1
|
Salmanov AG, Artyomenko V, Susidko OM, Korniyenko SM, Kovalyshyn OA, Rud VO, Voloshyn OA. URINARY TRACT INFECTIONS IN PREGNANT WOMEN IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2020-2022). WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1527-1535. [PMID: 37622493 DOI: 10.36740/wlek202307103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE The aim: To obtain the first national estimates of the current prevalence rate of urinary tract infections (UTIs) in pregnant women and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS Materials and methods: Prospective multicentre cohort study was conducted from January 2020 to December 2022. The study population consisted of 36,876 pregnant women from 17 regions of Ukraine. Antibiotic susceptibility was done by the disc diffusion test as recommended by European Committee on Antimicrobial Susceptibility Testing guidelines. RESULTS Results: A total 29.5% pregnant women were found to have UTIs. Among these cases, 36.5% Asymptomatic bacteriuria, 51.7% Cystitis and 11.8% Pyelonephritis were observed. Of all cases, 87.9% were defined as healthcare-acquired UTIs and 12.1% community-acquired UTIs. The most common uropathogen was Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa. Many uropathogens isolated from UTI cases were found to be multidrug resistant. CONCLUSION Conclusions: UTIs in pregnant women in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of UTIs in pregnant women, but prevention is the key element.
Collapse
Affiliation(s)
- Aidyn G Salmanov
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | | | | | | | | | - Victor O Rud
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
| | - Oleksandr A Voloshyn
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; KYIV REGIONAL MATERNITY HOSPITAL, KYIV, UKRAINE
| |
Collapse
|
2
|
Bekele H, Debella A, Getachew T, Balis B, Tamiru D, Eyeberu A, Tiruye G, Kure MA, Habte S, Eshetu B, Regassa LD, Mesfin S, Alemu A, Dessie Y, Shiferaw K. Prevalence of Group B Streptococcus Recto-Vaginal Colonization, Vertical Transmission, and Antibiotic Susceptibility Among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:851434. [PMID: 35651858 PMCID: PMC9149289 DOI: 10.3389/fpubh.2022.851434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Maternal 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. Methods Both 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. Results This 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). Conclusions Nearly 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 Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287540.
Collapse
Affiliation(s)
- Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Getahun Tiruye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sisay Habte
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bajrond Eshetu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kasiye Shiferaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
3
|
DENOBLE A, REID HW, KRISCHAK M, ROSETT H, SACHDEVA S, WEAVER K, HEINE RP, DOTTERS-KATZ S. Bad bugs: antibiotic-resistant bacteriuria in pregnancy and risk of pyelonephritis. Am J Obstet Gynecol MFM 2022; 4:100540. [PMID: 34856419 PMCID: PMC9785208 DOI: 10.1016/j.ajogmf.2021.100540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/13/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The introduction of antibiotics has significantly reduced morbidity and mortality from microbial infections, but the rise of antibiotic-resistant and multidrug-resistant microbes is of increasing clinical concern. Few studies have examined the prevalence and impact of antibiotic resistance in common antenatal infections. OBJECTIVE This study aimed to determine whether pregnant women with a urine culture positive for antibiotic-resistant or multidrug-resistant gram-negative bacteria are at increased risk of developing pyelonephritis than pregnant women infected with antibiotic-susceptible organisms. STUDY DESIGN This was a retrospective cohort study of pregnant women with asymptomatic bacteriuria or acute cystitis from a single health system from July 2013 to May 2019. Women with gram-negative antibiotic-resistant (resistance to 1-2 antibiotic classes) and multidrug-resistant (resistance to ≥3 antibiotic classes) lower urinary tract infections were compared with women with antibiotic-susceptible urinary tract infections in terms of demographic, infectious, antepartum, and intrapartum data. The primary outcome was pyelonephritis, defined as a billing code for pyelonephritis plus fever or flank pain. The secondary outcomes were length of stay in the hospital because of pyelonephritis, a composite of pyelonephritis complications (renal abscess, sepsis, and intensive care unit admission), and preterm delivery. The differences in the primary outcome were analyzed using multivariate logistic regression. RESULTS A total of 573 women were eligible for inclusion. Of the 573 women, 334 (58%) had gram-negative bacteria on urine culture. Of the 334 cases, 173 (52%) were antibiotic susceptible, 74 (22%) were antibiotic resistant, and 87 (26%) were multidrug resistant. Women with antibiotic-resistant and multidrug-resistant infections were more likely to have hypertension (P=.004), to be Black (P=.03), to have public insurance (P=.002), and to experience more urinary infections (P=.001). Pyelonephritis was more common in women with antibiotic-resistant (adjusted odds ratio, 2.27; 95% confidence interval, 1.08-4.78) and multidrug-resistant (adjusted odds ratio, 3.06; 95% confidence interval, 1.57-5.96) infections than in women with antibiotic-susceptible urinary tract infections. Length of stay, preterm delivery, and pyelonephritis complications did not differ between antibiotic-susceptible and antibiotic-resistant and multidrug-resistant infections. CONCLUSION In an age of increasing antibiotic resistance, more than one-half of pregnant women with bacteriuria experience at least 1 infection with an antibiotic-resistant organism. These resistance patterns have a real clinical impact as pregnant women with antibiotic-resistant gram-negative lower urinary tract infections have an estimated 2- to 3-fold increased odds of developing pyelonephritis.
