Prevalence, antimicrobial resistance and serotype distribution of group B streptococcus isolated among pregnant women and newborns in Rabat, Morocco

Moraleda, Cinta; Benmessaoud, Rachid; Esteban, Jéssica; López, Yuly; Alami, Hassan El; Barkat, Amina; Tligui, H.; Kabiri, M.; Bezad, R.; Chaacho, Saad; Madrid, Lola; Vila, Jordi; Muñoz-Almagro, Carmen; Bosch, Jordi; Soto, Sara M.; Bassat, Quique

doi:10.1099/jmm.0.000720

Cited by 16 publications

(12 citation statements)

References 40 publications

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“…GBS isolated from pregnant women in different primary studies conducted in Africa showed resistance to penicillin, ampicillin, erythromycin, clindamycin, vancomycin, ciprofloxacin, chloramphenicol, and tetracycline [10,11,15,31,36,65]. Unlike to Western countries, few data are available about GBS serotypes in different parts of the Africa since the 1989 in Ethiopia to 2018 in Morocco [22,28,30,31,33,39,49,54,66]. A review from the USA on GBS serotypes showed lower proportions of women with serotypes Ia, Ib, or III with the mean prevalence estimate of 55.0%, and in Europe, 58.3% [67].…”

Section: Introductionmentioning

confidence: 99%

Streptococcus agalactiae maternal colonization, antibiotic resistance and serotype profiles in Africa: a meta-analysis

Gizachew

Tiruneh

Moges

et al. 2019

Ann Clin Microbiol Antimicrob

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Background: Maternal rectovaginal colonization with Streptococcus agalactiae (Group B Streptococcus or GBS) is the most common route for the GBS disease in the perinatal period. The knowledge of maternal colonization, antibiotic resistance and serotype profiles is substantially needed to formulate the broad vaccine. However, it has not been estimated in Africa. This meta-analysis was aimed to determine the pooled prevalence of colonization, antibiotic resistance and serotype profiles of GBS reported in Africa. Methods: Potentially relevant studies from 1989 to 31th January, 2019 were retrieved from the Medline/PubMed, EMBASE, HINARI online databases, periodicals and by requesting authors. Unpublished studies retrieved from grey literature through Google and Google Scholar. Pooled estimates were calculated using the random effect model. Subgroup analysis was done to investigate the burden of colonization across sub-regions, sampling site and countries. Summary estimates were presented using words, Forest plots and Tables. Heterogeneity was assessed using the I 2 statistic. Results: Eighty-three articles were assessed, of which 57 studies conducted in five sub-regions with 21 countries (22,206 pregnant women) met pre-specified inclusion criteria. The overall estimate of recto-vaginal colonization was 19.3% (95% CI 16.9, 21.7). The highest estimate was observed in Southern Africa, 23.8% (95% CI 18.7, 28.9), followed by Northern Africa, 22.7% (95% CI 18.2, 27.2) while the lowest was driven from the Eastern Africa, 15.4% (95% CI 12.1, 18.7). Considerable heterogeneity across and within regions, sampling site, screening methods and countries (I 2 > 75%); and the publication bias were observed (p = 0.031). GBS showed the highest resistance to tetracycline. Resistance to penicillin, amoxicillin, chloramphenicol, ampicillin, ceftriaxone, ciprofloxacin, erythromycin, vancomycin and clindamycin also observed. The V, III, Ia, Ib, and II serotypes altogether were accounted 91.8% in the African studies. Conclusions: The pooled estimate of the maternal colonization with GBS was 19.3% which is equivalent with other many primary and review reports worldwide. The most antibiotic resistance estimate was recorded in the tetracycline followed by penicillin. Five serotypes were the most prevalent in Africa and more data on the antibiotic résistance and serotype distribution patterns are needed from developing countries to devise the effective preventive measures. In addition, the antibiotic susceptibility test methods used in the Africa shall be assessed for its quality.

