Vaginal bacterial flora of pregnant women colonized with group B streptococcus

Kubota, Takeyoshi; Nojima, Masanori; Itoh, Shigeru

doi:10.1007/s10156-002-0190-x

Cited by 28 publications

(26 citation statements)

References 16 publications

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“…1) at any observation point and a cumulative carriage rate of 54% (42 of 77) over the entire observation period. These figures are considerably higher than those (Ͻ15%) previously reported from Denmark and from several other countries (16,20,22,24,25,36). Results comparable to ours have been reported from the United States (5,14,28).…”

Section: Discussioncontrasting

confidence: 53%

“…It has been suggested that there probably are more than 400 to 500 different organisms present at any time in the normal intestinal tract, although only about 100 different species have been isolated (17). It is also clear that proportions of individual species or clones of species may show temporary fluctuations and that such bacteria may become detectable as a result of various changes of the microenvironment (9,24). The observation that some women (subjects 22, 32, and 70) who were found to be intermittently colonized carried the same clone on two or more occasions separated by a period without detectable GBS supports the assumption that the sensitivity of the detection method is a relevant parameter.…”

Section: Discussionmentioning

confidence: 99%

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Dynamics of Streptococcus agalactiae Colonization in Women during and after Pregnancy and in Their Infants

et al. 2004

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The population dynamics of Streptococcus agalactiae (group B streptococci [GBS]) colonization of the vagina and anorectal area was investigated in a cohort of 77 Danish women during and after their pregnancy by a new sensitive method. The mean carriage rate among individual observations was 36%, and the cumulative carriage rate over the entire observation period was 54%. Examination of more than 1,500 GBS isolates by pulsed-field gel electrophoresis demonstrated that the GBS population was remarkably homogeneous and stable in each carrier. Virtually all carriers were colonized by a single GBS clone on all occasions spanning up to 2 years. Repeated detection of the same clone even in women who were recorded as intermittent carriers suggests that the actual carrier rate exceeds 50% but that fluctuations in the GBS proportions of the flora occasionally preclude their detection. Newborns and young infants usually carried the same GBS clone as their mothers. However, only twice were identical clones of GBS detected in different women in contrast to the observed clonal relationships of clinical isolates. These observations strongly suggest differences in the properties and epidemiology of virulent GBS clones compared to clones commonly carried by healthy individuals.Infection by Streptococcus agalactiae (group B streptococci [GBS]) is still a common cause of neonatal diseases such as pneumonia, septicemia, and meningitis, although the incidence has declined in some countries as a result of active prevention efforts. The overall incidence of early-onset disease in 1998 to 2000 was 0.5 to 0.6 cases per 1,000 live births (12,25,30,32), although there are geographical and racial differences (11). An incidence of 0.24 per 1,000 live births of proven GBS infections in neonates and young infants has been reported for Denmark in the past (8). It is generally accepted that bacterial colonization of the child during its passage through the birth canal is the main cause of early-onset infections among children aged less than 7 days. Intrapartum chemoprophylaxis offered to pregnant carriers is, therefore, the strategy now recommended by the Centers for Disease Control to reduce neonatal GBS infection (13). GBS also causes invasive infections in nonpregnant and pregnant adults (6, 35), although the incidences are lower than for newborns.The carriage rates of GBS among pregnant and nonpregnant women and the rate of neonatal acquisition of GBS has been examined in the past (for reviews, see references 4, 13, and 33). However, relatively little is known about the kinetics of GBS colonization among individual carriers.The main purpose of the present longitudinal study was to evaluate the prevalence of GBS colonization among pregnant and nonpregnant women by using a new sensitive differential agar medium (mixed blood [MB] agar) (19) and to examine the complexity and stability of the GBS population in individual women and their newborns. This was achieved by determination of the carriage and the clonal diversity of GBS defined by pulsed...

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Dynamics of Streptococcus agalactiae Colonization in Women during and after Pregnancy and in Their Infants

et al. 2004

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“…The justification for this study was based on multiple, consistent research findings which found that women with higher vaginal colonisations of Lactobacillus are more likely to have no detectable vaginal GBS colonisations (Altoparlak et al, 2004;Donders et al, 2000;Kubota et al, 2002;Takeyoshi et al, 2002;Whitney et al, 2004). This finding from the current study supports the possibility that the consumption of oral probiotics can result in the colonisation of the vagina with…”

Section: Justification For Further Researchsupporting

confidence: 79%

“…As stated in the literature review chapter, research has consistently shown that women with higher vaginal colonisations of Lactobacillus are more likely to have no detectable vaginal GBS colonisations (Altoparlak et al, 2004;Donders et al, 2000;Kubota et al, 2002;Takeyoshi et al, 2002;Whitney et al, 2004). One potential means of manipulating Lactobacillus concentrations in order to attempt to impact the GBS colonisation rates is through the use of probiotics.…”