Collapse
Affiliation(s)
- Annalies DENOBLE
- Department of Obstetrics and Gynecology, Duke University Health System, Durham, NC
| | - Hadley W. REID
- Duke University School of Medicine, Duke University Health System, Durham, NC
| | - Madison KRISCHAK
- Duke University School of Medicine, Duke University Health System, Durham, NC
| | - Heather ROSETT
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT
| | - Sarika SACHDEVA
- Duke University School of Medicine, Duke University Health System, Durham, NC
| | - Kristin WEAVER
- Department of Obstetrics and Gynecology, Duke University Health System, Durham, NC
| | - R. Phillips HEINE
- Department of Obstetrics and Gynecology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Sarah DOTTERS-KATZ
- Department of Obstetrics and Gynecology, Duke University Health System, Durham, NC
| |
Collapse
|
4
|
Shazly SA, Radwan AA, Shawki AA, Said AE, Mohamed YI, Hemdan HN, Hemdan MN, Mohamed NG, Adam RI, Nassr AA, Eltaweel NA, Hortu I, Shehata A, Abdo MS, Moustafa HY, Abd-Elkariem AY, Ali SS, Ahmed NB, Hosny EM, Abouzeid MH. Middle-East OBGYN Graduate Education (MOGGE) Foundation practice guidelines: prevention of group B Streptococcus infection in pregnancy and in newborn. Practice guideline no. 02-O-20. J Matern Fetal Neonatal Med 2021; 35:5087-5098. [PMID: 33627019 DOI: 10.1080/14767058.2021.1875211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Rectovaginal colonization with group B streptococcus (GBS) is commonly encountered in pregnancy. GBS is the most common cause of early onset neonatal sepsis, which is associated with 12% case-fatality rate. Although screening protocols and prophylactic treatment are readily available worldwide, practice in low-resource countries is challenged by lack of awareness and limited implementation of these protocols. In addition, antibiotic susceptibility pattern may vary globally owing to different regulations of antibiotic prescription or prevalence of certain bacterial serotypes. This guideline appraises current evidence on screening and management of GBS colonization in pregnancy particularly in low-resource settings.
Collapse
Affiliation(s)
- Sherif A Shazly
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Ahmad A Radwan
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Abdelrahman A Shawki
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Aliaa E Said
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Yasmin I Mohamed
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Heba N Hemdan
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Menna N Hemdan
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Norhan G Mohamed
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Rania I Adam
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Ahmed A Nassr
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Nashwa A Eltaweel
- Department of Obstetrics and Gynecology, University Hospitals of Birmingham, Birmingham, United Kingdom
| | - Ismet Hortu
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Amr Shehata
- Department of Obstetrics and Gynecology, Aswan University, Aswan, Egypt
| | - Mohamed S Abdo
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Hajer Y Moustafa
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | | | - Shimaa Salah Ali
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Nermeen B Ahmed
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Esraa M Hosny
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Mostafa H Abouzeid
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | | |
Collapse
|
5
|
Moorhead R, Daley AJ, Lee L, Gorelik A, Garland SM. Compliance with screening for and recommended management of maternal group B streptococcus carriage in pregnancy. Aust N Z J Obstet Gynaecol 2019; 59:837-842. [DOI: 10.1111/ajo.12977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/23/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Andrew J. Daley
- Department of Microbiology and Infectious DiseaseRoyal Women's Hospital Melbourne Australia
- Department of MicrobiologyRoyal Children's Hospital Melbourne Australia
