Advertisement

Prevalence of colonisation by group B streptococcus in pregnant patients in Taguatinga, Federal District, Brazil: a cross-sectional study

  • Fábio SiqueiraEmail author
  • Eli Mendes Ferreira
  • Iracema de Matos Calderon
  • Adriano Dias
Maternal- Fetal Medicine
  • 30 Downloads

Abstract

Propose

Group B streptococcus is responsible for severe infections in neonates resulting from vertical transmission from pregnant women colonized in the anal, perineal or vaginal regions. The identification of colonized patients and use of intrapartum prophylaxis may reduce the risk of neonatal infection.

Methods

A cross-sectional study of pregnant women of gestational age between 35 and 37 weeks was conducted. Material was collected from patients for laboratory identification of group B streptococcus. Epidemiological data, including weight, height, body mass index, antibiotic use during pregnancy, pathologies during pregnancy (diabetes, hypertensive diseases, and hypothyroidism), twinning, and others, were also collected from patients.

Results

The sample consisted of 501 pregnant women, and the prevalence of group B streptococcus was 14%. The mean age was 29 years, and the mean BMI was 30.7. During pregnancy, 204 patients had some type of infection, and 201 used antibiotics. Ninety-five patients were diagnosed with gestational diabetes mellitus and 74 with some type of hypertensive disease.

Conclusions

The prevalence of group B streptococcus observed did not differ from that observed in other studies. None of the factors studied can be considered as risk or protective factors for maternal colonization by group B streptococcus.

Keywords

Group B streptococcus Pregnancy Prevalence Colonization Antibiotics 

Notes

Acknowledgements

This study is funded by Fundação de Ensino e Pesquisa em Ciências da Saúde-FEPECS (BR) (Grant no. 064.000.052/2012)

Author contributions

FS: project development, data collection, data analysis, and manuscript writing. AD: project development, data analysis, and manuscript editing. EMF: data collection and manuscript editing. IMC: data analysis and manuscript editing.

Funding

Health Sciences Education and Research Foundation (Fundação de Ensino e Pesquisa em Ciências da Saúde—FEPECS) of the Federal District. Thanks to Dra Riane Floriano, Gynecologist and Obstetrician, for their help in the collection of samples.

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest in this study.

