Vaginal Colonization with Group B Streptococcus: A Study in College Women

Baker, Carol J.; Goroff, Diana K.; Alpert, Susan; Crockett, Vicki Ann; Zinner, Stephen H.; Evrard, John R.; Rosner, Bernard; McCormack, William M.

doi:10.1093/infdis/135.3.392

Cited by 104 publications

(44 citation statements)

References 12 publications

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“…Similarly, although Baker and others found higher prevalence rates in sexually experienced women as compared to virgin women, no association was seen with increased numbers of sexual partners. 27 Confirming the results of an earlier study in Peru, 28 the prevalence of syphilis was very low in our population. In contrast, the prevalence rate of chlamydial infection in our family planning clinic population (11.7%) was similar to rates found in family planning clinics in San Antonio, Texas (10.5%), 29 South Carolina (16.6%), 30 and Seattle, Washington (9.3%).…”

Section: Discussionsupporting

confidence: 92%

Group B streptococcal colonization in a developing country: its association with sexually transmitted disease and socioeconomic factors.

Collins¹,

Calderón²,

Gilman³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Group B Streptococcus (GBS) is an important infectious organism in pregnant women and their neonates. Although excellent data are available from the developing world, little epidemiologic information is available from Latin America. To evaluate the prevalence of GBS colonization in a developing country, a prospective study was performed in Lima, Peru. We found a relatively low prevalence of GBS colonization of 6.0% in parturient women and 10.6% in nonpregnant women. No association of GBS colonization was made with previously identified risk factors such as age, parity, or birth control practices. We did find a positive association between GBS colonization and chlamydial carriage (P Ͻ 0.05). We also report an even distribution of GBS serotypes: Ia/c ϭ 35%, IIc ϭ 18%, III ϭ 29%, and V ϭ 18%. Our study provides evidence for a low prevalence of GBS maternal carriage in this urban Latin American population.Group B Streptococcus (GBS) is a cause of significant morbidity and mortality in certain populations of pregnant women and their neonates throughout the world. The attack rate for neonatal invasive disease, both early and late onset, is between 1.7 and 3.3 per 1,000 live births in the United States 1,2 and 0.2-0.6 per 1,000 live births in Europe, 3 Canada, 4 and Israel. 5 Case-fatality rates for the early-onset disease in the United States that range from 5% to 20% illustrate the seriousness of the infection. 6 A recent large multicenter study, the Vaginal Infections and Prematurity Study, detailed the association between heavy group B Streptococcal colonization and the delivery of a preterm, low-birth weight infant. 7 The infants born to the heavily colonized women were also at substantially increased risk of neonatal sepsis. Although excellent data are available from the developed world, there is little information on GBS invasive disease in the developing world. To our knowledge, only three maternal carriage studies have been performed in Latin America. [8][9][10] As the treatment of GBS by both chemoprophylaxis and vaccine becomes more refined, more GBS data is critical for effective public health planning. We performed a prospective study in Lima, Peru to evaluate the prevalence of GBS colonization in a developing country and its association with sexually transmitted disease. PATIENTS, MATERIALS, AND METHODSStudy design. This prospective study took place in Lima, Peru from August through October 1991. A parturient group of 151 women was chosen sequentially at La Maternidad de Lima, a large inner-city maternity hospital. Nonpregnant women were sampled sequentially in two clinical settings: 1) 60 women presenting to the family planning clinic at Loayza Hospital for a routine annual examination and birth control; and 2) 63 prostitutes presenting for their monthly clinic visit. Although the latter group was chosen for its high-risk sexual practices, these women are examined monthly, screened, and treated for sexually transmitted disease.Informed consent was obtained from all participants and human ethica...

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Section: Discussionsupporting

confidence: 92%

Group B streptococcal colonization in a developing country: its association with sexually transmitted disease and socioeconomic factors.

Collins¹,

Calderón²,

Gilman³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…The apparent discrepancies between the various findings may be consequences of the specificities of the populations studied. In particular, girl college students (2,4,12,19), pregnant women (1), and elderly women in menopause may present different characteristics depending on their gastrointestinal and genitourinary tract conditions and their sexual activity. Our study, assessing S. agalactiae colonization in a larger healthy population, which was representative of both sexes and a wide range of ages, brings additional data.…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Human-Colonizing Streptococcus agalactiae Strains Isolated from Throat, Skin, Anal Margin, and Genital Body Sites