- Department of PaediatricsUniversity of Melbourne Melbourne Australia
| | - Lai‐yang Lee
- Department of Microbiology and Infectious DiseaseRoyal Women's Hospital Melbourne Australia
- Department of MicrobiologyRoyal Children's Hospital Melbourne Australia
| | | | - Suzanne M. Garland
- Department of Microbiology and Infectious DiseaseRoyal Women's Hospital Melbourne Australia
- Department of MicrobiologyRoyal Children's Hospital Melbourne Australia
- Department of Obstetrics and GynaecologyUniversity of Melbourne Melbourne Victoria Australia
- Infection and ImmunityMurdoch Children's Research Institute Melbourne Australia
| |
Collapse
|
6
|
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
Collapse
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
| |
Collapse
|
7
|
Huang J, Li S, Li L, Wang X, Yao Z, Ye X. Alarming regional differences in prevalence and antimicrobial susceptibility of group B streptococci in pregnant women: A systematic review and meta-analysis. J Glob Antimicrob Resist 2016; 7:169-177. [DOI: 10.1016/j.jgar.2016.08.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/01/2016] [Accepted: 08/19/2016] [Indexed: 12/28/2022] Open
|
8
|
Gouvea MIS, Joao EC, Teixeira MDLB, Read JS, Fracalanzza SEL, Souza CTV, Souza MJD, Torres Filho HM, Leite CCF, do Brasil PEAA. Accuracy of a rapid real-time polymerase chain reaction assay for diagnosis of group B Streptococcus colonization in a cohort of HIV-infected pregnant women. J Matern Fetal Neonatal Med 2016; 30:1096-1101. [PMID: 27333822 DOI: 10.1080/14767058.2016.1205021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE There are limited data regarding Xpert performance to detect Group B Streptococcus (GBS) in HIV-infected pregnant women. We evaluated the accuracy of a rapid real-time polymerase chain reaction (PCR) test in a cohort of HIV-infected women. METHODS At 35-37 weeks of pregnancy, a pair of combined rectovaginal swabs were collected for two GBS assays in a cohort of sequentially included HIV-infected women in Rio de Janeiro: (1) culture; and (2) real-time PCR assay [GeneXpert GBS (Cepheid, Sunnyvale, CA)]. Using culture as the reference, sensitivity, specificity, positive and negative-likelihood ratios were estimated. RESULTS From June 2012 to February 2015, 337 pregnant women met inclusion criteria. One woman was later excluded, due to failure to obtain a result in the index test; 336 were included in the analyses. The GBS colonization rate was 19.04%. Sensitivity and specificity of the GeneXpert GBS assay were 85.94% (95% CI: 75.38-92.42) and 94.85% (95% CI: 91.55-96.91), respectively. Positive and negative predictive values were 79.71% (95% CI: 68.78-87.51) and 96.63% (95% CI: 93.72-98.22), respectively. CONCLUSIONS GeneXpert GBS is an acceptable test for the identification of GBS colonization in HIV-infected pregnant women and represents a reasonable option to detect GBS colonization in settings where culture is not feasible.
Collapse
Affiliation(s)
- Maria Isabel S Gouvea
- a Infectious Diseases Department, Hospital Federal dos Servidores do Estado , Rio de Janeiro , Brazil.,b Instituto Nacional de Infectologia Evandro Chagas - Fiocruz , Rio de Janeiro , Brazil
| | - Esau C Joao
- a Infectious Diseases Department, Hospital Federal dos Servidores do Estado , Rio de Janeiro , Brazil
| | - Maria de Lourdes B Teixeira
- a Infectious Diseases Department, Hospital Federal dos Servidores do Estado , Rio de Janeiro , Brazil.,b Instituto Nacional de Infectologia Evandro Chagas - Fiocruz , Rio de Janeiro , Brazil
| | - Jennifer S Read
- c Department of Epidemiology and Biostatistics , University of California at San Francisco , San Francisco , CA , USA
| | - Sergio E L Fracalanzza
- d Laboratório de Bacteriologia Médica do Instituto de Microbiologia Prof. Paulo de Góes , Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
| | - Claudia T V Souza
- b Instituto Nacional de Infectologia Evandro Chagas - Fiocruz , Rio de Janeiro , Brazil
| | - Maria José de Souza
- e Department of Bacteriology , Hospital Federal dos Servidores do Estado , Rio de Janeiro , Brazil , and
