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Wang F, Yi L, Ming F, Dong R, Wang F, Chen R, Hu X, Chen X, Sun B, Tang YW, Zhu Y, Wu L. Evaluation of the Xpert Xpress GBS test for rapid detection of group B Streptococcus in pregnant women. Microbiol Spectr 2024; 12:e0220623. [PMID: 38054718 PMCID: PMC10783076 DOI: 10.1128/spectrum.02206-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 11/10/2023] [Indexed: 12/07/2023] Open
Abstract
IMPORTANCE This was the first study evaluating the performance of the Xpert Xpress group B Streptococcus (GBS) test using rectovaginal swabs from Chinese pregnant women. Compared to the other three assays, the Xpert Xpress GBS test demonstrated high sensitivity and specificity when screening 939 pregnant women for GBS in rectovaginal specimens. Additionally, its reduced time to obtain results makes it valuable for the rapid detection of GBS.
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Affiliation(s)
- Feiling Wang
- Clinical Laboratory, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Lehui Yi
- Clinical Laboratory, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, Guangdong, China
- Department of Graduate and Scientific Research, Zunyi Medical University Zhuhai Campus, Zhuhai, Guangdong, China
| | - Fang Ming
- Department of Obstetrics, Shenzhen Key Medical Discipline, Maternal-Fetal Medicine Institute, Shenzhen Bao'an Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Rui Dong
- Clinical Laboratory, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Feng Wang
- Clinical Laboratory, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Ruirui Chen
- Department of Obstetrics, Shenzhen Key Medical Discipline, Maternal-Fetal Medicine Institute, Shenzhen Bao'an Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Xiaoling Hu
- Clinical Affairs, Cepheid, Sunnyvale, California, USA
| | - Xuri Chen
- Department of Obstetrics, Shenzhen Key Medical Discipline, Maternal-Fetal Medicine Institute, Shenzhen Bao'an Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Bo Sun
- Department of Obstetrics, Shenzhen Key Medical Discipline, Maternal-Fetal Medicine Institute, Shenzhen Bao'an Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Yi-Wei Tang
- Medical Affairs, Cepheid, Sunnyvale, California, USA
- Danaher Diagnostic Platform China, Shanghai, China
| | - Yuanfang Zhu
- Department of Obstetrics, Shenzhen Key Medical Discipline, Maternal-Fetal Medicine Institute, Shenzhen Bao'an Women’s and Children’s Hospital, Shenzhen, Guangdong, China
| | - Lijuan Wu
- Clinical Laboratory, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, Guangdong, China
- Department of Obstetrics, Shenzhen Key Medical Discipline, Maternal-Fetal Medicine Institute, Shenzhen Bao'an Women’s and Children’s Hospital, Shenzhen, Guangdong, China
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Chaguza C, Jamrozy D, Bijlsma MW, Kuijpers TW, van de Beek D, van der Ende A, Bentley SD. Population genomics of Group B Streptococcus reveals the genetics of neonatal disease onset and meningeal invasion. Nat Commun 2022; 13:4215. [PMID: 35864107 PMCID: PMC9304382 DOI: 10.1038/s41467-022-31858-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/06/2022] [Indexed: 11/09/2022] Open
Abstract
Group B Streptococcus (GBS), or Streptococcus agalactiae, is a pathogen that causes preterm births, stillbirths, and acute invasive neonatal disease burden and mortality. Here, we investigate bacterial genetic signatures associated with disease onset time and meningeal tissue infection in acute invasive neonatal GBS disease. We carry out a genome-wide association study (GWAS) of 1,338 GBS isolates from newborns with acute invasive disease; the isolates had been collected annually, for 30 years, through a national bacterial surveillance program in the Netherlands. After controlling for the population structure, we identify genetic variation within noncoding and coding regions, particularly the capsule biosynthesis locus, statistically associated with neonatal GBS disease onset time and meningeal invasion. Our findings highlight the impact of integrating microbial population genomics and clinical pathogen surveillance, and demonstrate the effect of GBS genetics on disease pathogenesis in neonates and infants.
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Affiliation(s)
- Chrispin Chaguza
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK.
