Prevalence, antimicrobial susceptibility patterns, serotypes and risk factors for group B streptococcus rectovaginal isolates among pregnant women at Kenyatta National Hospital, Kenya; A cross-sectional study
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
Posted 15 Apr, 2020
On 12 Apr, 2020
On 11 Apr, 2020
On 11 Apr, 2020
On 08 Apr, 2020
Received 05 Apr, 2020
Received 27 Mar, 2020
On 26 Mar, 2020
On 25 Mar, 2020
Invitations sent on 24 Mar, 2020
On 23 Mar, 2020
On 22 Mar, 2020
On 22 Mar, 2020
On 25 Feb, 2020
Received 25 Feb, 2020
On 11 Feb, 2020
On 19 Dec, 2019
Received 19 Dec, 2019
Invitations sent on 18 Dec, 2019
On 12 Dec, 2019
On 12 Dec, 2019
On 12 Dec, 2019
On 03 Dec, 2019
Prevalence, antimicrobial susceptibility patterns, serotypes and risk factors for group B streptococcus rectovaginal isolates among pregnant women at Kenyatta National Hospital, Kenya; A cross-sectional study
Posted 15 Apr, 2020
On 12 Apr, 2020
On 11 Apr, 2020
On 11 Apr, 2020
On 08 Apr, 2020
Received 05 Apr, 2020
Received 27 Mar, 2020
On 26 Mar, 2020
On 25 Mar, 2020
Invitations sent on 24 Mar, 2020
On 23 Mar, 2020
On 22 Mar, 2020
On 22 Mar, 2020
On 25 Feb, 2020
Received 25 Feb, 2020
On 11 Feb, 2020
On 19 Dec, 2019
Received 19 Dec, 2019
Invitations sent on 18 Dec, 2019
On 12 Dec, 2019
On 12 Dec, 2019
On 12 Dec, 2019
On 03 Dec, 2019
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