| | - Helio M Torres Filho
- f Laboratório Richet , Núcleo de Apoio à Pesquisa Clínica , Rio de Janeiro , Brazil
| | - Cassiana C F Leite
- f Laboratório Richet , Núcleo de Apoio à Pesquisa Clínica , Rio de Janeiro , Brazil
| | - Pedro E A A do Brasil
- b Instituto Nacional de Infectologia Evandro Chagas - Fiocruz , Rio de Janeiro , Brazil
| |
Collapse
|
9
|
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 2014; 53:210-4. [DOI: 10.1016/j.tjog.2014.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 11/20/2022] Open
|
10
|
Poncelet-Jasserand E, Forges F, Varlet MN, Chauleur C, Seffert P, Siani C, Pozzetto B, Ros A. Reduction of the use of antimicrobial drugs following the rapid detection ofStreptococcus agalactiaein the vagina at delivery by real-time PCR assay. BJOG 2013; 120:1098-108. [DOI: 10.1111/1471-0528.12138] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2012] [Indexed: 11/29/2022]
Affiliation(s)
- E Poncelet-Jasserand
- Department of Obstetrics; Gynaecology and Reproductive Medicine; University-Hospital of Saint-Etienne; France
| | - F Forges
- Unit of Clinical Research, Innovation and Pharmacology; INSERM CIE3; University-Hospital of Saint-Etienne; France
| | - M-N Varlet
- Department of Obstetrics; Gynaecology and Reproductive Medicine; University-Hospital of Saint-Etienne; France
| | - C Chauleur
- Department of Obstetrics; Gynaecology and Reproductive Medicine; University-Hospital of Saint-Etienne; France
| | - P Seffert
- Department of Obstetrics; Gynaecology and Reproductive Medicine; University-Hospital of Saint-Etienne; France
| | - C Siani
- Research Laboratory in Knowledge Engineering (ERIC); University of Lyon; Institute of Pharmaceutical and Biological Sciences (ISPB) of Lyon; France
| | | | - A Ros
- Department of Microbiology; Hôpital Nord; University-Hospital of Saint-Etienne; France
| |
Collapse
|
11
|
Alós Cortés JI, Andreu Domingo A, Arribas Mir L, Cabero Roura L, de Cueto López M, López Sastre J, Melchor Marcos JC, Puertas Prieto A, de la Rosa Fraile M, Salcedo Abizanda S, Sánchez Luna M, Sanchez Pérez MJ, Torrejon Cardoso R. [Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document]. Enferm Infecc Microbiol Clin 2012; 31:159-72. [PMID: 22658283 DOI: 10.1016/j.eimc.2012.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 03/23/2012] [Indexed: 12/18/2022]
Abstract
Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.
Collapse
|
12
|
Lambiase A, Agangi A, Del Pezzo M, Quaglia F, Testa A, Rossano F, Martinelli P, Catania MR. In vitro resistance to macrolides and clindamycin by Group B Streptococcus isolated from pregnant and nonpregnant women. Infect Dis Obstet Gynecol 2012; 2012:913603. [PMID: 22675244 PMCID: PMC3362851 DOI: 10.1155/2012/913603] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 03/18/2012] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Despite the introduction of screening bases intrapartum prophylaxis, Streptococcus agalactiae is still an important etiological agent of perinatal infections. The increasing rate of resistance and the differences in resistance pattern among countries suggest that a program of surveillance at the institutional level is important in determining optimal prophylaxis. In contrast, knowledge on GBS epidemiology in Italy is limited, and no data are available in the Southern region of the country. We sought to determine the occurrence of resistance to macrolides and clindamycin of GBS isolates in pregnant and nonpregnant women. METHODS Between 2005 and 2008, 1346 vaginal and 810 rectovaginal swabs were obtained from pregnant and not-pregnant women. RESULTS The occurrence of macrolides and clindamycin resistance was 16.5% in 2005 increasing up to 69.9% in 2008. A high percentage of isolates was resistant to tetracycline through all the study period with no statistically significant annual. CONCLUSIONS In our cohort, an increase of in vitro resistance of GBS to macrolides and clindamycin is clearly evident. The discordance with reports from different countries emphasize the crucial role of microbiological methods in setting possible therapeutic strategies.
