Streptococcus agalactiae Serotype Distribution and Antimicrobial Susceptibility in Pregnant Women in Gabon, Central Africa

Bélard, Sabine; Toepfner, Nicole; Melser, Meskuere Capan; Mombo-Ngoma, Ghyslain; Zoleko-Manego, Rella; Groger, Mirjam; Matsiégui, Pierre-Blaise; Agnandji, Selidji Todagbé; Adegnika, Ayôla Akim; González, Raquel; Kremsner, Peter G.; Menéndez, Clara; Ramharter, Michael; Berner, Reinhard

doi:10.1038/srep17281

Cited by 27 publications

(39 citation statements)

References 23 publications

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“…However, as seen in both our studies and other studies [2, 4, 14], these GBS vaccines would not protect a large number of women in several African countries.…”

Section: Discussioncontrasting

confidence: 42%

Carriage and serotype distribution of Streptococcus agalactiae in third trimester pregnancy in southern Ghana

Slotved

Dayie

Banini

et al. 2017

BMC Pregnancy Childbirth

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BackgroundThe aim of this study was to determine the prevalence of Streptococcus agalactiae (group B streptococci, GBS) among healthy, pregnant women attending antenatal care at different study sites in the Greater Accra Region, Ghana.MethodsBetween 2010 and June 2013, recto-vaginal swab samples were collected from pregnant women attending antenatal care from two study sites in southern Ghana. The samples were collected within 35 and 37 weeks of the gestation period. These were inoculated into Todd-Hewitt broth followed by sub-culturing onto a sheep-blood agar plate. Identification was performed on a single subcultured colony. Gram staining was performed, and isolates were evaluated for beta-haemolytic reactions. Furthermore, the isolates were serotyped using the GBS latex serotyping kit.ResultsThe carriage rates were found to be 25.5% (95% CI: 19.6–32.1) to 28.0% (95% CI: 21.9–34.8) for the two collection sites. The most common serotypes were serotypes VII and IX. The data showed that women below 20 years of age or above 30 years of age have a significantly (p = 0.037) higher risk of carrying GBS compared to women from the age group of 20 to 30 years.ConclusionsThe findings of this study revealed that prevalence of GBS colonization in pregnant women in Greater Accra region is high and comparable to rates observed in South Africa and Western countries. The most prevalent serotypes were serotypes VII and IX, which have not been observed before in West Africa.

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“…However, as seen in both our studies and other studies [2, 4, 14], these GBS vaccines would not protect a large number of women in several African countries.…”

Section: Discussioncontrasting

confidence: 42%

Carriage and serotype distribution of Streptococcus agalactiae in third trimester pregnancy in southern Ghana

Slotved

Dayie

Banini

et al. 2017

BMC Pregnancy Childbirth

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“…The incidence of erythromycin resistance found (21•3%) is similar to previous studies conducted in Ireland (18•6%), Poland (18•4%) and Italy (20%) [5,27,28], but lower than rates in France (34•7%) and Taiwan (46%) [29,30]. Interestingly the rate of clindamycin resistance in the current study indicates that resistance has increased in the Irish population from 15•25% [5] to 20•4% and is higher than reports from other countries, including Poland and Africa [27,31]. As with other countries, a high rate of tetracycline resistance (87•2%) was evident for the isolates reported here [28,29].…”

Section: Discussionsupporting

confidence: 88%

Emergence of the L phenotype in Group B Streptococci in the South of Ireland

et al. 2017

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Group B Streptococcal isolates (n = 235) from the South of Ireland were characterised by serotyping, antimicrobial susceptibility and determination of the phenotypic and genotypic mechanisms of resistance. Resistance to erythromycin and clindamycin was observed in 21·3% and 20·4% of the total population, respectively. The c-MLSB phenotype was the most common phenotype detected (62%), with ermB being the predominant genetic determinant, present in 84% of resistant isolates. The rare L phenotype was observed in 2·9% (n = 7) of isolates, four of which harboured the lsaC gene responsible for clindamycin resistance. Serotypes Ia, III and II were the most common amongst the entire study population (28·1%, 24·7% and 14%, respectively). Four of the seven L phenotype isolates were serotype III and two of these strains were confirmed as the hypervirulent clone, ST-17 and harboured the hvgA gene. This is the first documented case of the L phenotype in Ireland to date and the study findings emphasise the need for continued monitoring of antibiotic resistance and serotype distribution in GBS isolates from Ireland.

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“…Primary studies conducted in the East African countries showed the colonization rates ranged from 3.0% to 28.8% [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]; Central Africa,20.0% [27,28]; Western Africa, 2.5% to 34.2% [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]; Southern Africa, 1.77% to 48.23% [49][50][51][52][53][54][55][56][57]…”

Section: Introductionmentioning

confidence: 99%

“…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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Streptococcus agalactiae Serotype Distribution and Antimicrobial Susceptibility in Pregnant Women in Gabon, Central Africa

Cited by 27 publications

References 23 publications

Carriage and serotype distribution of Streptococcus agalactiae in third trimester pregnancy in southern Ghana

Carriage and serotype distribution of Streptococcus agalactiae in third trimester pregnancy in southern Ghana

Emergence of the L phenotype in Group B Streptococci in the South of Ireland

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

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