References

  1. 1.
    Shah M, Aziz N, Leva N, Cohan D (2011) Group B Streptococcus colonization by HIV status in pregnant women: prevalence and risk factors. J Womens Health (Larchmt) 20(11):1737–1741Google Scholar
  2. 2.
    de-Paris F, Mombach AB, Machado P, Gheno TC, Ascoli BM, Oliveira KR et al (2011) Group B Streptococcus detection: comparison of PCR assay and culture as a screening method for pregnant women. Braz J Infect Dis 15(4):323–327Google Scholar
  3. 3.
    Dyke MKV, Phares CR, Lynfield R, Thomas AR, Arnold KE, Craig AS et al (2009) Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med 360:2626–2636Google Scholar
  4. 4.
    Busetti M, D’Agaro P, Campello C (2007) Group B streptococcus prevalence in pregnant women from North-Eastern Italy: advantages of a screening strategy based on direct plating plus broth enrichment. J Clin Pathol 60:1140–1143Google Scholar
  5. 5.
    Konrad G, Katz A (2007) Épidémiologie de l’infection néonatale à streptocoques du groupe B à début précoce. Can Fam Physician 53:1054–1055Google Scholar
  6. 6.
    Berardi A, Rossi C, Guidotti I, Vellani G, Lugli L, Bacchi Reggiani ML et al (2014) Factors associated with intrapartum transmission of group B Streptococcus. Pediatr Infect Dis J 33(12):1211–1215Google Scholar
  7. 7.
    Sakata H (2012) Evaluation of intrapartum antibiotic prophylaxis for the prevention of early-onset group B streptococcal infection. J Infect Chemother 18(6):853–857Google Scholar
  8. 8.
    Hiller JE, McDonald HM, Darbyshire P, Crowther CA (2005) Antenatal screening for group B streptococcus: a diagnostic cohort study. BMC Pregnancy Childbirth 5:12Google Scholar
  9. 9.
    El Aila NA, Tency I, Claeys G, Saerens B, Cools P, Verstraelen H et al (2010) Comparison of different sampling techniques and of different culture methods for detection of group B streptococcus carriage in pregnant women. BMC Infect Dis 10:285Google Scholar
  10. 10.
    Le Doare K, Heath PT (2013) An overview of global GBS epidemiology. Vaccine 31(Suppl 4):D7–D12Google Scholar
  11. 11.
    Verani JR, McGee L, Schrag SJ (2010) Prevention of perinatal group B streptococcal disease–revised guidelines from CDC, 2010. MMWR Recomm Rep 59(RR-10):1–36Google Scholar
  12. 12.
    Krohn MA, Hillier SL, Baker CJ (1999) Maternal peripartum complications associated with vaginal group B streptococci colonization. J Infect Dis 179(6):1410–1415Google Scholar
  13. 13.
    Função JM, Narchi NZ (2013) A study of group B streptococcus in pregnant women of eastern Sao Paulo. Rev Esc Enfer USP 47(1):22–29Google Scholar
  14. 14.
    Edwards MS, Gonik B (2012) Preventing the broad spectrum of perinatal morbidity and mortality through group B streptococcal vaccination. Vaccine 31(Supp 4):D66–71Google Scholar
  15. 15.
    Schrag SJ, Verani JR (2013) Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease: experience in the US and implications for a potential group B streptococcal vaccine. Vaccine 31(Suppl 4):D20–D26Google Scholar
  16. 16.
    Barcaite E, Bartusevicius A, Tameliene R, Maleckiene L, Vitkauskiene A, Nadisauskiene R (2012) Group B streptococcus and Escherichia coli colonization in pregnant women and neonates in Lithuania. Int J Gynaecol Obstet 117(1):69–73Google Scholar
  17. 17.
    Numanovic F, Smajlovic J, Gegic M, Delibegovic Z, Bektas S, Halilovic E et al (2017) Presence and resistance of Streptococcus agalactiae in vaginal specimens of pregnant and adult non-pregnant women and association with other aerobic bacteria. Med Glas (Zenica) 14(1):98–105Google Scholar
  18. 18.
    Khan MA, Faiz A, Ashshi AM (2015) Maternal colonization of group B streptococcus: prevalence, associated factors and antimicrobial resistance. Ann Saudi Med 35(6):423–427Google Scholar
  19. 19.
    Le Doare K, Jarju S, Darboe S, Warburton F, Gorringe A, Heath PT et al (2016) Risk factors for group B streptococcus colonisation and disease in Gambian women and their infants. J Infect 72(3):283–294Google Scholar
  20. 20.
    Krasnianin E, Skret-Magierlo J, Witalis J, Barnas E, Kluz T, Koziel A et al (2009) The incidence of streptococcus group B in 100 parturient women and the transmission of pathogens to the newborn. Ginekol Pol 80(4):285–289Google Scholar
  21. 21.
    Brzychczy-Wloch M, Wojkowska-Mach J, Helwich E, Heczko PB (2013) Incidence of maternal GBS colonization and neonatal GBS disease among very low birth weight Polish neonates. Med Sci Monit 19:34–39Google Scholar
  22. 22.