Collapse
Affiliation(s)
- Antonietta Lambiase
- Department of Cellular and Molecular Biology and Pathology Luigi Califano, “Federico II” University of Naples, 80131 Naples, Italy
| | - Annalisa Agangi
- Department of Obstetrics and Gynecology, Centre for STD and HIV/AIDS in Obstetrics and Gynecology, “Federico II” University of Naples, 80131 Naples, Italy
| | - Mariassunta Del Pezzo
- Department of Cellular and Molecular Biology and Pathology Luigi Califano, “Federico II” University of Naples, 80131 Naples, Italy
| | - Filomena Quaglia
- Department of Obstetrics and Gynecology, Centre for STD and HIV/AIDS in Obstetrics and Gynecology, “Federico II” University of Naples, 80131 Naples, Italy
| | - Antonio Testa
- Department of Cellular and Molecular Biology and Pathology Luigi Califano, “Federico II” University of Naples, 80131 Naples, Italy
| | - Fabio Rossano
- Department of Cellular and Molecular Biology and Pathology Luigi Califano, “Federico II” University of Naples, 80131 Naples, Italy
| | - Pasquale Martinelli
- Department of Obstetrics and Gynecology, Centre for STD and HIV/AIDS in Obstetrics and Gynecology, “Federico II” University of Naples, 80131 Naples, Italy
| | - Maria Rosaria Catania
- Department of Cellular and Molecular Biology and Pathology Luigi Califano, “Federico II” University of Naples, 80131 Naples, Italy
| |
Collapse
|
13
|
Ma YY, Hsu TY, Shen SY, Huang TS, Moh JS, Liu CM, Ou CY, Lin H. Epidemiology of group B Streptococcus ST-17 clone in pregnant women of South Taiwan. Gynecol Obstet Invest 2012; 73:285-93. [PMID: 22516869 DOI: 10.1159/000334406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 10/16/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We aimed to utilize a simple molecular assay to simultaneously detect both group B Streptococcus (GBS) and virulent ST-17 rectovaginal colonization. We also attempted to estimate the prevalence of maternal GBS and ST-17 carriers and to evaluate their seasonal association. SUBJECTS AND METHODS We used an optimized multiplex PCR method employing scp-B and ST-17 primers to analyze DNA extracted from rectovaginal swabs of 3,064 cases collected over 3 years. The incidence trends, seasonal variations, and temperature preference were analyzed. RESULTS The overall prevalence of maternal colonization for GBS and ST-17 clone were 13.25 and 2.48%, respectively. The ST-17 to GBS ratio was 18.72%. The occurrence of ST-17 colonization was significantly associated with seasonal variations with a preference for lower temperatures. CONCLUSIONS We developed a novel multiplex PCR method suitable for the simultaneous detection of GBS and ST-17 clone. The phenomenon of lower temperature preference for ST-17 clone necessitates further investigation. The epidemiological data for GBS and ST-17 incidence are especially important to establish a public policy for universal GBS screening in the future.
Collapse
Affiliation(s)
- Yen-Ying Ma
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC
| | | | | | | | | | | | | | | |
Collapse
|
14
|
High rates of perinatal group B Streptococcus clindamycin and erythromycin resistance in an upstate New York hospital. Antimicrob Agents Chemother 2011; 56:739-42. [PMID: 22143529 DOI: 10.1128/aac.05794-11] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to evaluate the rates of clindamycin and erythromycin resistance among group B Streptococcus (GBS)-positive isolates cultured from pregnant women in an upstate New York community hospital. All GBS-positive perinatal rectovaginal cultures obtained from January 2010 through October 2011 were tested for resistance to erythromycin and clindamycin. Among the 688 GBS-positive cultures, clindamycin resistance was found in 38.4% and erythromycin resistance was found in 50.7%. Rates of GBS resistance to clindamycin and erythromycin are much higher than reported in earlier U.S. studies, suggesting both increasing resistance and regional variation in resistance. These findings lend strong support to the CDC and American College of Obstetricians and Gynecologists (ACOG) recommendations that clindamycin use for intrapartum antibiotic prophylaxis be restricted to penicillin-allergic women at high risk of anaphylaxis and that GBS isolates be tested for antibiotic resistance prior to the use of clindamycin in these women.
