Group B streptococcus prevalence, serotype distribution and colonization dynamics in Western Australian pregnant women

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Abstract

Purpose. Streptococcus agalactiae, or group B streptococcus (GBS), is a leading neonatal pathogen that causes sepsis, meningitis and pneumonia. Globally, strategies have been implemented to address vertical transmission, and in Western Australia (WA), culture-based screening at 35-37 weeks' gestation is part of routine care and guides antibiotic administration. Previous Australian studies have focused on other regions or included low sample-size representatives; we aimed to describe antenatal GBS colonization in WA.

Methodology. A cohort of 814 pregnant women attending antenatal clinics (2015-2017) self-collected vaginal and rectal swabs at = 22 weeks (n= 814) and >= 33 weeks' (n=567) gestation. These were assessed for GBS presence using culture and PCR, and serotyping was conducted using molecular methods. Lifestyle questionnaires and medical data were collected.

Results. We observed an overall GBS colonization rate of 24%, with 10.6 % of positive participants transiently colonized. Ethnicity (Aboriginal, Torres Strait Islander and African), maternal age >= 25 years, vitamin use, frequent sexual intercourse (>= 5 times/week) and use of sex toys were associated with GBS colonization. The dominant serotypes identified were Ia (27.9%), III (20.9%), II (16.3%), V (15.8%), Ib (8.4%), VI (5.1%), IV (2.8%), NT (1.9), VIII (0.5%) and IX (0.5%) at visit one, with V (18.9%) preceding serotype II (18.2%) at visit two. Serotype VII was not detected.

Conclusion. This is the first cohort study to assess GBS colonization in Western Australian pregnant women and will be highly beneficial for guiding clinical practice and future therapeutic options, in particular, the selection of suitable vaccine candidates.

Original languageEnglish
Pages (from-to)728-740
Number of pages13
JournalJournal of Medical Microbiology
Volume68
Issue number5
DOIs
Publication statusPublished - May 2019

Cite this

@article{f68ac327382a43feb87230f2e37d86da,
title = "Group B streptococcus prevalence, serotype distribution and colonization dynamics in Western Australian pregnant women",
abstract = "Purpose. Streptococcus agalactiae, or group B streptococcus (GBS), is a leading neonatal pathogen that causes sepsis, meningitis and pneumonia. Globally, strategies have been implemented to address vertical transmission, and in Western Australia (WA), culture-based screening at 35-37 weeks' gestation is part of routine care and guides antibiotic administration. Previous Australian studies have focused on other regions or included low sample-size representatives; we aimed to describe antenatal GBS colonization in WA.Methodology. A cohort of 814 pregnant women attending antenatal clinics (2015-2017) self-collected vaginal and rectal swabs at = 22 weeks (n= 814) and >= 33 weeks' (n=567) gestation. These were assessed for GBS presence using culture and PCR, and serotyping was conducted using molecular methods. Lifestyle questionnaires and medical data were collected.Results. We observed an overall GBS colonization rate of 24{\%}, with 10.6 {\%} of positive participants transiently colonized. Ethnicity (Aboriginal, Torres Strait Islander and African), maternal age >= 25 years, vitamin use, frequent sexual intercourse (>= 5 times/week) and use of sex toys were associated with GBS colonization. The dominant serotypes identified were Ia (27.9{\%}), III (20.9{\%}), II (16.3{\%}), V (15.8{\%}), Ib (8.4{\%}), VI (5.1{\%}), IV (2.8{\%}), NT (1.9), VIII (0.5{\%}) and IX (0.5{\%}) at visit one, with V (18.9{\%}) preceding serotype II (18.2{\%}) at visit two. Serotype VII was not detected.Conclusion. This is the first cohort study to assess GBS colonization in Western Australian pregnant women and will be highly beneficial for guiding clinical practice and future therapeutic options, in particular, the selection of suitable vaccine candidates.",
keywords = "Streptococcus agalactiae, Group B streptococcus, epidemiology, antenatal screening, serotype, risk factor, MULTIPLEX PCR ASSAY, MATERNAL COLONIZATION, VAGINAL COLONIZATION, PREMATURE RUPTURE, RISK-FACTORS, AGALACTIAE, DISEASE, EPIDEMIOLOGY, MEMBRANES, GENOTYPES",
author = "Furfaro, {Lucy L.} and Nathan, {Elizabeth A.} and Chang, {Barbara J.} and Payne, {Matthew S.}",
year = "2019",
month = "5",
doi = "10.1099/jmm.0.000980",
language = "English",
volume = "68",
pages = "728--740",
journal = "Journal of Medical Microbiology",
issn = "0022-2615",
publisher = "Society for General Microbiology",
number = "5",

}

TY - JOUR

T1 - Group B streptococcus prevalence, serotype distribution and colonization dynamics in Western Australian pregnant women

AU - Furfaro, Lucy L.