    Mengist A, Kannan H, Abdissa A (2016) Prevalence and antimicrobial susceptibility pattern of anorectal and vaginal group B Streptococci isolates among pregnant women in Jimma, Ethiopia. BMC Res Notes 9:351Google Scholar
  23. 23.
    Capanna F, Emonet SP, Cherkaoui A, Irion O, Schrenzel J, Martinez de Tejada B (2013) Antibiotic resistance patterns among group B Streptococcus isolates: implications for antibiotic prophylaxis for early-onset neonatal sepsis. Swiss Med Wkly 143:w13778Google Scholar
  24. 24.
    Miyata A, Takahashi H, Kubo T, Watanabe N, Tsukamoto K, Ito Y et al (2012) Early-onset group B streptococcal disease following culture-based screening in Japan: a single center study. J Obstet Gynaecol Res 38(8):1052–1056Google Scholar
  25. 25.
    Beraldo C, Brito ASJ, Saridakis HO, Matsuo T (2004) Prevalência da colonização vaginal e anorretal por estreptococo de grupo B em gestantes do terceiro trimestre. Rev Bras Ginecol Obstet 26(7):543–549Google Scholar
  26. 26.
    Alves VMN, Simões JA (2005) Prevalência e fatores associados ã colonização retal e vaginal pelo estreptococo do grupo B em parturientes e suas características fenotípicas—Resumo de Tese. Rev Bras Ginecol Obstet 27(7):435Google Scholar
  27. 27.
    Pogere A, Soccoli CM, Tobouti NR, Freitas PF, d’Acampora AJ, Zunino JN (2005) Prevalência da colonização pelo estreptococo do grupo B em gestantes atendidas em ambulatório de pré-natal. Rev Bras Ginecol Obstet 27(4):174–180Google Scholar
  28. 28.
    Zusman AS, Baltimore RS, Fonseca SN (2006) Prevalence of maternal group B streptococcal colonization and related risk factors in a Brazilian population. Braz J Infect Dis 10(4):242–246Google Scholar
  29. 29.
    Costa ALR, Filho FL, Chein MBC, Brito LMO, Lamy SC, Andrade KL (2008) Prevalência de colonização por estretococos do grupo B em gestantes antedndidas em maternidade pública da região Nordeste do Brasil. Rev Bras Ginecol Obstet 30(8):274–280Google Scholar
  30. 30.
    Nomura ML, Passini Junior R, Oliveira UM, Calil R (2009) Group B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor. Rev Bras Ginecol Obstet 31(8):397–403Google Scholar
  31. 31.
    Soares GC, Alviano DS, da Silva Santos G, Alviano CS, Mattos-Guaraldi AL, Nagao PE (2013) Prevalence of group B streptococcus serotypes III and V in pregnant women of Rio de Janeiro, Brazil. Braz J Microbiol 44(3):869–872Google Scholar
  32. 32.
    Melo SC, Santos NC, Oliveira M, Scodro RB, Cardoso RF, Padua RA et al (2016) Antimicrobial susceptibility of streptococcus agalactiae isolated from pregnant women. Rev Inst Med Trop Sao Paulo 58:83Google Scholar
  33. 33.
    Johri AK, Lata H, Yadav P, Dua M, Yang Y, Xu X et al (2013) Epidemiology of group B streptococcus in developing countries. Vaccine 31(Suppl 4):D43–D45Google Scholar
  34. 34.
    Dutra VG, Alves VM, Olendzki AN, Dias CA, de Bastos AF, Santos GO et al (2014) Streptococcus agalactiae in Brazil: serotype distribution, virulence determinants and antimicrobial susceptibility. BMC Infect Dis 14:323Google Scholar
  35. 35.
    Edmond KM, Kortsalioudaki C, Scott S, Schrag S, Zaidi AK, Cousens S et al (2012) Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. Lancet 379(9815):547–556Google Scholar
  36. 36.
    Fröhlicher S, Reichen-Fahrni G, Muller M, Surbek D, Droz S, Spellerberg B et al (2014) Serotype distribution and antimicrobial susceptibility of group B streptococci in pregnant women: results from a Swiss tertiary centre. Swiss Med Wkly 144:w13935Google Scholar
  37. 37.
    Brzychczy-Wloch M, Gosiewski T, Bulanda M (2014) Multilocus sequence types of invasive and colonizing neonatal group B streptococci in Poland. Med Princ Pract 23(4):323–330Google Scholar
  38. 38.
    Bekker V, Bijlsma MW, van de Beek D, Kuijpers TW, van der Ende A (2014) Incidence of invasive group B streptococcal disease and pathogen genotype distribution in newborn babies in the Netherlands over 25 years: a nationwide surveillance study. Lancet Infect Dis 14(11):1083–1089Google Scholar
  39. 39.
    Lu B, Li D, Cui Y, Sui W, Huang L, Lu X (2014) Epidemiology of group B streptococcus isolated from pregnant women in Beijing, China. Clin Microbiol Infect 20(6):O370–O373Google Scholar
  40. 40.
    Poulain P, Betremieux P, Donnio PY, Proudhon JF, Karege G, Giraud JR (1997) Selective intrapartum anti-bioprophylaxy of group B streptococci infection of neonates: a prospective study in 2454 subsequent deliveries. Eur J Obstet Gynecol Reprod Biol 72(2):137–140Google Scholar