Collapse
|
15
|
Kunze M, Ziegler A, Fluegge K, Hentschel R, Proempeler H, Berner R. Colonization, serotypes and transmission rates of group B streptococci in pregnant women and their infants born at a single University Center in Germany. J Perinat Med 2011; 39:417-22. [PMID: 21557677 DOI: 10.1515/jpm.2011.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate colonization, transmission rate and serotype distribution of group B streptococci (GBS) in pregnant women and infants born in a single University Center in Germany. METHODS In a prospective study we collected cultures from pregnant women and ear cultures from newborns. We performed serotyping and susceptibility testing. Obstetrical factors associated with mother to infant transmission were analyzed using logistic regression. RESULTS We evaluated cultures of 869 pregnant women and 845 neonates including 657 paired maternal-neonatal cultures. Maternal colonization occurred in 21.1% (183/869), transmission from mother to newborn in 11.2% (17/152). Intrapartum antimicrobial prophylaxis (IAP) and cesarean delivery were associated with reduction of transmission rate (P=0.014 and 0.019, respectively). The incidence for early-onset disease (EOD) was 1.71 per 1000 live births. Of GBS positive women IAP was administered in only 39% (59/152). Serotype III was the most prevalent isolate (28% maternal; 52% neonatal) and transmission occurred more frequently compared to other serotypes. CONCLUSIONS The incidence of EOD and distribution of serotypes in Germany are similar to published data from the USA prior to 1996. Despite national guidelines with universal GBS screening, our study demonstrated a lack of adherence to this recommendation. There is a need for enhanced compliance.
Collapse
Affiliation(s)
- Mirjam Kunze
- Department of Obstetrics and Gynecology, University Hospital Freiburg, Freiburg, Germany.
| | | | | | | | | | | |
Collapse
|
16
|
Joao EC, Gouvêa MI, Menezes JA, Matos HJ, Cruz MLS, Rodrigues CAS, de Souza MJ, Fracalanzza SEL, Botelho ACN, Calvet GA, Grinsztejn BGJ. Group B Streptococcus in a cohort of HIV-infected pregnant women: prevalence of colonization, identification and antimicrobial susceptibility profile. ACTA ACUST UNITED AC 2011; 43:742-6. [PMID: 21671824 DOI: 10.3109/00365548.2011.585178] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Group B Streptococcus (GBS) is a leading cause of infectious morbidity in newborns. We describe the prevalence of GBS colonization and the serotypes and antibiotic susceptibility profiles of isolates obtained from a cohort of human immunodeficiency virus (HIV)-infected pregnant women. This was a cross-sectional study at a centre for the prevention of mother-to-child transmission of HIV. Vaginal and rectal swabs were collected at 35-37 weeks of gestation from 158 eligible women. GBS isolates were serotyped and antimicrobial susceptibility tests performed. Patient sociodemographic characteristics, CD4 counts and viral loads were abstracted from records. The overall anogenital prevalence of GBS colonization was 49/158 (31.0%): 40/158 (25.3%) for vagina, 19/158 (12.0%) for rectum and 10/158 (6.3%) for both. Predominant serotypes were Ib (34.9%) and Ia (25.6%). All were penicillin-susceptible. Two were resistant to erythromycin (4.0%) and one to clindamycin (2.0%). The colonization rate by GBS was high in this cohort. Serotype Ib was the most frequently identified.
Collapse
Affiliation(s)
- Esau C Joao
- Department of Infectious Diseases, Hospital dos Servidores do Estado, Rua Sacadura Cabral 178, Pesquisa Clínica Saúde, Rio de Janeiro, RJ, Brazil.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Clerc O, Greub G. Routine use of point-of-care tests: usefulness and application in clinical microbiology. Clin Microbiol Infect 2010; 16:1054-61. [PMID: 20670287 DOI: 10.1111/j.1469-0691.2010.03281.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Point-of-care (POC) tests offer potentially substantial benefits for the management of infectious diseases, mainly by shortening the time to result and by making the test available at the bedside or at remote care centres. Commercial POC tests are already widely available for the diagnosis of bacterial and viral infections and for parasitic diseases, including malaria. Infectious diseases specialists and clinical microbiologists should be aware of the indications and limitations of each rapid test, so that they can use them appropriately and correctly interpret their results. The clinical applications and performance of the most relevant and commonly used POC tests are reviewed. Some of these tests exhibit insufficient sensitivity, and should therefore be coupled to confirmatory tests when the results are negative (e.g. Streptococcus pyogenes rapid antigen detection test), whereas the results of others need to be confirmed when positive (e.g. malaria). New molecular-based tests exhibit better sensitivity and specificity than former immunochromatographic assays (e.g. Streptococcus agalactiae detection). In the coming years, further evolution of POC tests may lead to new diagnostic approaches, such as panel testing, targeting not just a single pathogen, but all possible agents suspected in a specific clinical setting. To reach this goal, the development of serology-based and/or molecular-based microarrays/multiplexed tests will be needed. The availability of modern technology and new microfluidic devices will provide clinical microbiologists with the opportunity to be back at the bedside, proposing a large variety of POC tests that will allow quicker diagnosis and improved patient care.
