Dataset Information

Performance of Hitchens-Pike-Todd-Hewitt medium for group B streptococcus screening in pregnant women.

ABSTRACT: Group B streptococcus (GBS), which commonly colonizes the female genital tract and rectum, can cause infections in newborns with varying severity, possibly leading to death. The aim of the present study was to evaluate Hitchens-Pike-Todd-Hewitt (HPTH) medium performance for GBS screening in pregnant women. A descriptive analytical cross-sectional study was performed with 556 pregnant women, of which 496 were at 35-37 weeks of gestation and 60 were at ? 38 weeks of gestation. The study was conducted from September 2011 to March 2014 in northern Paraná, Brazil. Vaginal and anorectal clinical specimens from each pregnant woman were plated on sheep blood agar (SBA) and seeded on HPTH medium and Todd-Hewitt enrichment broth. Of the 496 pregnant women at 35-37 weeks of gestation, 141 (28.4%) were positive for GBS, based on the combination of the three culture media and clinical specimens. The GBS colonization rates that were detected by each medium were 22.2% for HPTH medium, 21.2% for SBA, and 13.1% for Todd-Hewitt enrichment broth. Of the 60 pregnant women at ? 38 weeks of gestation, seven (11.7%) were positive for GBS. These results demonstrate that HPTH medium and SBA were more sensitive than Todd-Hewitt enrichment broth for GBS screening in pregnant women and good GBS recovery in culture, indicating that the two media should be used together for vaginal and anorectal specimens.

SUBMITTER: de Melo SC

PROVIDER: S-EPMC4400012 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Performance of Hitchens-Pike-Todd-Hewitt medium for group B streptococcus screening in pregnant women.

de Melo Simone Cristina Castanho Sabaini SC Gavena Angela Andréia França AA Silva Flávia Teixeira Ribeiro FT Moreira Ricardo Castanho RC de Lima Scodro Regiane Bertin RB Cardoso Rosilene Fressatti RF Siqueira Vera Lúcia Dias VL de Pádua Rúbia Andreia Faleiros RA Carvalho Maria Dalva de Barros MD Pelloso Sandra Marisa SM

PloS one 20150416 4

Group B streptococcus (GBS), which commonly colonizes the female genital tract and rectum, can cause infections in newborns with varying severity, possibly leading to death. The aim of the present study was to evaluate Hitchens-Pike-Todd-Hewitt (HPTH) medium performance for GBS screening in pregnant women. A descriptive analytical cross-sectional study was performed with 556 pregnant women, of which 496 were at 35-37 weeks of gestation and 60 were at ≥ 38 weeks of gestation. The study was conduc ...[more]

PMID: 25881083

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Project description:BACKGROUND:Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test. METHODS:We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected. RESULTS:In April and May 2015, 200 women were enrolled with a median age of 27?years (IQR: 23-32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38?weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women. CONCLUSIONS:Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.

Project description:BackgroundVaginal microbiome studies frequently report diversity metrics and communities of microbiomes associated with reproductive health outcomes. Reports of Streptococcus agalactiae (also known as Group B Streptococcus or GBS), the leading cause of neonatal infectious morbidity and mortality, are notably lacking from the studies of the vaginal microbiome, despite being a known contributor to preterm birth and other complications. Therefore, the purpose of this systematic review was to explore the frequency of GBS reporting in vaginal microbiome literature pertaining to pregnancy and to examine methodological bias that contributes to differences in species and genus-level microbiome reporting. Lack of identification of GBS via sequencing-based approaches due to methodologic or reporting bias may result incomplete understanding of bacterial composition during pregnancy and subsequent birth outcomes.MethodologyA systematic review was conducted following the PRISMA guideline. Three databases (PubMed, CINAHL, and Web of Science) were used to identify papers for review based on the search terms "vaginal microbiome", "pregnancy", and "16S rRNA sequencing". Articles were evaluated for methods of DNA extraction and sequencing, 16S region, taxonomy classification database, number of participants or vaginal specimens, and pregnancy trimester.ResultsForty-five research articles reported employing a metagenomic approach or 16S approach for vaginal microbiome analysis during pregnancy that explicitly reported taxonomic composition and were included in this review. Less than 30% of articles reported the presence of GBS (N = 13). No significant differences in methodology were identified between articles that reported versus did not report GBS. However, there was large variability across research methods used for vaginal microbiome analysis and species-level bacterial community reporting.ConclusionConsiderable differences in study design and data formatting methods may contribute to underrepresentation of GBS, and other known pathogens, in existing vaginal microbiome literature. Previous studies have identified considerable variation in methodology across vaginal microbiome studies. This study adds to this body of work because in addition to laboratory or statistical methods, how results and data are shared (e.g., only analyzing genus level data or 20 most abundant microbes), may hinder reproducibility and limit our understanding of the influence of less abundant microbes. Sharing detailed methods, analysis code, and raw data may improve reproducibility and ability to more accurately compare microbial communities across studies.

Dataset Information

Performance of Hitchens-Pike-Todd-Hewitt medium for group B streptococcus screening in pregnant women.

Publications

Performance of Hitchens-Pike-Todd-Hewitt medium for group B streptococcus screening in pregnant women.

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