  41. 41.
    Bianco A, Larosa E, Pileggi C, Pavia M, Collaborative Working Group (2016) Appropriateness of intrapartum antibiotic prophylaxis to prevent neonatal group B streptococcus disease. PLoS ONE 11(11):e0166179Google Scholar
  42. 42.
    England Public Health London (2015) Enriched culture medium test for group B streptococcus infection. https://www.gov.uk/phe. Accessed 5 Feb 2018
  43. 43.
    Secretaria Municipal da Saúde (2017) Nota Técnica prevenção da infecção neonatal pelo streptococcus agalactiae. In: Áreas técnicas da saúde da mulher e da criança, Secretaria Municipal da Saúde, São PauloGoogle Scholar
  44. 44.
    Silva JM, Stein AT, Schunemann HJ, Bordin R, Kuchenbecker R, de Lourdes Drachler M (2013) Academic detailing and adherence to guidelines for group B streptococci prenatal screening: a randomized controlled trial. BMC Pregnancy Childbirth 13:68Google Scholar
  45. 45.
    Ministério da Saúde (2014) Direito de informação da gestante e obrigatoriedade do cartão da gestante, carta de informação de partograma na saúde suplementar. In: Agência Nacional de Saúde Complementar, Ministério da Saúde, BrasíliaGoogle Scholar
  46. 46.
    IPEA (2014) Objetivos de Desenvolvimento do Milênio: Relatório Nacional de Acompanhamento. In: Instituto de Pesquisa Econômica Aplicada e Secretaria de Manejamento e Investimentos Estratégicos, editor. : IPEA, BrasíliaGoogle Scholar
  47. 47.
    Ministério da Saúde (2014) Política Nacional de Atenção Integral à Saúde da Mulher: princípios e diretrizes. In: Secretaria de Atenção à Saúde, Ministério da SaúdeGoogle Scholar
  48. 48.
    Brasil (2003) Urgências e Emergências Maternas. Secretaria de Políticas de Saúde, Área Técnica da Saúde da Mulher, Ministério da SaúdeGoogle Scholar
  49. 49.
    Sullivan KM, Dean A, Soe MM (2009) OpenEpi: a web-based epidemiologic and statistical calculator for public health. Public Health Rep 124(3):471–474Google Scholar
  50. 50.
    Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A (2002) Prevention of perinatal group B streptococcal disease Revised guidelines from CDC. MMWR Recomm Rep 51(RR-11):1–22Google Scholar
  51. 51.
    CDC (1996) Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep 45(RR-7):1–24Google Scholar
  52. 52.
    Alos-Cortes JI, Andreu-Domingo A, Arribas-Mir L, Cabero-Roura L, de Cueto-Lopez M, Lopez-Sastre J et al (2013) Prevention of neonatal group B sreptococcal infection. Spanish recommendations update 2012 SEIMC/SEGO/SEN/SEQ/SEMFYC consensus document. Enferm Infecc Microbiol Clin 31(3):159–172Google Scholar
  53. 53.
    Bryant AS, Cheng YW, Caughey AB (2011) Equality in obstetrical care: racial/ethnic variation in group B streptococcus screening. Matern Child Health J 15(8):1160–1165Google Scholar
  54. 54.
    David W, Hosmer J, Lemeshow S (2005) Applied logistic regression. 2nd Edn. Hoboken, NJ, WileyGoogle Scholar
  55. 55.
    Ueno H, Yamamoto Y, Yamamichi A, Kikuchi K, Kobori S, Miyazaki M (2012) Characterization of group B streptococcus isolated from women in Saitama city, Japan. Jpn J Infect Dis 65(6):516–521Google Scholar
  56. 56.
    Capraro GA, Rambin ED, Vanchiere JA, Bocchini JA Jr, Matthews-Greer JM (2013) High rates of inducible clindamycin resistance among prenatal group B streptococcal isolates in one northwest Louisiana academic medical center. J Clin Microbiol 51(7):2469Google Scholar
  57. 57.
    Lee WT, Lai MC (2014) High prevalence of Streptococcus agalactiae from vaginas of women in Taiwan and its mechanisms of macrolide and quinolone resistance. J Microbiol Immunol Infect 48(5):510–516Google Scholar
  58. 58.
    Yeung SW, Sahota DS, Leung TY (2014) Comparison of the effect of penicillins versus erythromycin in preventing neonatal group B streptococcus infection in active carriers following preterm prelabor rupture of membranes. Taiwan J Obstet Gynecol. 53(2):210–214Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Federal District State Secretariat of Health (Secretaria de Estado de Saúde do Distrito Federal)BrasiliaBrasil
  2. 2.Graduate Program in Obstetrics Gynaecology and MastologyPaulista State University (Universidade Estadual Paulista, UNESP), Campus de BotucatuBotucatuBrazil
  3. 3.Graduate Program in Collective (Public) HealthPaulista State University (Universidade Estadual Paulista, UNESP), Campus de BotucatuBotucatuBrazil
  4. 4.Hospital Regional de Taguatinga, Farmácia HospitalarTaguatingaBrazil

Personalised recommendations