Collapse
Affiliation(s)
- O Clerc
- Infectious Diseases Service, University Hospital Centre and University of Lausanne, Lausanne, Switzerland
| | | |
Collapse
|
18
|
Daniels JP, Gray J, Pattison HM, Gray R, Hills RK, Khan KS. Intrapartum tests for group B streptococcus: accuracy and acceptability of screening. BJOG 2010; 118:257-65. [DOI: 10.1111/j.1471-0528.2010.02725.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Hong JS, Choi CW, Park KU, Kim SN, Lee HJ, Lee HR, Choi EH, Park KH, Suh CS, Kim BI, Choi ST, Kim SS. Genital group B Streptococcus carrier rate and serotype distribution in Korean pregnant women: implications for group B streptococcal disease in Korean neonates. J Perinat Med 2010; 38:373-7. [PMID: 20297897 DOI: 10.1515/jpm.2010.050] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS We investigated the genital group B streptococcus (GBS) carrier rate in Korean pregnant women and the serotype distribution in face of the recent increase of late-onset GBS disease in Korea. METHODS GBS screening was performed on 4045 healthy pregnant women at 35-37 weeks' gestation. In case of positive GBS culture, serotyping was performed by using GBS typing antisera. RESULTS When both vaginal and anorectal culture were performed, the GBS carrier rate was 10.0% (n=121/1205), which is the highest rate ever reported in Korea. Type III was more common (36%), and type Ia (13%) and Ib (7%) were less prevalent. CONCLUSIONS Increased maternal genital GBS carrier rate and difference in serotype distribution pattern of GBS may be related to the recent increase of late-onset GBS disease in Korea.
Collapse
Affiliation(s)
- Joon-Seok Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Group B streptococcal disease in infants: progress in prevention and continued challenges. Clin Perinatol 2010; 37:375-92. [PMID: 20569813 DOI: 10.1016/j.clp.2010.02.002] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The burden of early-onset disease caused by group B Streptococcus (GBS) has decreased dramatically in the United States over the past 20 years. Universal culture-based screening at 35 to 37 weeks gestational age and use of intrapartum antibiotic prophylaxis are the cornerstones of prevention measures that have led to this decline. GBS, however, remains the leading cause of early-onset neonatal sepsis in the United States. Revised guidelines for prevention of perinatal GBS are planned for issuance in 2010. This article discusses implementation challenges for clinicians caring for pregnant women and newborns and presents an updated algorithm for neonatal management.
Collapse
|
21
|
Inactivation of DNA-binding response regulator Sak189 abrogates beta-antigen expression and affects virulence of Streptococcus agalactiae. PLoS One 2010; 5:e10212. [PMID: 20419089 PMCID: PMC2856668 DOI: 10.1371/journal.pone.0010212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 03/27/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Streptococcus agalactiae is able to colonize numerous tissues employing different mechanisms of gene regulation, particularly via two-component regulatory systems. These systems sense the environmental stimuli and regulate expression of the genes including virulence genes. Recently, the novel two-component regulatory system Sak188/Sak189 was identified. In S. agalactiae genome, it was adjacent to the bac gene encoding for beta-antigen, an important virulence factor. METHODOLOGY/PRINCIPAL FINDINGS In this study, the sak188 and sak189 genes were inactivated, and the functional role of Sak188/Sak189 two-component system in regulation of the beta-antigen expression was investigated. It was demonstrated that both transcription of bac gene and expression of encoded beta-antigen were controlled by Sak189 response regulator, but not Sak188 histidine kinase. It was also found that the regulation occurred at transcriptional level. Finally, insertional inactivation of sak189 gene, but not sak188 gene, significantly affected virulent properties of S. agalactiae. CONCLUSIONS/SIGNIFICANCE Sak189 response regulator is necessary for activation of bac gene transcription. It also controls the virulent properties of S. agalactiae. Given that the primary functional role of Sak188/Sak189 two-component systems is a control of bac gene transcription, this system can be annotated as BgrR/S (bacgene regulatory system).
Collapse
|