers published in the period 2015–2019 that have addressed the relative merits and disadvantages of screening versus risk-factor-based identification of women requiring IAP. Although screening-based IAP appears to be more efficacious than risk-based IAP, IAP-based prevention has several limitations including ineffectiveness in prevention of late-onset GBS infection in babies, premature and still births, impact of IAP on neonatal microbiota, emergence of antimicrobial resistance and difficulties in implementing IAP-based strategies in middle and low income countries. Alternative strategies, principally maternal immunization against GBS would circumvent use of IAP. However, no licensed vaccines are currently available for use.

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Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia

Cited by 13 publications

References 15 publications

Group B streptococcus colonization, antibiotic susceptibility, and serotype distribution among Saudi pregnant women

Group B streptococcus colonization, antibiotic susceptibility, and serotype distribution among Saudi pregnant women

Epidemiological Characteristics and Drug Resistance Analysis of Cerebrospinal Fluid Microbial Infections in Wenzhou Area

To screen or not to screen women for Group B Streptococcus (Streptococcus agalactiae) to prevent early onset sepsis in newborns: recent advances in the unresolved debate

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