et al. 2008

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Streptococcus agalactiae carriage was evaluated by sampling four body sites in a group of 249 healthy individuals including both sexes and a wide range of ages; the aims were to study the population structure of colonizing strains by multilocus sequence typing (MLST) and to evaluate their diversity by serotyping, SmaI macrorestriction analysis, and PCR screening for genetic markers of highly virulent clones for neonates. The prevalences of carriage were 27% in women and 32% in men. The major positive body site was the genital tract (23% in women and 21% in men); skin, throats, and anal margins were also positive in 2%, 4%, and 14%, respectively. These human-colonizing strains belonged mostly to serotypes III (24%), Ia (21%), V (18%), and Ib (17%). Twenty-three sequence types ( Streptococcus agalactiae is the pathogen most commonly responsible for maternofetal and neonatal infections, and serogroup III sequence type (ST) 17 strains of this species have been identified as more likely to cause these infections (3,17,(24)(25)(26)28).S. agalactiae infections in nonpregnant adults have been reported increasingly since the 1970s (5,7,10,14,20,21,23,26,27). The major clinical forms consist of skin, soft tissue, and bone infections; bacteremia; urinary tract infections; pneumonia; and peritonitis. More rarely, S. agalactiae is responsible for septic arthritis, meningitis, and endocarditis. Risk factors have been identified (16) and include an age of over 60 years and diagnoses of diabetes, cancer, decubitus acutus, AIDS, longcourse corticotherapy, chronic renal disease, cirrhosis, and neurological vessel disorders. However, cases of invasive S. agalactiae infections in immunocompetent nonpregnant adults have recently been reported (7,20,21,23). The physiopathology of these infections is not well understood and may be linked in part to S. agalactiae strains with particular properties.Reports on the genetic characteristics of the strains associated with infections in adults showed that they are diverse and belong mostly to serotypes Ia, III, and V (5, 14) and clonal complexes 1, 9, 17, 19, and 23 (17).The portal of entry of these infections in adults is not often well documented. A better knowledge of the genetic characteristics of the S. agalactiae strains colonizing various body sites would contribute to a better understanding of the origin of infections in adults. Although the molecular features of S. agalactiae strains isolated during infectious diseases have been described in many cases, little is known about the molecular characteristics of human-colonizing strains. Therefore, we screened for S. agalactiae carriage in 249 healthy individuals of both sexes; the individuals were living at home and covered a range of ages, from the start of the teenage period until old age. Genital, skin, throat, and anal margin carriage was sampled by self-swabbing. The strains isolated were serotyped. The population structure of the strains was investigated by multilocus sequence typing (MLST). The genetic diversity of isolates was ev...

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“…Although rapid detection techniques are available, none of these methods have the sensitivity needed to identify colonized women (5). Similarly, direct culture onto solid medium, such as sheep blood agar plates (SBAP), underestimates the actual incidence of rectovaginal colonization (3,4,15). Recently, new techniques have become available that may increase the sensitivity of group B streptococcus detection or decrease the turnaround time until detection.…”

mentioning

confidence: 99%

Evaluation of Methods To Increase the Sensitivity and Timeliness of Detection of Streptococcus agalactiae in Pregnant Women

et al. 2002

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Streptococcus agalactiae (group B streptococcus) is a significant cause of perinatal and neonatal infections in the United States. Colonization occurs in 10 to 30% of pregnant women (1, 7, 10) and is responsible for 1.8 neonatal infections per 1,000 live births per year (8). Neonatal colonization with group B streptococcus occurs in about 11% of babies (2). Screening of pregnant women for group B streptococcus is aimed at identifying those pregnancies at highest risk for developing maternal and neonatal diseases. The Centers for Disease Control and Prevention presently recommends culturing samples from pregnant women at 35 to 37 weeks gestation for S. agalactiae from vaginal and anorectal swabs after 18 to 24 h of growth in a selective enrichment medium, such as LIM or SBM (8). This process requires a minimum of 48 h to complete. A more rapid and sensitive method would be beneficial, especially in dealing with patients who present for delivery without any prenatal care. Although rapid detection techniques are available, none of these methods have the sensitivity needed to identify colonized women (5). Similarly, direct culture onto solid medium, such as sheep blood agar plates (SBAP), underestimates the actual incidence of rectovaginal colonization (3,4,15). Recently, new techniques have become available that may increase the sensitivity of group B streptococcus detection or decrease the turnaround time until detection. Granada agar is a differential medium that was developed to identify colonies of group B streptococci by their orange pigment production (9) while the AccuProbe S. agalactiae rRNA probe assay (GenProbe, San Diego, Calif.) was developed to detect bacterial rRNA. This study investigated the use of both Granada agar and the AccuProbe assay as potential methods for increasing the detection of S. agalactiae in pregnant women and in decreasing the turnaround time for reporting the results.Four hundred sixty-three serially collected anovaginal swab specimens were tested in parallel by three different group B streptococcus detection methods. Swabs were inoculated directly onto Granada agar (Hardy Diagnostics, Santa Maria, Calif.) and were then placed into LIM broth (Remel, Lenexa, Kans.). Granada agar was incubated anaerobically at 35°C and was examined after 24 and 48 h of incubation. S. agalactiae colonies were detected by their production of an orange pigment. Such colonies were confirmed as S. agalactiae by using the Streptex latex agglutination reagent (Murex Biotech Ltd., Dartford, England). LIM broth was incubated aerobically at 35°C for 18 to 24 h. The broth was then subcultured onto an SBAP (Remel) for detection of beta-hemolytic colonies after 24 h of additional growth on the solid medium. Beta-hemolytic colonies were again confirmed as S. agalactiae by using the Streptex latex agglutination reagent. Immediately after inoculating the SBAP, the LIM broth was thoroughly mixed by using a vortex-type mixer and a 50-l aliquot that was tested by using the AccuProbe S. agalactiae rRNA probe assay (Gen...

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Vaginal Colonization with Group B Streptococcus: A Study in College Women

Cited by 104 publications

References 12 publications

Group B streptococcal colonization in a developing country: its association with sexually transmitted disease and socioeconomic factors.

Group B streptococcal colonization in a developing country: its association with sexually transmitted disease and socioeconomic factors.

Molecular Characterization of Human-Colonizing Streptococcus agalactiae Strains Isolated from Throat, Skin, Anal Margin, and Genital Body Sites

Evaluation of Methods To Increase the Sensitivity and Timeliness of Detection of Streptococcus agalactiae in Pregnant Women

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