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Dorota Jamrozy
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Merijn W Bijlsma
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Taco W Kuijpers
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory of the Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Paediatric Haematology, Immunology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arie van der Ende
- Department of Medical Microbiology, Amsterdam Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
- Netherlands Reference Laboratory for Bacterial Meningitis, Center of Infection and Immunity Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands.
| | - Stephen D Bentley
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK.
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Incidence of Vaginal Colonization of Group B Streptococci among Pregnant Women Attending a Tertiary Care Hospital – Chennai, India. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Streptococcus agalactiae or Group B Streptococcus (GBS) is an important pathogen, which can cause serious illness and sometimes death especially in newborns, pregnant women and in people with compromised immune system. The major risk factor for neonatal disease is vaginal colonization of GBS during pregnancy and delivery. 1) To study the incidence of vaginal colonization of Group B Streptococcus (GBS) among pregnant women. 2) To compare the efficacy of sheep blood agar vs selective medium like HiCHROME Strep B Selective agar (HIMEDIA) in the isolation of GBS. Vaginal swabs were collected from 150 antenatal women at 35-37 weeks of gestation or at any gestational age if additional risk factors were present. The swabs were cultured on non-selective medium like Blood agar and a chromogenic medium (HiCHROME Strep B Agar, HiMedia). GBS was identified by standard microbiological techniques. Bluish, purple-colored colonies were confirmed as GBS by CAMP test and latex agglutination test. Only 3 out of 150 women (2%) of the screened antenatal women were colonized with GBS. Incidence was quite low, compared to the literature from the West. All the 3 babies born to the three women colonized with GBS were healthy with no indication of invasive GBS disease. The chromogenic medium supported the growth of Group B Streptococcus and Enterococcus spp. only and was a useful selective medium for isolation of GBS.
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Makinde O, Okusanya BO, Osanyin G. Group B Streptococcus vaginal colonization in pregnant women living with HIV infection: prevalence and antibiotic susceptibility at HIV referral centers in Lagos, Nigeria. J Matern Fetal Neonatal Med 2021; 35:9098-9104. [PMID: 34894995 DOI: 10.1080/14767058.2021.2015575] [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: 10/19/2022]
Abstract
OBJECTIVES Group B Streptococcus (GBS) colonization of the genital tract is often asymptomatic yet associated with increased risks of maternal and neonatal morbidity especially amongst women living with HIV infection. The objectives of this study were to determine the prevalence of GBS colonization of the genital tract in women living with HIV infection and antibiotic susceptibility of GBS in the genital tract. METHOD This cross-sectional study recruited 244 pregnant women (122 women living with HIV infection and 122 HIV-uninfected women) between 35 and 37 weeks of gestation. GBS colonization was determined by collecting lower vaginal and anal swabs at recruitment. Swabs were cultured in Todd Hewitt's broth and confirmed by Christie, Atkins, and Munch-Peterson (CAMP) test. Most recent CD4 count and viral load estimates were retrieved from the women's records. Maternal and neonatal outcomes and antibiotic susceptibility were assessed. Statistical analysis was performed at 95% confidence interval at a statistical significance of p < .005. RESULTS The prevalence of GBS colonization of the genital tract in all participants was 3.3%; GBS was isolated in 4 (3.3%) of 122 pregnant women living with HIV. No woman with a GBS-colonized genital tract developed puerperal sepsis and no neonatal infection occurred in neonates born to GBS-positive women, irrespective of HIV infection status. In women living with HIV, GBS isolate was resistant to Ampicillin (100%), Ceftriaxone (100%), Vancomycin (100%), yet partially sensitive to Ciprofloxacin (50%). CONCLUSION Pregnant women living with HIV do not have an increased risk of genital GBS colonization. Vaginal GBS colonization was not associated with an adverse perinatal outcome. Antibiotic use for GBS colonization should be based on sensitivity pattern and not empiric.
