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Davi SD, Okwu DG, Luetgehetmann M, Abba FM, Aepfelbacher M, Endamne LR, Alabi A, Zoleko-Manego R, Mombo-Ngoma G, Mahmoudou S, Addo MM, Ramharter M, Mischlinger J. Epidemiology of co-infections in pregnant women living with human immunodeficiency virus 1 in rural Gabon: a cross-sectional study. Infect Dis Poverty 2023; 12:64. [PMID: 37408012 DOI: 10.1186/s40249-023-01114-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/06/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND There is no recent epidemiological data on HIV infection in Gabon, particularly in pregnant women. To close this gap, an HIV-prevalence survey was conducted among Gabonese pregnant women, followed by a cross-sectional case-control study in which the prevalence of various co-infections was compared between HIV-positive and HIV-negative pregnant women. METHODS Between 2018 and 2019, data for the HIV-prevalence survey were collected retrospectively in 21 Gabonese antenatal care centres (ANCs). Subsequently, for the prospective co-infection study, all HIV-positive pregnant women were recruited who frequented the ANC in Lambaréné and a comparator sub-sample of HIV-negative pregnant women was recruited; these activities were performed from February 2019 to February 2020. The mean number of co-infections was ascertained and compared between HIV-positive and HIV-negative women. Additionally, the odds for being co-infected with at least one co-infection was evaluated and compared between HIV-positive and HIV-negative women. RESULTS HIV-positivity was 3.9% (646/16,417) among pregnant women. 183 pregnant women were recruited in the co-infection study. 63% of HIV-positive and 75% of HIV-negative pregnant women had at least one co-infection. There was a trend indicating that HIV-negative women were more often co-infected with sexually transmitted infections (STIs) than HIV-positive women [mean (standard deviation, SD): 2.59 (1.04) vs 2.16 (1.35), respectively; P = 0.056]; this was not the case for vector-borne infections [mean (SD): 0.47 (0.72) vs 0.43 (0.63), respectively; P = 0.59]. CONCLUSIONS Counterintuitively, the crude odds for concomitant STIs was lower in HIV-positive than in HIV-negative women. The change of magnitude from the crude to adjusted OR is indicative for a differential sexual risk factor profile among HIV-positive and HIV-negative women in this population. This might potentially be explained by the availability of sexual health care counselling for HIV-positive women within the framework of the national HIV control programme, while no such similar overall service exists for HIV-negative women. This highlights the importance of easy access to sexual healthcare education programmes for all pregnant women irrespective of HIV status.
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Affiliation(s)
- Saskia Dede Davi
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Marc Luetgehetmann
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Martin Aepfelbacher
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Ayodele Alabi
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Albinusdreef, The Netherlands
| | | | - Ghyslain Mombo-Ngoma
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Marylyn Martina Addo
- German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Department for Clinical Immunology of Infectious Diseases and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Ramharter
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Johannes Mischlinger
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany.
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2
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Ngom NS, Gassama O, Dieng A, Diakhaby EB, Ndiaye SML, Tine A, Karam F, Lo G, Ba-Diallo A, Boye CSB, Toure-Kane C, Seck A, Diop-Ndiaye H, Camara M. Vaginal Carriage of Group B Streptococcus (GBS) in Pregnant Women, Antibiotic Sensitivity and Associated Risk Factors in Dakar, Senegal. Microbiol Insights 2023; 16:11786361231174419. [PMID: 37275206 PMCID: PMC10233617 DOI: 10.1177/11786361231174419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/20/2023] [Indexed: 06/07/2023] Open
Abstract
The eradication of neonatal Group B Streptococcus (GBS) infections, considered as a major public health priority, necessarily requires a mastery of the data on vaginal carriage in pregnant women. The aims of this study were to determine the prevalence of vaginal carriage of GBS in pregnant women, antibiotic susceptibility, and associated risk factors. This was a cross-sectional, descriptive study conducted over a period of 9 months (July 2020 to March 2021) in pregnant women between 34 and 38 weeks of gestation (WG) followed at the Nabil Choucair health center in Dakar. Identification and antibiotic susceptibility of GBS isolates were performed on the Vitek 2 from vaginal swabs cultured on Granada medium. Demographic and obstetric interview data were collected and analyzed on SPSS (version 25). The level of significance for all statistical tests was set at P < .05. The search of GBS vaginal carriage had involved 279 women aged 16 to 46 years, with a median pregnancy age of 34 (34-37) weeks' gestation. GBS was found in 43 women, for a vaginal carriage rate of 15.4%. In 27.9% (12/43) of volunteers screened, this carriage was monomicrobial, while in 72.1% (31/43) of women, GBS was associated with other pathogens such as Candida spp. (60.5%), Trichomonas vaginalis (2.3%), Gardnerella vaginalis (34.9%) and/or Mobiluncus spp. (11.6%). The level of resistance was 27.9% (12/43) for penicillin G, 53.5% (23/43) for erythromycin, 25.6% (11/43) for clindamycin and 100% for tetracycline. However, the strains had retained fully susceptible to vancomycin and teicoplanin. The main risk factor associated with maternal GBS carriage were ectocervical inflammation associated with contact bleeding (OR = 3.55; P = .005). The high rate of maternal vaginal GBS carriage and the levels of resistance to the various antibiotics tested confirm the importance of continuous GBS surveillance in our resource-limited countries.
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Affiliation(s)
- Ndeye Safietou Ngom
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Omar Gassama
- Gynecological and Obstetrical Clinic,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Assane Dieng
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Elhadji Bambo Diakhaby
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Serigne Mbaye Lo Ndiaye
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Alioune Tine
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Farba Karam
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Gora Lo
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Awa Ba-Diallo
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Cheikh Saad Bouh Boye
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Coumba Toure-Kane
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Abdoulaye Seck
- Laboratory of Medical Biology, Pasteur
Institute of Dakar, Senegal
| | - Halimatou Diop-Ndiaye
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Makhtar Camara
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
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3
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Distribution and Prevalence of Serotypes of Group B Streptococcus Isolated from Pregnant Women in 30 Countries: A Systematic Review. MATERNAL-FETAL MEDICINE 2023. [DOI: 10.1097/fm9.0000000000000174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Sangeetha AV, devi S, Subramanian A, Daniel M, Anandh P. Genotype Distribution and Antibiotic Susceptibility Pattern of Clinical Isolates of Group B Streptococcus in a Tertiary Care Hospital in Puducherry, South India. J Trop Med 2023; 2023:9910380. [PMID: 36935773 PMCID: PMC10017211 DOI: 10.1155/2023/9910380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 03/21/2023] Open
Abstract
Background Streptococcus agalactiae apart from being a colonizer in the genital region is also associated with several other invasive infections in all age groups. With the varied distribution of serotypes across different regions of the world, universal vaccination is also unattainable. However, in India, the knowledge of group B Streptococcus (GBS) genotype distribution is deficient. Thus, this study was initiated to add data on this aspect. Methodology. A cross-sectional study was conducted using isolates of group B Streptococcus from all clinical specimens. Along with that, the clinical specimen type and the antibiotic resistance profile of the isolates were correlated with the genotypes recognized through a multiplex PCR assay. Results Among the 86 isolates subjected to multiplex PCR for genotype identification, five genotypes were identified with genotype Ib as the predominant one (34.9%), followed by III (20.9%), II (16.3%), Ia (12.7%), and V (11.6%). Conclusion The results demonstrated a correlation of types Ib and III with vaginal colonization and type II with urine specimens in the current study. This preliminary study exhibited the distribution of common genotypes and their antibiotic resistance profiles in various GBS isolates. However, multiple studies across the country with larger sample sizes are needed to validate these findings.
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Affiliation(s)
- A. V. Sangeetha
- 1Laboratory Division, Central Leprosy Teaching and Research Institute, Chengalpattu 604001, Tamil Nadu, India
| | - Sheela devi
- 2Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry 605014, India
| | - Anandhalakshmi Subramanian
- 3Department of Microbiology and Parasitology, College of Medicine, King Khalid University, Abha 62521, Saudi Arabia
| | - Mary Daniel
- 4Department of Obstetrics and Gynecology, Pondicherry Institute of Medical Sciences, Puducherry 605014, India
| | - Perumal Anandh
- 5Department of Microbiology, Manakula Vinayagar Medical College, Kalitheerthalkuppam, Puducherry, India
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Bignoumba M, Mbombe Moghoa KH, Muandze-Nzambe JU, Kassa Kassa RF, Mouanga Ndzime Y, Gafou A, Longo Pendy NM, Onanga R, Kumulungui BS. Vaginal Infections' Etiologies in South-Eastern Gabon - An Overview. Int J Womens Health 2022; 14:505-515. [PMID: 35437354 PMCID: PMC9013257 DOI: 10.2147/ijwh.s349754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/23/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Discomfort in women of childbearing age associated with vaginal infections, namely bacterial vaginosis (BV), aerobic vaginitis (AV), vulvovaginal candidiasis (VVC), and trichomoniasis (TV), represent a serious and ongoing gynecological complication throughout the world. Objective This study aimed to investigate the etiologies of vaginal infections among outpatients in south-eastern Gabon. Methodology A cross-sectional study was designed using participants referred directly by their treating doctor for a vaginal swab. Socio-demographic data were collected using a structured questionnaire. Microscopic examinations were used for TV and BV diagnostic. All vaginal swabs were cultured for AV and VVC isolates using standard microbiology methods. Results A total of 573 women of reproductive age participated in the study. The most common identified vaginal infections were BV (62.8%) and AV (51.1%) followed by VVC (34.1%). No significant difference was observed for each etiology compared to socio-demographic data. Streptococcus B (23.9%), Staphylococcus aureus (17.7%), Klebsiella spp. (11.6%), and E. coli (5.8%) were the bacteria most associated with AV. A high incidence of non-C. albicans Candida (NCAC) strains causing vulvovaginitis were found. The prevalence of TV (2.1%) was low. Mixed infections had been common among participants. No association was found with TV and other vaginal infections, unlike others studies. The present study identified BV 228 (83.5%) and AV 227 (83.2%) as the main cause of mixed infections. The mixed infection AV-BV 113 (41.4%) was the most represented. Conclusion Also that simultaneous AV-BV-VVC represented 69 (25.3%) of mixed infections. Molecular analyses would be needed to identify the key species commonly associated with these vaginal infections.
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Affiliation(s)
- Michelle Bignoumba
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon.,Doctoral School of Science and Technology, Masuku University of Science and Technology (USTM), Franceville, BP 067, Gabon
| | - Kelly H Mbombe Moghoa
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon.,Central African Regional Doctoral School in Tropical Infectiology (ECODRAC), Masuku University of Science and Technology (USTM), Franceville, BP 876, Gabon
| | - Jean Ulrich Muandze-Nzambe
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon.,Laboratory of Biochemistry and Applied Immunology (LABIA), Department de Biochimie-Microbiologie, Joseph KI-ZERBO University, Ouagadougou 03, 03 BP 7021, Burkina Faso
| | - Roland Fabrice Kassa Kassa
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon
| | - Yann Mouanga Ndzime
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon
| | - Amahani Gafou
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon
| | - Neil Michel Longo Pendy
- Central African Regional Doctoral School in Tropical Infectiology (ECODRAC), Masuku University of Science and Technology (USTM), Franceville, BP 876, Gabon
| | - Richard Onanga
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon
| | - Brice Serge Kumulungui
- Medical Analysis Research Unit (URAM)/Bacteriology, International Center for Medical Research (CIRMF), Franceville, BP 769, Gabon.,Doctoral School of Science and Technology, Masuku University of Science and Technology (USTM), Franceville, BP 067, Gabon
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Leykun Y, Genet C, Mulu W. Group B Streptococci Vaginal-Recto Colonization, Vertical Transmission to Newborns, Antimicrobial Susceptibility Profile and Associated Factors in Selected Health Facilities of Bahir Dar City: A Cross-Sectional Study. Infect Drug Resist 2021; 14:5457-5472. [PMID: 34949929 PMCID: PMC8691132 DOI: 10.2147/idr.s343429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/09/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Group B streptococci (GBS) is an important pathogen involved in stillbirths, neonatal deaths and neurological defects, and the occurrence of multi-drug resistance (MDR) is an alarming issue. This study determined the prevalence of GBS colonization in pregnant women and newborns, the proportion of vertical transmission, antimicrobial susceptibility profiles of isolates, and the factors associated with colonization and vertical transmission. METHODS A cross-sectional study was conducted from March 1, 2021 to June 30, 2021, at selected health facilities of Bahir Dar city. Vaginal-recto swabs from 292 pregnant women and pooled ear, nasal and umbilical swabs from 292 newborns were collected. GBS were identified following standard microbiological protocols. Antimicrobial susceptibility testing was performed using modified Kirby-Bauer disk diffusion method and interpreted by the accepted 2020 CLSI M100 guidelines. Logistic regression analysis was computed. RESULTS Overall, 54 (18.5%) of pregnant women and 22 (7.5%) of newborns had GBS colonization. The proportion of GBS vertical transmission was 22 (40.7%). Group B Streptococcus isolates scored susceptibility to penicillin, ampicillin and vancomycin with 88.9%, 90.7%, and 96.3% for pregnant women and 86.4%, 90.9% and 95.9% for newborns, respectively. A high percentage of non-susceptibility was found for clindamycin and erythromycin with 33.3% and 25.9% for pregnant women and 31.8% and 22.7% from newborns, respectively. Besides, 19 (35.2%) GBS from pregnant women and 8 (36.4%) from newborns were MDR. Group B streptococci colonization was significantly associated with delivery before 37th week of gestation (AOR=2.77, 95% CI 1.14-6.68) and history of stillbirth (AOR=3.13, 95% CI 1.13-8.70). CONCLUSION Pregnant women vaginal-recto GBS colonization and transmission to newborns connected with MDR are a matter of concerns. Although non-susceptible GBS isolates are obtained, penicillin and vancomycin are relatively effective. The use of clindamycin, erythromycin and ceftriaxone should be guided by antimicrobial susceptibility testing. Genetic analysis is recommended to exactly identify the epidemiology of GBS strains, vertical transmission and antimicrobial resistance at the country level.
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Affiliation(s)
- Yasabe Leykun
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Chalachew Genet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Biochemistry and Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium
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Haimbodi EL, Mukesi M, Moyo SR. Prevalence and molecular characterization of group B streptococcus in pregnant women from hospitals in Ohangwena and Oshikoto regions of Namibia. BMC Microbiol 2021; 21:224. [PMID: 34353281 PMCID: PMC8340439 DOI: 10.1186/s12866-021-02283-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 07/21/2021] [Indexed: 11/26/2022] Open
Abstract
Background The main purpose of this study was to investigate the prevalence rate, antimicrobial susceptibility patterns and molecular characteristics of Streptococcus agalactiae isolated from pregnant women at 35 weeks of gestation and above, who attended antenatal screening at selected hospitals in Ohangwena and Oshikoto regions of Namibia. Results Out of 210 women screened for Group B Streptococcus (GBS), 12 (5.7%) were colonised of which 25.0% were colonised rectovaginally, 58.0% vaginally and 17.0% rectally. No significant association was reported between GBS colonisation and maternal age, geographic location, marital status, education, employment, parity, still births and miscarriages (P values > 0.05). Antimicrobial susceptibility was reported at 100% for ampicillin, penicillin & ceftriaxone which are commonly used for empiric treatment of infection with GBS. Resistance to tetracycline was reported at 100%. Tetracycline resistance gene tet(M) was present in 88.9% of the isolates only and none of the isolates presented with tet(O). Polysaccharide capsular type Ia was found in 9(50%) and Ib was found in 1(5.5%) of the total isolates. The remaining isolates were not typeable using PCR. Conclusion Streptococcus agalactiae’s positive rate was 5.7% among the pregnant women examined. Socio-demographic and obstetric factors had no influence on GBS colonisation (P values > 0.05). No resistance was reported to ampicillin, penicillin and ceftriaxone. No sensitivity was reported to tetracycline. Fifty percent of the isolates were capsular type Ia, 5.5% were type Ib and 44.4% were not typeable using PCR. The study provides crucial information for informing policy in screening of GBS in pregnant women.
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Affiliation(s)
- Erastus Lafimana Haimbodi
- Department of Health Sciences, Faculty of Health and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia
| | - Munyaradzi Mukesi
- Department of Health Sciences, Faculty of Health and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia
| | - Sylvester Rodgers Moyo
- Department of Health Sciences, Faculty of Health and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia.
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Dos Santos NFB, da Silva LR, Costa FJMD, de Mattos DM, de Carvalho E, Ferreira LCDS, Ferreira RDCC. Immunization with a recombinant BibA surface protein confers immunity and protects mice against group B Streptococcus (GBS) vaginal colonization. Vaccine 2020; 38:5286-5296. [PMID: 32571719 DOI: 10.1016/j.vaccine.2020.05.076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/30/2020] [Accepted: 05/27/2020] [Indexed: 11/29/2022]
Abstract
Streptococcus agalactiae or group B Streptococcus (GBS) is a Gram-positive bacterium divided into ten distinct serotypes that colonizes the vaginal and rectal tracts of approximately 30% of women worldwide. GBS is the leading cause of invasive infection in newborns, causing sepsis, pneumoniae and meningitis. The main strategy to prevent GSB infection in newborns includes the use of intrapartum antibiotic therapy, which does not prevent late-onset diseases and may select resistant bacterial strains. We still do not have a vaccine formulation specific for this pathogen approved for human use. Conserved surface proteins are potential antigens that could be targets for recognition by antibodies and activation of cell opsonization. We used a serotype V GBS (GBS-V)-derived recombinant surface protein, rBibA, and evaluated the potential protective role of the induced antigen-specific antibodies after parenteral or mucosal immunizations in C57BL/6 mice. In vitro and in vivo assays demonstrated that vaccine formulations containing BibA combined with different adjuvants induced serum IgG and/or secreted IgA antibodies, leading to enhanced opsonophagocytosis of GBS-V cells and reduced invasion of epithelial cells. One BibA-based vaccine formulation adjuvanted with a nontoxic derivative of the heat-labile toxin produced by enterotoxigenic Escherichia coli (ETEC) strains was capable of inducing protection against vaginal colonization and lethal parenteral challenge with GBS-V. Serum collected from vaccinated mice conferred passive protection against vaginal colonization in naïve mice challenged with GBS-V. Taken together, the present data demonstrate that the BibA protein is a promising antigen for development of a vaccine to protect against GBS infection.
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Affiliation(s)
- Nayara Fernanda Barros Dos Santos
- Laboratory of Vaccine Development, Department of Microbiology, Biomedical Science Institute, University of São Paulo, 1374 Prof. Lineu Prestes Avenue, São Paulo, SP 05508-000, Brazil.
| | - Lukas Raposo da Silva
- Laboratory of Vaccine Development, Department of Microbiology, Biomedical Science Institute, University of São Paulo, 1374 Prof. Lineu Prestes Avenue, São Paulo, SP 05508-000, Brazil.
| | - Fagner James Martins Dantas Costa
- Laboratory of Vaccine Development, Department of Microbiology, Biomedical Science Institute, University of São Paulo, 1374 Prof. Lineu Prestes Avenue, São Paulo, SP 05508-000, Brazil.
| | - Daniely Maranhão de Mattos
- Laboratory of Vaccine Development, Department of Microbiology, Biomedical Science Institute, University of São Paulo, 1374 Prof. Lineu Prestes Avenue, São Paulo, SP 05508-000, Brazil.
| | - Enéas de Carvalho
- Laboratory of Molecular Biotechnology I, Biotechnology Center, Butantan Institute, 1500 Vital Brasil Avenue, São Paulo, SP 03178-200, Brazil.
| | - Luís Carlos de Souza Ferreira
- Laboratory of Vaccine Development, Department of Microbiology, Biomedical Science Institute, University of São Paulo, 1374 Prof. Lineu Prestes Avenue, São Paulo, SP 05508-000, Brazil.
| | - Rita de Cássia Café Ferreira
- Laboratory of Vaccine Development, Department of Microbiology, Biomedical Science Institute, University of São Paulo, 1374 Prof. Lineu Prestes Avenue, São Paulo, SP 05508-000, Brazil.
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Group B Streptococcus colonization rate and serotype distribution among pregnant women and their newborns at Adama Hospital Medical College, Ethiopia. Sci Rep 2020; 10:9301. [PMID: 32518331 PMCID: PMC7283305 DOI: 10.1038/s41598-020-66474-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/22/2020] [Indexed: 11/08/2022] Open
Abstract
Rectovaginal area of pregnant women can be colonized transiently with group B Streptococcus (GBS) without causing disease. The bacteria can be transmitted to the newborn before and during birth and cause early-onset neonatal disease. In this study, we aimed to determine the GBS colonization rate among pregnant women before delivery and their newborns and serotypes distribution of GBS. Two hundred-eighty pregnant women along with their newborns were screened for GBS colonization from June 2014 to October 2014 at Adama Hospital Medical College. Rectovaginal swabs from pregnant women before delivery and specimen from nasal area, external ear, umbilical cord and throat of newborns were collected and cultured. The serotyping of GBS was performed by using serotype-specific antisera. To collect sociodemographic and clinical data we employed a structured questionnaire. GBS colonization among pregnant women and their newborns were 13.2% 95% CI (8.9-17.5) and 7.4% 95% CI (4.6-10.6). Out of 37 GBS strains recovered from pregnant women, the prevalent serotypes were Ia 6(16.2%), Ib 8(21.6%), II 10(27%), III 3(8.1%), and V 8(21.6%). Out of 21 GBS strains recovered from newborns, prevalent serotypes were Ia 3(14.3%), Ib 6(28.6%), II 6(28.6%), III 4(19%), and V 1(4.8%). This study indicated the existence of primary risk factors for neonatal disease in Adama area. Serotype II was the common serotype detected in this study which is followed by serotype Ib, Ia, and V. As colonizing GBS serotypes could cause invasive disease among newborns, vaccine formulation which includes serotype II, Ia, V, Ib, and III can prevent of invasive disease caused by GBS in the study area.
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Paveenkittiporn W, Ungcharoen R, Kerdsin A. Streptococcus agalactiae infections and clinical relevance in adults, Thailand. Diagn Microbiol Infect Dis 2020; 97:115005. [DOI: 10.1016/j.diagmicrobio.2020.115005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/02/2020] [Accepted: 01/26/2020] [Indexed: 01/13/2023]
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Pumchan A, Krobthong S, Roytrakul S, Sawatdichaikul O, Kondo H, Hirono I, Areechon N, Unajak S. Novel Chimeric Multiepitope Vaccine for Streptococcosis Disease in Nile Tilapia (Oreochromis niloticus Linn.). Sci Rep 2020; 10:603. [PMID: 31953479 PMCID: PMC6969146 DOI: 10.1038/s41598-019-57283-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/18/2019] [Indexed: 12/21/2022] Open
Abstract
Streptococcus agalactiae is a causative agent of streptococcosis disease in various fish species, including Nile tilapia (Oreochromis niloticus Linn.). Vaccination is an effective disease prevention and control method, but limitations remain for protecting against catastrophic mortality of fish infected with different strains of streptococci. Immunoproteomics analysis of S. agalactiae was used to identify antigenic proteins and construct a chimeric multiepitope vaccine. Epitopes from five antigenic proteins were shuffled in five helices of a flavodoxin backbone, and in silico analysis predicted a suitable RNA and protein structure for protein expression. 45F2 and 42E2 were identified as the best candidates for a chimeric multiepitope vaccine. Recombinant plasmids were constructed to produce a recombinant protein vaccine and DNA vaccine system. Overexpressed proteins were determined to be 30 kDa and 25 kDa in the E. coli and TK1 systems, respectively. The efficacy of the chimeric multiepitope construct as a recombinant protein vaccine and DNA vaccine was evaluated in Nile tilapia, followed by S. agalactiae challenge at 1 × 107 CFU/mL. Relative percentage survival (RPS) and cumulative mortality were recorded at approximately 57-76% and 17-30%, respectively. These chimeric multiepitope vaccines should be applied in streptococcosis disease control and developed into a multivalent vaccine to control multiple diseases.