Section: Introductionmentioning

confidence: 99%

The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

et al. 2018

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AimThe aim of this study was to complete a pilot project to ascertain if the research design was appropriate to determine whether a daily oral dose of probiotics can reduce the rate of vaginal group B streptococcal (GBS) colonisation in pregnancy. MethodologyA pilot randomised controlled trial was performed which recruited 34 GBS-positive women who were approximately 36 weeks pregnant. The participants were randomly allocated to the control group, who continued with standard antenatal care, or to the intervention group, which continued with standard antenatal care and received a daily oral dose of probiotics for three weeks or until the birth of their infant. A lower vaginal swab to detect the presence of GBS was collected three weeks post consent or when a participant was in labour. ResultsNo significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n=16), also showed no significant difference in vaginal GBS when compared to the control. As a secondary finding of the analysis did show significantly more vaginal commensals in the probiotics group (p=0.048).iii DiscussionThere are five possible reasons for the lack of significant results: The length of the intervention was too short. The dosage of the probiotics was too low. The wrong strains of probiotics were used. The sample size was inadequate. Oral probiotics are ineffective in impacting vaginal GBS. ImplicationsThe secondary finding of a significant increase of vaginal commensals (normal

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“…The host and mucosal microbiota constituents that govern GBS presence in the vaginal tract are not fully known. Several clinical studies have observed an inverse correlation between levels of Lactobacillus species and GBS in the human vaginal tract (15,16). Even so, preliminary human studies with Lactobacillus probiotic treatments (16,17), as well as murine models (5), have failed to show significant reduction of GBS vaginal colonization.…”

Section: Discussionmentioning

confidence: 99%

Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization

Patras

Wescombe²,

Rösler

et al. 2015

Infect Immun

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c Streptococcus agalactiae (group B streptococcus [GBS]) colonizes the rectovaginal tract in 20% to 30% of women and during pregnancy can be transmitted to the newborn, causing severe invasive disease. Current routine screening and antibiotic prophylaxis have fallen short of complete prevention of GBS transmission, and GBS remains a leading cause of neonatal infection. We have investigated the ability of Streptococcus salivarius, a predominant member of the native human oral microbiota, to control GBS colonization. Comparison of the antibacterial activities of multiple S. salivarius strains by use of a deferred-antagonism test showed that S. salivarius strain K12 exhibited the broadest spectrum of activity against GBS. K12 effectively inhibited all GBS strains tested, including disease-implicated isolates from newborns and colonizing isolates from the vaginal tract of pregnant women. Inhibition was dependent on the presence of megaplasmid pSsal-K12, which encodes the bacteriocins salivaricin A and salivaricin B; however, in coculture experiments, GBS growth was impeded by K12 independently of the megaplasmid. We also demonstrated that K12 adheres to and invades human vaginal epithelial cells at levels comparable to GBS. Inhibitory activity of K12 was examined in vivo using a mouse model of GBS vaginal colonization. Mice colonized with GBS were treated vaginally with K12. K12 administration significantly reduced GBS vaginal colonization in comparison to nontreated controls, and this effect was partially dependent on the K12 megaplasmid. Our results suggest that K12 may have potential as a preventative therapy to control GBS vaginal colonization and thereby prevent its transmission to the neonate during pregnancy. S treptococcus agalactiae (group B streptococcus [GBS]) is aGram-positive organism that is currently the leading infectious agent responsible for neonatal morbidity and mortality in the United States (1). The primary risk factor for newborn disease is maternal GBS colonization within the gastrointestinal or vaginal tract (1). GBS colonization of the vaginal tract during pregnancy may be constant, intermittent, or transient in nature among individual women (2). In lieu of an effective vaccine, the current recommendations from the Centers for Disease Control and Prevention include late-gestational screening and intrapartum antibiotic prophylaxis (IAP) for GBS-positive mothers, which has resulted in reduced early-onset GBS disease and infant colonization (1). However, IAP with ampicillin for GBS-positive mothers has been determined an independent risk factor for ampicillin-resistant Escherichia coli early-onset sepsis (3) and has recently been shown to reduce beneficial Bifidobacterium spp. in week-old newborn intestinal flora (4). There are likely to be other unrecognized negative effects of antibiotic exposure on long-term gut health, which prompts development of alternative prophylactic strategies. Several studies have proposed the use of probiotic strains to control GBS and have observed inhibitory acti...

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Vaginal bacterial flora of pregnant women colonized with group B streptococcus

Cited by 28 publications

References 16 publications

Dynamics of Streptococcus agalactiae Colonization in Women during and after Pregnancy and in Their Infants

Dynamics of Streptococcus agalactiae Colonization in Women during and after Pregnancy and in Their Infants

The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization

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