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Affiliation(s)
- O Makinde
- SouthShore Women's Clinic, Victoria Island, Lagos, Nigeria
| | - B O Okusanya
- Department of Obstetrics and Gynaecology College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - G Osanyin
- Department of Obstetrics and Gynaecology College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Wang CH, Kung WJ, Lee CH, Lee CF, Kao CL, Chen HC, Hsu TW, Lin CC. High rates of colonization and antimicrobial resistance of group B streptococcus highlight the need for vaccination even after implementation of guidelines for intrapartum antibiotic prophylaxis. Vaccine 2021; 40:282-287. [PMID: 34865875 DOI: 10.1016/j.vaccine.2021.11.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION It is estimated that about 11-35% of pregnant women are colonized with Group B streptococcus. Intrapartum antibiotic prophylaxis (IAP) is the primary intervention to decrease the risk of infecting babies born to GBS colonized mothers. METHODS A total of 5,996 pregnant women, who received the Taiwanese universal GBS screening program from 2012 to 2020, were included in this study that investigated GBS colonization, antimicrobial resistance rates and their neonatal incidence of invasive GBS infection. RESULTS The average GBS colonization rate was 18.5%. Older age groups had higher colonization rates than younger age groups. Compared to Taiwanese, immigrant women from Indonesia had a greater positive rate. GBS isolated from Vietnamese women had significant greater resistance to clindamycin relative to Taiwanese women. Rates of resistance to erythromycin increase from 35.5% to 45.5% over the 9 years of measurements. The incidence of invasive GBS disease was about 0.6/1,000 (4/6,204) live births during the study. CONCLUSIONS Although relatively low incidence of invasive GBS diseases was observed after implementation of IAP, the colonization of GBS remains high and antimicrobial resistance of GBS is increasing. An effective GBS vaccine holds promise to be a solution for these issues.
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Affiliation(s)
- Ching-Hui Wang
- Department of Laboratory Medicine, Fooyin University Hospital, Pingtung, Taiwan
| | - Wan-Ju Kung
- Department of Laboratory Medicine, Fooyin University Hospital, Pingtung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health and Environmental Medicine Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Fa Lee
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Ling Kao
- Department of Nursing, Fooyin University Hospital, Pingtung, Taiwan
| | - Hui-Chi Chen
- Department of Nursing, Fooyin University Hospital, Pingtung, Taiwan
| | - Ting-Wen Hsu
- Department of Nursing, Fooyin University Hospital, Pingtung, Taiwan
| | - Ching-Chiang Lin
- Department of Laboratory Medicine, Fooyin University Hospital, Pingtung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan; Department of Education and Research, Fooyin University Hospital, Pingtung, Taiwan.
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Effects of group B streptococcus infection on vaginal micro-ecology and pregnancy outcomes of pregnant women in late pregnancy. Eur J Obstet Gynecol Reprod Biol 2021; 267:274-279. [PMID: 34839249 DOI: 10.1016/j.ejogrb.2021.11.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/05/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Invasive infection with group B streptococcus (GBS) can lead to intrauterine infection, and GBS can also spread via vertical transmission between mother and infant, resulting in adverse pregnancy outcomes. This study aimed to investigate the effects of GBS colonization in late gestation on vaginal micro-ecology, pregnancy outcomes and neonatal outcome. METHODS One hundred and twenty pregnant women in the third trimester infected with GBS and 120 healthy counterparts who underwent a prenatal examination in the obstetrics department of the study hospital from June 2019 to December 2020 were selected for inclusion in the study. Vaginal micro-ecological index, mode of delivery, adverse pregnancy outcomes and neonatal Apgar score were compared between the two groups. RESULTS The incidence rates of vaginal micro-ecological disorders, intrauterine infection and neonatal infection were significantly higher in the GBS group compared with the control group. The incidence rates of neonatal fetal distress and pathological jaundice were much higher in the GBS group compared with the control group. The neonatal Apgar score was markedly lower in the GBS group compared with the control group. CONCLUSIONS GBS infection is correlated with the vaginal micro-environment. GBS colonization in late pregnancy has adverse effects on vaginal micro-ecology and pregnancy outcome.