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Affiliation(s)
- Ansaya Pumchan
- Department of Biochemistry, Faculty of Science, Kasetsart University, 50 Ngam Wong Wan, Chatuchak, Bangkok, 10900, Thailand
| | - Sucheewin Krobthong
- Proteomics Laboratory, Genome Institutes, National Center for Genetic Engineering and Biotechnology, Pathumthani, 12120, Thailand
| | - Sittiruk Roytrakul
- Proteomics Laboratory, Genome Institutes, National Center for Genetic Engineering and Biotechnology, Pathumthani, 12120, Thailand
| | - Orathai Sawatdichaikul
- Department of Nutrition and Health, Institute of Food Research and Product Development, Kasetsart University, 50 Ngam Wong Wan, Chatuchak, Bangkok, 10900, Thailand
| | - Hidehiro Kondo
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, Konan 4-5-7, Minato-KU, Tokyo, 108-8477, Japan
| | - Ikuo Hirono
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, Konan 4-5-7, Minato-KU, Tokyo, 108-8477, Japan
| | - Nontawith Areechon
- Department of Aquaculture, Faculty of Fisheries, Kasetsart University, 50 Ngam Wong Wan Road, Chatuchak, Bangkok, 10900, Thailand
| | - Sasimanas Unajak
- Department of Biochemistry, Faculty of Science, Kasetsart University, 50 Ngam Wong Wan, Chatuchak, Bangkok, 10900, Thailand.
- Omics Center for Agriculture, Bioresources, Food and Health, Kasetsart University (OmiKU), Kasetsart University, 50 Ngam Wong Wan Road, Chatuchak, Bangkok, 10900, Thailand.
- Center for Advanced Studies for Agriculture and Food, KU Institute for Advanced Studies, Kasetsart University, (CASAF, NRU-KU, Thailand), Bangkok, 10900, Thailand.
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12
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Determinants of Group B streptococcal virulence potential amongst vaginal clinical isolates from pregnant women. PLoS One 2019; 14:e0226699. [PMID: 31851721 PMCID: PMC6919605 DOI: 10.1371/journal.pone.0226699] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/03/2019] [Indexed: 11/19/2022] Open
Abstract
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a Gram-positive bacterium isolated from the vaginal tract of approximately 25% of women. GBS colonization of the female reproductive tract is of particular concern during pregnancy as the bacteria can invade gestational tissues or be transmitted to the newborn during passage through the birth canal. Infection of the neonate can result in life-threatening pneumonia, sepsis and meningitis. Thus, surveillance of GBS strains and corresponding virulence potential during colonization is warranted. Here we describe a panel of GBS isolates from the vaginal tracts of a cohort of pregnant women in Michigan, USA. We determined that capsular serotypes III and V were the most abundant across the strain panel, with only one isolate belonging to serotype IV. Further, 12.8% of strains belonged to the hyper-virulent serotype III, sequence type 17 (ST-17) and 15.4% expressed the serine rich repeat glycoprotein-encoding gene srr2. Functional assessment of the colonizing isolates revealed that almost all strains exhibited some level of β-hemolytic activity and that ST-17 strains, which express Srr2, exhibited increased bacterial adherence to vaginal epithelium. Finally, analysis of strain antibiotic susceptibility revealed the presence of antibiotic resistance to penicillin (15.4%), clindamycin (30.8%), erythromycin (43.6%), vancomycin (30.8%), and tetracycline (94.9%), which has significant implications for treatment options. Collectively, these data provide important information on vaginal GBS carriage isolate virulence potential and highlight the value of continued surveillance.
