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Research article
Jisuvei Clayton Salano
kenyatta national hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2210-4631
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Estimates of group B streptococcus ( GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS.
Methods We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization.
Results A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/58 (72.4%) isolates, ampicillin in 32/58 (55.2%) isolates, clindamycin in 14/46 (30.4%) isolates, and vancomycin in 14/58 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization.
Conclusion The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.
Keywords
Group B Streptococcus, Pregnant women, Antimicrobial susceptibility, Serotypes, Kenya
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CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
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Posted 15 Apr, 2020
No community comments so far
Editorial decision: Accept
On 13 Apr, 2020
Editor assigned
On 12 Apr, 2020
Submission checks complete
On 11 Apr, 2020
Editor invited
On 11 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 08 Apr, 2020
Review #2 received
Received 05 Apr, 2020
Review #1 received
Received 27 Mar, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 25 Mar, 2020
Reviewers invited
Invitations sent on 24 Mar, 2020
Editor assigned
On 23 Mar, 2020
Submission checks complete
On 22 Mar, 2020
Editor invited
On 22 Mar, 2020
No comments provided
Editorial decision: Major revision
On 25 Feb, 2020
Review #2 received
Received 25 Feb, 2020
Reviewer #2 agreed
On 11 Feb, 2020
Reviewer #1 agreed
On 19 Dec, 2019
Review #1 received
Received 19 Dec, 2019
Reviewers invited
Invitations sent on 18 Dec, 2019
Editor assigned
On 12 Dec, 2019
Submission checks complete
On 12 Dec, 2019
Editor invited
On 12 Dec, 2019
First submitted
On 03 Dec, 2019
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Jisuvei Clayton Salano
kenyatta national hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2210-4631
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 3
Posted 15 Apr, 2020
No community comments so far
Editorial decision: Accept
On 13 Apr, 2020
Editor assigned
On 12 Apr, 2020
Submission checks complete
On 11 Apr, 2020
Editor invited
On 11 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 08 Apr, 2020
Review #2 received
Received 05 Apr, 2020
Review #1 received
Received 27 Mar, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 25 Mar, 2020
Reviewers invited
Invitations sent on 24 Mar, 2020
Editor assigned
On 23 Mar, 2020
Submission checks complete
On 22 Mar, 2020
Editor invited
On 22 Mar, 2020
No comments provided
Editorial decision: Major revision
On 25 Feb, 2020
Review #2 received
Received 25 Feb, 2020
Reviewer #2 agreed
On 11 Feb, 2020
Reviewer #1 agreed
On 19 Dec, 2019
Review #1 received
Received 19 Dec, 2019
Reviewers invited
Invitations sent on 18 Dec, 2019
Editor assigned
On 12 Dec, 2019
Submission checks complete
On 12 Dec, 2019
Editor invited
On 12 Dec, 2019
First submitted
On 03 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background Estimates of group B streptococcus ( GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS.
Methods We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization.
Results A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/58 (72.4%) isolates, ampicillin in 32/58 (55.2%) isolates, clindamycin in 14/46 (30.4%) isolates, and vancomycin in 14/58 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization.
Conclusion The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.
Figure 1
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