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Gatea Kaabi SA, Musafer HK. New Phage cocktail against infantile Sepsis bacteria. Microb Pathog 2020; 148:104447. [PMID: 32805360 DOI: 10.1016/j.micpath.2020.104447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/27/2022]
Abstract
A total of 54 positive blood aerobic cultures of suspected blood sepsis in neonates were purified, diagnosed and tested for antibiotic susceptibility. Six bacterial pathogens of Escherichia coli (10 isolates), Klebsiella pneumoniae (10 isolates), Haemophilus influenzae (4 isolates), Pseudomonas aeruginosa (3 isolates), Citrobacter fruendii (1 isolate) and Moraxella catarrhalis (1 isolate) were selected for preparation of phages active against all isolates of each species. Virulent phages towards bacterial isolates were isolated from sewage water by spot lysis method, and a total of 29 phages active towards selected bacterial pathogens were isolated and purified. Phage(s) active against each bacterial species showed activity spectrum within each species of 30-80%, 50-80%, 50%, 50%, 100% and 100% for isolates of Escherichia coli, Klebsiella spp., Haemophilus influenzae, Pseudomonas aeruginosa, Citrobacter fruendii and Moraxella catarrhalis, respectively. A total of 29 phages were formulated in one cocktail in a concentration of 106 PFU/ml in SM buffer for each of a total of 29 phages in SM buffer and showed activity spectrum of 100% against all their bacterial hosts in vitro.
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Affiliation(s)
| | - Hadeel Kareem Musafer
- Department of Biology, College of Science, Mustansiriyah University, Box 14022, Baghdad, Iraq.
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Hasperhoven GF, Al‐Nasiry S, Bekker V, Villamor E, Kramer BWW. Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent early-onset group B streptococcal disease: a systematic review and meta-analysis. BJOG 2020; 127:680-691. [PMID: 31913562 PMCID: PMC7187465 DOI: 10.1111/1471-0528.16085] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Early-onset group B streptococcal (EOGBS) disease (including sepsis, meningitis, and pneumonia) causes significant morbidity and mortality in newborn infants worldwide. Antibiotic prophylaxis can prevent vertical streptococcal transmission, yet no uniform criteria exist to identify eligible women for prophylaxis. Some guidelines recommend universal GBS screening to pregnant women in their third trimester (screening-based protocol), whereas others employ risk-based protocols. OBJECTIVES To compare the effectiveness of screening-based versus risk-based protocols in preventing EOGBS disease. SEARCH STRATEGY Key words for the database searches included GBS, Streptococcus agalactiae, pregnancy, screening, culture-based, risk-based. SELECTION CRITERIA Studies were included if they investigated EOGBS disease incidence in newborn infants and compared screening or risk-based protocols with each other or with controls. DATA COLLECTION AND ANALYSIS Risk ratios (RR) and 95% confidence intervals (CI) were determined using Mantel-Haenszel analyses with random effects. MAIN RESULTS Seventeen eligible studies were included. In this meta-analysis, screening was associated with a reduced risk for EOGBS disease compared either with risk-based protocols (ten studies, RR 0.43, 95% CI 0.32-0.56) or with no policy (four studies, RR 0.31, 95% CI 0.11-0.84). Meta-analysis could not demonstrate a significant effect of risk-based protocols versus no policy (seven studies, RR 0.86, 95% CI 0.61-1.20). In studies reporting on the use of antibiotics, screening was not associated with higher antibiotic administration rates (31 versus 29%). CONCLUSIONS Screening-based protocols were associated with lower incidences of EOGBS disease compared with risk-based protocols, while not clearly overexposing women to antibiotics. This information is of relevance for future policymaking. TWEETABLE ABSTRACT Meta-analysis: general screening is associated with lower rates of early-onset group B strep. neonatal sepsis compared with risk-based protocols.
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Affiliation(s)
- GF Hasperhoven
- Faculty of Health Medicine and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
| | - S Al‐Nasiry
- Department of Gyneacology and ObstetricsMaastricht University Medical CentreMaastrichtthe Netherlands
| | - V Bekker
- Department of PaediatricsLeiden University Medical CentreLeidenthe Netherlands
| | - E Villamor
- Department of PaediatricsMaastricht University Medical CentreMaastrichtthe Netherlands
| | - BWW Kramer
- Department of PaediatricsMaastricht University Medical CentreMaastrichtthe Netherlands
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Chiu NC. Prevention of Group B streptococcus infection. Pediatr Neonatol 2019; 60:233-234. [PMID: 31101450 DOI: 10.1016/j.pedneo.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nan-Chang Chiu
- Department of Pediatrics, Mackay Children's Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei 10449, Taiwan.
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