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Section: Introductionmentioning

confidence: 99%

Streptococcus agalactiae maternal colonization, antibiotic resistance and serotype profiles in Africa: a meta-analysis

Gizachew

Tiruneh

Moges

et al. 2019

Ann Clin Microbiol Antimicrob

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“…Alternative antibiotics, such as lincosamides, are used for patients with ␤-lactam allergies. Due to resistance evolution, macrolides, aminoglycosides, and tetracyclines are no longer clinically efficacious (21)(22)(23)(24). While our group and others have observed that GBS is resistant to a wide range of antibiotics, GBS resistance remains poorly characterized and is a frontier of concern in the clinic.…”

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confidence: 96%

A Solution to Antifolate Resistance in Group B Streptococcus : Untargeted Metabolomics Identifies Human Milk Oligosaccharide-Induced Perturbations That Result in Potentiation of Trimethoprim

Chambers

Moore

Craft

et al. 2020

mBio

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Adjuvants can be used to potentiate the function of antibiotics whose efficacy has been reduced by acquired or intrinsic resistance. In the present study, we discovered that human milk oligosaccharides (HMOs) sensitize strains of group B Streptococcus (GBS) to trimethoprim (TMP), an antibiotic to which GBS is intrinsically resistant. Reductions in the MIC of TMP reached as high as 512-fold across a diverse panel of isolates. To better understand HMOs’ mechanism of action, we characterized the metabolic response of GBS to HMO treatment using ultrahigh-performance liquid chromatography–high-resolution tandem mass spectrometry (UPLC-HRMS/MS) analysis. These data showed that when challenged by HMOs, GBS undergoes significant perturbations in metabolic pathways related to the biosynthesis and incorporation of macromolecules involved in membrane construction. This study represents reports the metabolic characterization of a cell that is perturbed by HMOs. IMPORTANCE Group B Streptococcus is an important human pathogen that causes serious infections during pregnancy which can lead to chorioamnionitis, funisitis, premature rupture of gestational membranes, preterm birth, neonatal sepsis, and death. GBS is evolving antimicrobial resistance mechanisms, and the work presented in this paper provides evidence that prebiotics such as human milk oligosaccharides can act as adjuvants to restore the utility of antibiotics.

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“…Epidemiological reports show serotype V is predominant in most regions of the African continent comprising not less than one third of the GBS isolates. This includes the North as reported in Egypt [26], Algeria [27] and Morocco [28]; in the West as shown in Senegal [29], Gambia [30,31] and Nigeria [32]; in central Africa as described in Gabon and Central African Republic [29]; the South as found in Botswana [33] and the Western Cape region of South Africa [34]. The reported prevalence ranged from 30.3 to 66.67%.…”

Section: Gbs Prevalence and Serotype Predominancementioning

confidence: 87%

Group B Streptococcal Colonization in African Countries: Prevalence, Capsular Serotypes, and Molecular Sequence Types

2021

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Streptococcus agalactiae or group B streptococcus (GBS) is a commensal of the gastrointestinal and genitourinary tracts of healthy women and an important cause of neonatal invasive infections worldwide. Transmission of bacteria to the newborn occurs at birth and can be prevented by intrapartum antibiotic prophylaxis. However, this not available in resource limited settings in Africa, which carries a particular high burden of disease. Serotype based vaccines are in development and present a suitable alternative to prevent neonatal infections. To be able to assess vaccine efficacy, knowledge and surveillance of GBS epidemiological data are required. This review summarizes investigations about the serotype distribution and the multi-locus sequence types (MLST) found in different African countries. While most serotypes and MLST data are comparable to findings from other continents, some specific differences exist. Serotype V is predominant among colonizing maternal strains in many different African countries. Serotypes that are rarely detected in western industrialized nations, such as serotypes VI, VII and IX, are prevalent in studies from Ghana and Egypt. Moreover, some specific MLST sequence types that seem to be more or less unique to Africa have been detected. However, overall, the data confirm that a hexavalent vaccine can provide broad coverage for the African continent and that a protein vaccine could represent a promising alternative.

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Prevalence, antimicrobial resistance and serotype distribution of group B streptococcus isolated among pregnant women and newborns in Rabat, Morocco

Cited by 16 publications

References 40 publications

Streptococcus agalactiae maternal colonization, antibiotic resistance and serotype profiles in Africa: a meta-analysis

Streptococcus agalactiae maternal colonization, antibiotic resistance and serotype profiles in Africa: a meta-analysis

A Solution to Antifolate Resistance in Group B Streptococcus : Untargeted Metabolomics Identifies Human Milk Oligosaccharide-Induced Perturbations That Result in Potentiation of Trimethoprim

Group B Streptococcal Colonization in African Countries: Prevalence, Capsular Serotypes, and Molecular Sequence Types

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