Prevalence of maternal intrapartum colonization due to the Group-B Streptococus: epidemiological analysis in the province of Jaén (Spain)
e202209064
Keywords:
Group B streptococcus, Perinatal infection, Rectum, Vagina, Pregnancy, Delivery, Vertical transmissionAbstract
BACKGROUND // Group B Streptococcus (GBS) infection remains to datey, without peripartum prophylaxis, the most common cause of vertically transmitted perinatal bacterial infection in the Western world. It is estimated that the prevalence of asymptomatic pregnant women with GBS in our country ranges between 10 and 20.5%, but there are few studies in this regard. With this research, we tried to establish the rate of pregnant women colonized by GBS at the recto-vaginal level at the time of delivery and to evaluate the validity of our strategy for the identification of pregnant women with GBS.
METHODS // A 290 women sample representative of pregnant population from the province of Jaén was randomly selected and the presence or absence of GBS in the recto-vaginal microbiota was determined on the day of delivery. Subsequently, a retrospective analysis was made, case by case, in order to establish whether the screening techniques applied during pregnancy had been able to correctly identify the state of GBS colonization at the time of delivery. Statistical techniques were applied to perform a descriptive sample analysis, which was complemented with a case-by-case concordance analysis for the two GBS determinations made over time for each subject (repeated observations over time on individuals from the same cohort).
RESULTS // The rate of pregnant women carrying GBS at the recto-vaginal level at the time of delivery was 23.10%.
CONCLUSIONS // In our province, the rate of pregnant women with GBS at the time of delivery is higher than previously reported in the literature. Furthermore, our screening strategy during pregnancy could misclassify one of each eight women, causing one in sixteen GBS carriers to not be adequately identified.
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References
Armistead B, Oler E, Adams K, Rajagopal L. The Double Life of Group B Streptococcus: Asymptomatic Colonizer and Potent Pathogen. J Mol Biol. 2019; 431:2914-2931.
Paoletti LC, Kasper DL. Surface Structures of Group B Streptococcus Important in Human Immunity. Microbiol Spectr. 2019; 7:2.
Lawn JE, Bianchi-Jassir F, Russell N, Kohli-Lynch M, Tann C, Hall J et al. Group B streptococcal disease worldwide for pregnant women, stillbirths, and children: why, what, and how to undertake estimates? Clin Infect Dis 2017; 65:89-99.
Russell NJ, Seale AC, O’Driscoll, O´Sullivan C, Bianchi-Jassir F, Gonzáes guarín J et al. Maternal Colonization With Group B Streptococcus and Serotype Distribution Worldwide: Systematic Review and Meta-analyses. Clin Infect Dis 2017; 65:100-111.
Regan JA, Klebanoff MA, Nugent RP, Eschenbach DA, Backwelder WC, Lou Y et al. Colonization with group B streptococci in pregnancy and adverse outcome. Am J Obstet Gynecol. 1996; 174:1354-1360.
Bianchi-Jassir F, Seale AC, Kohli-Lynch M, Lawn JE, Baker CJ, Barlett L et al. Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses. Clin Infect Dis 2017; 65:133-142.
Kruk CR, Feuerschuette OH, da Silveira SK, Cordazo M, Trapani A. Epidemiologic profile of Streptococcus agalactiae colonization in pregnant women attending prenatal care in a city of southern of Brazil. Braz J Infect Dis. 2013; 17:722-723.
Schuchat A. Group B streptococcus. Lancet. 1999; 353:51-56.
Fairlie T, Zell ER, Schrag S. Effectiveness of intrapartum antibiotic prophylaxis for prevention of early-onset group B streptococcal disease. Obstet Gynecol. 2013; 21:570-577.
Alós JI, Andreu A, Arribas L. Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. Enferm Infecc Microbiol Clin. 2013;31:159-172.
Álvarez EM, Jaqueti J, García I. Tasas de colonización por Streptococcus agalactiae en gestantes españolas y extranjeras en el Hospital Universitario de Fuenlabrada. Rev Esp Quimioter 2018; 31:274-277.
Fraile R, Rodríguez J, De Cueto, Sampedro A, Gaye EB, Haro JM et al. Use of Granada medium to detect group B streptococcal colonization in pregnant women. J Clin Microbiol. 1999; 37:2674-6777.
Ramos JM, Milla A, López-García. Estudio de colonización por Streptococcus agalactiae en gestante extranjeras y españolas, en Elche y comarca. Enferm Infecc Microbiol Clin. 2009; 27:249-251.
