Dataset Information

High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan.

ABSTRACT: 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.

SUBMITTER: Clouse K

PROVIDER: S-EPMC6528311 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan.

Clouse Kate K Shehabi Asem A Suleimat Abel Mani AM Faouri Samir S Khuri-Bulos Najwa N Al Jammal Abeer A Chappell James J Fortner Kimberly B KB Chamby Anna B AB Randis Tara M TM Ratner Adam J AJ Aronoff David M DM Halasa Natasha N

BMC pregnancy and childbirth 20190520 1

<h4>Background</h4>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.<h4>Methods</h4>We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to id ...[more]

PMID: 31109301

Similar Datasets

Project description:BackgroundMaternal Group B Streptococcus (GBS) recto-vaginal colonization is the most common route for early onset neonatal GBS diseases. A good understanding of the rate of maternal GBS colonization, vertical transmission rate, and antibiotic susceptibility profiles is needed to formulate a broad protection mechanism, like vaccine preparation. For that reason, this meta-analysis aimed at determining the pooled prevalence of GBS recto-vaginal colonization, vertical transmission rate, and antibiotic susceptibility profiles in Ethiopia.MethodsBoth published and unpublished studies were searched from MEDLINE/PubMed, CINAHL (EBSCO), Embase, Cochrane Library, SCOPUS, Web of Sciences databases, and Google Scholar. Independent selection was then carried out by the authors based on the eligibility criteria and data extraction using Microsoft excel. The authors then used STATA version 14.1 software for further cleaning and analysis. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines. Using the random-effect model, the prevalence with a 95% confidence interval (CI) and forest plot were used to present the findings. Besides, the studies' heterogeneity was assessed using Cochrane chi-square (I2) statistics, while Egger intercept was used to assess publication bias.ResultsThis review included nineteen studies. The pooled prevalence of recto-vaginal colonization was 15% (95% CI: 11, 19), while the prevalence of vertical transmission was 51% (95% CI: 45, 58) and highest-level susceptibility to vancomycin was 99% (95% CI: 98, 100). However, the GBS susceptibility to tetracycline was 23% (95% CI: 9, 36).ConclusionsNearly one out of seven pregnant women in Ethiopia had recto-vaginal colonization of GBS. As a result, half of the pregnancies end with vertical transmission of GBS. Hence, the review emphasizes that policy and programs should consider planning and implementing prophylactic programs.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287540.

Project description:BackgroundStreptococcus agalactiae or group B Streptococcus (GBS) asymptomatically colonizes the genitourinary tracts of up to 30% of pregnant women. Globally, GBS is an important cause of neonatal morbidity and mortality. GBS has recently been linked to adverse pregnancy outcomes. The potential interactions between GBS and the vaginal microbiome composition remain poorly understood. In addition, little is known about the vaginal microbiota of pregnant Egyptian women.ResultsUsing V3-V4 16S rRNA next-generation sequencing, we examined the vaginal microbiome in GBS culture-positive pregnant women (22) and GBS culture-negative pregnant women (22) during the third trimester in Ismailia, Egypt. According to the alpha-diversity indices, the vaginal microbiome of pregnant GBS culture-positive women was significantly more diverse and less homogenous. The composition of the vaginal microbiome differed significantly based on beta-diversity between GBS culture-positive and culture-negative women. The phylum Firmicutes and the family Lactobacillaceae were significantly more abundant in GBS-negative colonizers. In contrast, the phyla Actinobacteria, Tenericutes, and Proteobacteria and the families Bifidobacteriaceae, Mycoplasmataceae, Streptococcaceae, Corynebacteriaceae, Staphylococcaceae, and Peptostreptococcaceae were significantly more abundant in GBS culture-positive colonizers. On the genus and species levels, Lactobacillus was the only genus detected with significantly higher relative abundance in GBS culture-negative status (88%), and L. iners was the significantly most abundant species. Conversely, GBS-positive carriers exhibited a significant decrease in Lactobacillus abundance (56%). In GBS-positive colonizers, the relative abundance of the genera Ureaplasma, Gardnerella, Streptococcus, Corynebacterium, Staphylococcus, and Peptostreptococcus and the species Peptostreptococcus anaerobius was significantly higher. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways related to the metabolism of cofactors and vitamins, phosphatidylinositol signaling system, peroxisome, host immune system pathways, and host endocrine system were exclusively enriched among GBS culture-positive microbial communities. However, lipid metabolism KEGG pathways, nucleotide metabolism, xenobiotics biodegradation and metabolism, genetic information processing pathways associated with translation, replication, and repair, and human diseases (Staphylococcus aureus infection) were exclusively enriched in GBS culture-negative communities.ConclusionsUnderstanding how perturbations of the vaginal microbiome contribute to pregnancy complications may result in the development of alternative, targeted prevention strategies to prevent maternal GBS colonization. We hypothesized associations between inferred microbial function and GBS status that would need to be confirmed in larger cohorts.

Project description:BackgroundStreptococcus Group B (GBS) colonization in pregnant women is the most important risk factor for newborn disease due to vertical transmission during delivery. GBS colonization during pregnancy has been implicated as a leading cause of perinatal infections. Traditionally, pregnant women are screened for GBS between 35 and 37 weeks of gestation. However, antenatal culture-based screening yields no information on GBS colonization status and offers low predictive value for GBS colonization at delivery. Numerous assays have been evaluated for GBS screening in an attempt to validate a fast and efficient method. The aim of this study was to compare bacteria isolation by culture and two qPCR techniques, targeting sip and cfb genes, respectively, for detecting colonizing GBS.MethodsCultures - the gold-standard technique, a previous qPCR technique targeting the sip gene, and a new proposed qPCR assay targeting the cfb gene were evaluated as diagnostic tools on 320 samples.ResultsConsidering cultures as the gold standard, the evaluated qPCR method detected 75 out of 78 samples, representing a sensitivity of 93.58% (95% confidence interval (CI), 90.89-96.27) and specificity of 94.62% (95% CI, 91.78-97.46). However, an additional analysis was performed for true positives that included not only samples showing positives by culture but samples showing positive for both qPCR assays. The sensitivity and specificity were recalculated including these discrepant samples and a total of 89 samples were considered as positive, giving a prevalence of 27.81%. With this new analysis, the qPCR targeting the cfb gene showed a sensitivity of 95.5% (95% CI, 88.65-98.59) and specificity of 99.13% (95% CI, 96.69-99.97).ConclusionsThe new qPCR method is a sensitive and specific assay for detecting GBS colonization and represents a valuable tool for identifying candidates for intrapartum antibiotic prophylaxis. Cultures should be retained as the reference and the routine technique because of its specificity and cost analysis ratio, but it would be convenient to introduce PCR techniques to check negative culture samples or when an urgent detection is required to reduce risk of infection among infants.

Dataset Information

High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan.

Publications

High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets