Rectal Colonization with Group B Streptococcus: Relation to Vaginal Colonization of Pregnant Women

Badri, Mohamad S.; Zawaneh, Sam M.; Cruz, Amelia C.; Mantilla, Gonzalo; Baer, Herman; Spellacy, William N.; Ayoub, Elía M.

doi:10.1093/infdis/135.2.308

Cited by 188 publications

(82 citation statements)

References 12 publications

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“…Swabbing both the lower vagina and the rectum increases the yield of GBS-positive antenatal culture and the predictive values for intrapartum colonization status [1,4,88,89]. Speculum should not be used for vaginal collection.…”

Section: Specimen Collectionmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

152

135

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Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

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Section: Specimen Collectionmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

152

135

View full text Add to dashboard Cite

show abstract

“…Swabbing both the lower vagina and the rectum (through the anal sphincter) substantially increases the yield compared with sampling only the cervix or sampling the vagina without swabbing the rectum [30]. Isolation rates will be increased by approximately 10-15% if the lower genital and anorectal areas are sampled rather than only the upper vagina and cervix [31].…”

Section: Commentmentioning

confidence: 99%

Prevalence of colonisation with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands

Berg

Sprij

Oostvogel³

et al. 2006

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: This study was performed to determine the prevalence of GBS and to identify GBS colonisation risk factors in a multicultural population of pregnant women in The Netherlands. We calculated predictive values of cultures in pregnancy for intrapartum GBS carriage. Study design: From a total of 1702 women visiting several antenatal outpatient departments, rectovaginal swabs were collected at 35-37 weeks' gestation. In 761 women swabs were repeated at time of delivery. Carriage of GBS late in third trimester and at time of delivery was analysed in relation to age, parity, ethnicity and socio-economic status. Results: Twenty-one percent was GBS carrier late in pregnancy. Compared to Europeans, African women were at a higher risk (29%, RR 1.4, CI 1.1-1.7) and Asian women were at lower risk (13%, RR 0.6, CI 0.4-0.8) for GBS carriage. No differences in colonisation were found between women with respect to age, parity or socio-economic background. Positive predictive value of GBS carriage at 35-37 weeks' gestation for carriage at time of parturition was 79% and negative predictive value was 93%. Conclusions: It was not possible to identify a group of pregnant women at high risk for GBS colonisation. Predictive values of antenatal genital group B streptococci cultures at 35-37 weeks' gestation for intrapartum GBS carriage are lower than previously reported. # 2005 Published by Elsevier Ireland Ltd.

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“…Failure to eradicate carriage from the genital tract during pregnancy is recognlzede' which may in part be due to persistent carriage in the lower intestinal tract 35 . The use of intrapartum chemoprophylaxis in the form of intravenous ampicillin has been shown to prevent early onset GBS disease of the neonate.…”

Section: Prophylaxismentioning

confidence: 99%

Streptococci and the Genital Tract

Rowen

1993

Int J STD AIDS

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Summary: Streptococci of Lancefield Group B (GBS) are known to cause maternal sepsis and neonatal infection, whereas streptococci Lancefield Group A (GAS) cause vulvo-vaginitis in both children and adults. Prevalence of SGB colonization of the lower genital tract of normal women is between 4-18%, with higher rates found in hospital personnel and delivery rooms. Such high carriage rates may be a significant factor in nosocomial transmission of GBS to neonates. Symptomatic infection is uncommon and usually secondary to other pathological states. Amnionitis is a complication of vaginal carriage of GBS and there is now evidence that chorioamnionitis is associated with pre-term labour and its attendant problems. GBS infection of the male genitalia has also been described. Intrapartum chemoprophylaxis has been shown to prevent early onset GBS disease of the neonate. Prevalence of GAS in the genital tract is lower than that for GBS, but is more likely to be symptomatic. The response to penicillin is usually prompt. Optimal drug regimens need to be determined, particularly for use in pregnancy.

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Rectal Colonization with Group B Streptococcus: Relation to Vaginal Colonization of Pregnant Women

Cited by 188 publications

References 12 publications

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Prevalence of colonisation with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands

Streptococci and the Genital Tract

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