AU - Nathan, Elizabeth A.

AU - Chang, Barbara J.

AU - Payne, Matthew S.

PY - 2019/5

Y1 - 2019/5

N2 - Purpose. Streptococcus agalactiae, or group B streptococcus (GBS), is a leading neonatal pathogen that causes sepsis, meningitis and pneumonia. Globally, strategies have been implemented to address vertical transmission, and in Western Australia (WA), culture-based screening at 35-37 weeks' gestation is part of routine care and guides antibiotic administration. Previous Australian studies have focused on other regions or included low sample-size representatives; we aimed to describe antenatal GBS colonization in WA.Methodology. A cohort of 814 pregnant women attending antenatal clinics (2015-2017) self-collected vaginal and rectal swabs at = 22 weeks (n= 814) and >= 33 weeks' (n=567) gestation. These were assessed for GBS presence using culture and PCR, and serotyping was conducted using molecular methods. Lifestyle questionnaires and medical data were collected.Results. We observed an overall GBS colonization rate of 24%, with 10.6 % of positive participants transiently colonized. Ethnicity (Aboriginal, Torres Strait Islander and African), maternal age >= 25 years, vitamin use, frequent sexual intercourse (>= 5 times/week) and use of sex toys were associated with GBS colonization. The dominant serotypes identified were Ia (27.9%), III (20.9%), II (16.3%), V (15.8%), Ib (8.4%), VI (5.1%), IV (2.8%), NT (1.9), VIII (0.5%) and IX (0.5%) at visit one, with V (18.9%) preceding serotype II (18.2%) at visit two. Serotype VII was not detected.Conclusion. This is the first cohort study to assess GBS colonization in Western Australian pregnant women and will be highly beneficial for guiding clinical practice and future therapeutic options, in particular, the selection of suitable vaccine candidates.

AB - Purpose. Streptococcus agalactiae, or group B streptococcus (GBS), is a leading neonatal pathogen that causes sepsis, meningitis and pneumonia. Globally, strategies have been implemented to address vertical transmission, and in Western Australia (WA), culture-based screening at 35-37 weeks' gestation is part of routine care and guides antibiotic administration. Previous Australian studies have focused on other regions or included low sample-size representatives; we aimed to describe antenatal GBS colonization in WA.Methodology. A cohort of 814 pregnant women attending antenatal clinics (2015-2017) self-collected vaginal and rectal swabs at = 22 weeks (n= 814) and >= 33 weeks' (n=567) gestation. These were assessed for GBS presence using culture and PCR, and serotyping was conducted using molecular methods. Lifestyle questionnaires and medical data were collected.Results. We observed an overall GBS colonization rate of 24%, with 10.6 % of positive participants transiently colonized. Ethnicity (Aboriginal, Torres Strait Islander and African), maternal age >= 25 years, vitamin use, frequent sexual intercourse (>= 5 times/week) and use of sex toys were associated with GBS colonization. The dominant serotypes identified were Ia (27.9%), III (20.9%), II (16.3%), V (15.8%), Ib (8.4%), VI (5.1%), IV (2.8%), NT (1.9), VIII (0.5%) and IX (0.5%) at visit one, with V (18.9%) preceding serotype II (18.2%) at visit two. Serotype VII was not detected.Conclusion. This is the first cohort study to assess GBS colonization in Western Australian pregnant women and will be highly beneficial for guiding clinical practice and future therapeutic options, in particular, the selection of suitable vaccine candidates.

KW - Streptococcus agalactiae

KW - Group B streptococcus

KW - epidemiology

KW - antenatal screening

KW - serotype

KW - risk factor

KW - MULTIPLEX PCR ASSAY

KW - MATERNAL COLONIZATION

KW - VAGINAL COLONIZATION

KW - PREMATURE RUPTURE

KW - RISK-FACTORS

KW - AGALACTIAE

KW - DISEASE

KW - EPIDEMIOLOGY

KW - MEMBRANES

KW - GENOTYPES

U2 - 10.1099/jmm.0.000980

DO - 10.1099/jmm.0.000980

M3 - Article

VL - 68

SP - 728

EP - 740

JO - Journal of Medical Microbiology

JF - Journal of Medical Microbiology

SN - 0022-2615

IS - 5

ER -