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Chen SL. Genomic Insights Into the Distribution and Evolution of Group B Streptococcus. Front Microbiol 2019; 10:1447. [PMID: 31316488 PMCID: PMC6611187 DOI: 10.3389/fmicb.2019.01447] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/11/2019] [Indexed: 01/31/2023] Open
Abstract
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a bacteria with truly protean biology. It infects a variety of hosts, among which the most commonly studied are humans, cattle, and fish. GBS holds a singular position in the history of bacterial genomics, as it was the substrate used to describe one of the first major conceptual advances of comparative genomics, the idea of the pan-genome. In this review, I describe a brief history of GBS and the major contributions of genomics to understanding its genome plasticity and evolution as well as its molecular epidemiology, focusing on the three hosts mentioned above. I also discuss one of the major recent paradigm shifts in our understanding of GBS evolution and disease burden: foodborne GBS can cause invasive infections in humans.
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Affiliation(s)
- Swaine L Chen
- Division of Infectious Diseases, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Infectious Diseases Group, Genome Institute of Singapore, Singapore, Singapore
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Gizachew M, Tiruneh M, Moges F, Tessema B. Streptococcus agalactiae maternal colonization, antibiotic resistance and serotype profiles in Africa: a meta-analysis. Ann Clin Microbiol Antimicrob 2019; 18:14. [PMID: 30922308 PMCID: PMC6437888 DOI: 10.1186/s12941-019-0313-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/15/2019] [Indexed: 12/31/2022] Open
Abstract
Background Maternal rectovaginal colonization with Streptococcus agalactiae (Group B Streptococcus or GBS) is the most common route for the GBS disease in the perinatal period. The knowledge of maternal colonization, antibiotic resistance and serotype profiles is substantially needed to formulate the broad vaccine. However, it has not been estimated in Africa. This meta-analysis was aimed to determine the pooled prevalence of colonization, antibiotic resistance and serotype profiles of GBS reported in Africa. Methods Potentially relevant studies from 1989 to 31th January, 2019 were retrieved from the Medline/PubMed, EMBASE, HINARI online databases, periodicals and by requesting authors. Unpublished studies retrieved from grey literature through Google and Google Scholar. Pooled estimates were calculated using the random effect model. Subgroup analysis was done to investigate the burden of colonization across sub-regions, sampling site and countries. Summary estimates were presented using words, Forest plots and Tables. Heterogeneity was assessed using the I2 statistic. Results Eighty-three articles were assessed, of which 57 studies conducted in five sub-regions with 21 countries (22,206 pregnant women) met pre-specified inclusion criteria. The overall estimate of recto-vaginal colonization was 19.3% (95% CI 16.9, 21.7). The highest estimate was observed in Southern Africa, 23.8% (95% CI 18.7, 28.9), followed by Northern Africa, 22.7% (95% CI 18.2, 27.2) while the lowest was driven from the Eastern Africa, 15.4% (95% CI 12.1, 18.7). Considerable heterogeneity across and within regions, sampling site, screening methods and countries (I2 > 75%); and the publication bias were observed (p = 0.031). GBS showed the highest resistance to tetracycline. Resistance to penicillin, amoxicillin, chloramphenicol, ampicillin, ceftriaxone, ciprofloxacin, erythromycin, vancomycin and clindamycin also observed. The V, III, Ia, Ib, and II serotypes altogether were accounted 91.8% in the African studies. Conclusions The pooled estimate of the maternal colonization with GBS was 19.3% which is equivalent with other many primary and review reports worldwide. The most antibiotic resistance estimate was recorded in the tetracycline followed by penicillin. Five serotypes were the most prevalent in Africa and more data on the antibiotic résistance and serotype distribution patterns are needed from developing countries to devise the effective preventive measures. In addition, the antibiotic susceptibility test methods used in the Africa shall be assessed for its quality. Trial registration Prospero Registration Number CRD42018094525
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Affiliation(s)
- Mucheye Gizachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Moges Tiruneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belay Tessema
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Perinatal Streptococcus agalactiae Epidemiology and Surveillance Targets. Clin Microbiol Rev 2018; 31:31/4/e00049-18. [PMID: 30111577 DOI: 10.1128/cmr.00049-18] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Streptococcus agalactiae, or group B streptococcus (GBS), is a major neonatal pathogen. Recent data have elucidated the global prevalence of maternal and neonatal colonization, but gaps still remain in the epidemiology of this species. A number of phenotypic and genotypic classifications can be used to identify the diversity of GBS strains, and some are more discriminatory than others. This review explores the main schemes used for GBS epidemiology and further details the targets for epidemiological surveillance. Current screening practices across the world provide a unique opportunity to gain detailed information on maternal colonizing strains and neonatal disease-causing strains, which is vital for monitoring and therapeutics, if sufficient detail can be extracted. Deciphering which isolates are circulating within specific populations and recording targets within invasive strains are crucial steps in monitoring the implementation of therapeutics, such as vaccines, as well as developing novel therapies against prevalent GBS strains. Having a detailed understanding of global GBS epidemiology will prove invaluable for understanding the pathogenesis of this organism and equipping future prevention strategies for success.