Aznar J. Manual de obtención y manejo de muestras para el laboratorio clínico. Servicio Andaluz de Salud. Sevilla: Consejería de Salud. Junta de Andalucía 2009. Disponible en: https://www.sspa.juntadeandalucia.es/servicioandaluzdesalud/publicaciones/manual-de-obtencion-y-manejo-de-muestras-para-el-laboratorio-clinico-2009
Rogan WJ, Gladen B. Estimating prevalence from the results of a screening test. Am J Epidemiol. 1978;107:71-76.
Turrentine MA, Colicchia LC, Hirsch E.,Cheng, Tam T, Ramsey P et al. Efficiency of Screening for the Recurrence of Antenatal Group B Streptococcus Colonization in a Subsequent Pregnancy: A Systematic Review and Metaanalysis with Independent Patient Data. Am J Perinatol. 2016; 33:510-517.
Bliss SJ, Manning SD, Tallman P, Baker CJ, Pearlman MD, Marrs CF et al. Group B Streptococcus colonization in male and nonpregnant female university students: A cross-sectional prevalence study. Clin Infect Dis. 2002;15:184-190.
Hasperhoven F, Al-Nasiry S, Bekker V. Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent early-onset group B streptococcal disease: a systematic review and meta-analysis. BJOG. 2020; 127:680-691.
Li QY, Wang DY, Li HT, Lui JM. Screening-based and Risk-based Strategy for the Prevention of Early-onset Group B Streptococcus/Non-group B Streptococcus Sepsis in the Neonate: A Systematic Review and Meta-analysis. Pediatr Infect Dis J. 2020; 39:740-748.
Swamy GK , Metz TD, Edwards KM, Soper DE, Beigi RH, Campbell JD et al. Safety and immunogenicity of an investigational maternal trivalent group B streptococcus vaccine in pregnant women and their infants: Results from a randomized placebo-controlled phase II trial Vaccine. 2020; 38:6930-6940.
Dzani S, Madhi SA. Systematic review of the clinical development of group B streptococcus serotype-specific capsular polysaccharide-based vaccines Expert Rev Vaccines. 2018; 17:635-651.
Berardi A, Cassetti T, Creti R, Vocale C, Ambretti S, Sarti M et al. The Italian arm of the PREPARE study: an international project to evaluate and license a maternal vaccine against group B streptococcus. Ital J Pediatr. 2020; 46:160.
Ohlsson A, Shah VS, Stade BC. Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD003520. DOI: https://www.doi.org/10.1002/14651858.CD003520.pub3
Jois RS, Tan JK, Silva D. Do probiotics in pregnancy reduce the risk of group B streptococcal colonisation? J Paediatr Child Health. 2020; 56:1468-1472.
Verani JR, McGee L, Schrag SJ, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). 2010 Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep 59(RR-10):1-36.
Raignoux J, Benard M, Huo Y, Dicky O, Berrebi A, Bibet L et al. Is a rapid intrapartum vaginal screeening test of group B streptococci (GSB) during partum useful in identifying infans developing early-onset GBS sepsis in postpartum period? Arch Pediatr. 2016; 23:899-907.
Hu S, Zhong H, Huang W, Zhan W, Yang X, Tang B et al. Rapid and visual detection of Group B streptococcus using recombinase polymerase amplification combined with lateral flow strips. Diagn Microbiol Infect Dis. 2019; 93:9-13.
Valkenburg-van den Berg AW, Houtman-Roelofsen RL, Oostvogel PM, Dekker FW, Dörr PJ Sprig AJ. Timing of group B streptococcus screening in pregnancy: a systematic review. Gynecol Obstet Invest. 2010; 69:174-183.
Moroi H, Kimura K, Kotani T, Tsuda H, Banno H, Jin W et al. Isolation of group B Streptococcus with reduced β-lactam susceptibility from pregnant women. Emerg Microbes Infect. 2019; 8:2-7.
Guo D, Cao X, Li S. Neonatal colonization of group B Streptococcus in China: Prevalence, antimicrobial resistance, serotypes, and molecular characterization. Am J Infect Control. 2018; 46:19-24.
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Copyright (c) 2022 Jesús Joaquín Hijona Elósegui, Antonio Luis Carballo García, Ana Cristina Fernández Rísquez, Martín Bermúdez Quintana, Juan Francisco Expósito Montes
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