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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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Roth BM, Laps A, Yamba K, Heil EL, Johnson JK, Stafford K, Hachaambwa LM, Kalumbi M, Mulenga L, Patel DM, Claassen CW. Antibiogram Development in the Setting of a High Frequency of Multi-Drug Resistant Organisms at University Teaching Hospital, Lusaka, Zambia. Antibiotics (Basel) 2021; 10:782. [PMID: 34203126 PMCID: PMC8300684 DOI: 10.3390/antibiotics10070782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 11/24/2022] Open
Abstract
Antimicrobial resistance is a global challenge requiring reliable surveillance data collection and use. Prior studies on resistance in Zambia depended on laboratory methods with limited standardization. Since 2015, the University Teaching Hospital (UTH) microbiology laboratory has used the Vitek 2 Compact (bioMerieux, Inc., Marcy-l'Étoile, France) for standardized identification and susceptibility testing. We conducted a cross-sectional study of 2019 bacterial isolates collected from July 2015 to April 2017 to identify bacterial causes of infections, their susceptibility to commonly used antibiotics at UTH, and develop hospital antibiograms with a multidisciplinary team using World Health Organization guidance. We found high levels of antibiotic resistance among Gram negative bacteria. Escherichia coli and Klebsiella pneumoniae were highly resistant to all antibiotics except amikacin and carbapenems. E. coli had susceptibilities of 42.4% to amoxicillin/clavulanic acid, 41.4% to ceftriaxone, 40.2% to ciprofloxacin, and 10.4% to trimethoprim/sulfamethoxazole (TMP/SMX). K. pneumoniae had susceptibilities of 20.7% to amoxicillin/clavulanic acid, 15.6% to ceftriaxone, 48.5% to ciprofloxacin, and 12.3% to TMP/SMX. The high resistance to 3rd generation cephalosporins indicates high rates of beta-lactamase production. This is information that clinicians need to inform clinical decision making and choice of empiric antibiotics and that UTH requires to inform antimicrobial stewardship such as improvements in antibiotic use.
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Affiliation(s)
- Brenna M. Roth
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD 21201, USA; (K.S.); (L.M.H.); (C.W.C.)
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Alexandra Laps
- University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Kaunda Yamba
- Department of Pathology and Microbiology, University Teaching Hospital, Lusaka 10101, Zambia; (K.Y.); (M.K.)
| | - Emily L. Heil
- Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA;
| | - J. Kristie Johnson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Kristen Stafford
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD 21201, USA; (K.S.); (L.M.H.); (C.W.C.)
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Lottie M. Hachaambwa
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD 21201, USA; (K.S.); (L.M.H.); (C.W.C.)
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Department of Medicine, University of Zambia School of Medicine, Lusaka 10101, Zambia;
- Infectious Diseases Unit, Department of Internal Medicine, University Teaching Hospital, Lusaka 10101, Zambia
| | - Mox Kalumbi
- Department of Pathology and Microbiology, University Teaching Hospital, Lusaka 10101, Zambia; (K.Y.); (M.K.)
| | - Lloyd Mulenga
- Department of Medicine, University of Zambia School of Medicine, Lusaka 10101, Zambia;
- Infectious Diseases Unit, Department of Internal Medicine, University Teaching Hospital, Lusaka 10101, Zambia
- Ministry of Health, Government of the Republic of Zambia, Lusaka 10101, Zambia
| | - Devang M. Patel
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Cassidy W. Claassen
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD 21201, USA; (K.S.); (L.M.H.); (C.W.C.)
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Department of Medicine, University of Zambia School of Medicine, Lusaka 10101, Zambia;
- Infectious Diseases Unit, Department of Internal Medicine, University Teaching Hospital, Lusaka 10101, Zambia
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Hombach M, Zbinden R, Böttger EC. Standardisation of disk diffusion results for antibiotic susceptibility testing using the sirscan automated zone reader. BMC Microbiol 2013; 13:225. [PMID: 24099061 PMCID: PMC3852248 DOI: 10.1186/1471-2180-13-225] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 10/03/2013] [Indexed: 12/04/2022] Open
Abstract
Background Standardisation of disk diffusion readings could improve reproducibility and accuracy of antibiotic susceptibility testing (AST). This study evaluated accuracy, reproducibility, and precision of automated inhibition zone reading using the “Sirscan automatic” zone reader (i2a, Perols Cedex, France). Results In a first step we compared Sirscan results with manual calliper measurements for comparability and accuracy. Sirscan readings were checked and adjusted on-screen as recommended by the manufacturer. One hundred clinical bacterial isolates representing a broad spectrum of organisms routinely isolated in a clinical laboratory were tested, and zone diameter values and interpretation according to EUCAST guidelines were compared. In a second step we analysed, whether fully automated zone reading can decrease standard deviation of diameter measurements and, thus, improve reproducibility and precision of the disk diffusion method. Standard deviations of manual measurements, on-screen adjusted Sirscan measurements, and fully automated Sirscan readings were compared for 19 repeat independent measurements of inhibition zones of S. aureus ATCC 29213, E. coli ATCC 25922, and P. aeruginosa ATCC 27853 (EUCAST quality control strains). On-screen adjusted Sirscan and calliper measurements displayed high comparability. No significant differences were detected comparing the results of both reading methods. Standard deviations of inhibition zone diameters were significantly lower for fully automated Sirscan measurements compared with both adjusted Sirscan readings and the manual method, resulting in better reproducibility and precision of the automated readings. Conclusions Our results indicate that fully automated zone reading can further improve standardisation of AST by decreasing standard deviation and, thus, improve precision of inhibition zone diameter results.
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Affiliation(s)
- Michael Hombach
- Institut für Medizinische Mikrobiologie, Universität Zürich, Gloriastrasse 30/32, 8006 Zürich, Switzerland.
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