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Development of a multiplex PCR for identification of β-hemolytic streptococci relevant to human infections and serotype distribution of invasive Streptococcus agalactiae in Thailand. Mol Cell Probes 2017; 36:10-14. [DOI: 10.1016/j.mcp.2017.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/07/2017] [Accepted: 06/26/2017] [Indexed: 11/23/2022]
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Population structure and virulence gene profiles of Streptococcus agalactiae collected from different hosts worldwide. Eur J Clin Microbiol Infect Dis 2017; 37:527-536. [PMID: 29181634 DOI: 10.1007/s10096-017-3146-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/14/2017] [Indexed: 01/25/2023]
Abstract
Streptococcus agalactiae is a leading cause of morbidity and mortality among neonates and causes severe infections in pregnant women and nonpregnant predisposed adults, in addition to various animal species worldwide. Still, information on the population structure of S. agalactiae and the geographical distribution of different clones is limited. Further data are urgently needed to identify particularly successful clones and obtain insights into possible routes of transmission within one host species and across species borders. We aimed to determine the population structure and virulence gene profiles of S. agalactiae strains from a diverse set of sources and geographical origins. To this end, 373 S. agalactiae isolates obtained from humans and animals from five different continents were typed by DNA microarray profiling. A total of 242 different S. agalactiae strains were identified and further analyzed. Particularly successful clonal lineages, hybridization patterns, and strains were identified that were spread across different continents and/or were present in more than one host species. In particular, several strains were detected in both humans and cattle, and several canine strains were also detected in samples from human, bovine, and porcine hosts. The findings of our study suggest that although S. agalactiae is well adapted to various hosts including humans, cattle, dogs, rodents, and fish, interspecies transmission is possible and occurs between humans and cows, dogs, and rabbits. The virulence and resistance gene profiles presented enable new insights into interspecies transmission and make a crucial contribution to the identification of suitable targets for therapeutic agents and vaccines.
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Abstract
Group B Streptococcal isolates (n = 235) from the South of Ireland were characterised by serotyping, antimicrobial susceptibility and determination of the phenotypic and genotypic mechanisms of resistance. Resistance to erythromycin and clindamycin was observed in 21·3% and 20·4% of the total population, respectively. The c-MLSB phenotype was the most common phenotype detected (62%), with ermB being the predominant genetic determinant, present in 84% of resistant isolates. The rare L phenotype was observed in 2·9% (n = 7) of isolates, four of which harboured the lsaC gene responsible for clindamycin resistance. Serotypes Ia, III and II were the most common amongst the entire study population (28·1%, 24·7% and 14%, respectively). Four of the seven L phenotype isolates were serotype III and two of these strains were confirmed as the hypervirulent clone, ST-17 and harboured the hvgA gene. This is the first documented case of the L phenotype in Ireland to date and the study findings emphasise the need for continued monitoring of antibiotic resistance and serotype distribution in GBS isolates from Ireland.
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Slotved HC, Dayie NTKD, Banini JAN, Frimodt-Møller N. Carriage and serotype distribution of Streptococcus agalactiae in third trimester pregnancy in southern Ghana. BMC Pregnancy Childbirth 2017; 17:238. [PMID: 28732495 PMCID: PMC5520380 DOI: 10.1186/s12884-017-1419-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the prevalence of Streptococcus agalactiae (group B streptococci, GBS) among healthy, pregnant women attending antenatal care at different study sites in the Greater Accra Region, Ghana. METHODS Between 2010 and June 2013, recto-vaginal swab samples were collected from pregnant women attending antenatal care from two study sites in southern Ghana. The samples were collected within 35 and 37 weeks of the gestation period. These were inoculated into Todd-Hewitt broth followed by sub-culturing onto a sheep-blood agar plate. Identification was performed on a single subcultured colony. Gram staining was performed, and isolates were evaluated for beta-haemolytic reactions. Furthermore, the isolates were serotyped using the GBS latex serotyping kit. RESULTS The carriage rates were found to be 25.5% (95% CI: 19.6-32.1) to 28.0% (95% CI: 21.9-34.8) for the two collection sites. The most common serotypes were serotypes VII and IX. The data showed that women below 20 years of age or above 30 years of age have a significantly (p = 0.037) higher risk of carrying GBS compared to women from the age group of 20 to 30 years. CONCLUSIONS The findings of this study revealed that prevalence of GBS colonization in pregnant women in Greater Accra region is high and comparable to rates observed in South Africa and Western countries. The most prevalent serotypes were serotypes VII and IX, which have not been observed before in West Africa.
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Affiliation(s)
- Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, -2300, Copenhagen, DK, Denmark.
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Josephine A N Banini
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Niels Frimodt-Møller
- Department of Clinical Microbiology, University Hospital, Hvidovre, Copenhagen, Denmark
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