Prevalence of Streptococcus agalactiae colonisation among pregnant women in Slovenia, 2013-2014
Abstract
Abstract
Background: Streptococcus agalactiae is the leading cause of preventable invasive neonatal infections. Detection of maternal colonisation and use of antimicrobial prophylaxis during labour is a standard preventative approach. Very few data about the prevalence of colonisation with S. agalactiae among pregnant women in Slovenia are available.
Methods: We performed a retrospective study of consecutive samples from pregnant women screened for S. agalactiae colonisation with enrichment culture during the period 2013-2014. Basic demographic data, specimen type, timing and result of the assay were analysed. Cumulative antimicrobial susceptibility for the positive samples was calculated.
Results: During 2 years study period 1564 pregnant women were tested. Mean age 31 years (18-46 years). Among samples received, majority were vaginal swabs 57,0 % (n=893). Recommended combined vaginal-rectal swabs were received in 12,9 % (n=192). Overall prevalence of maternal colonisation was 17,1 % (n=268) and did not differ with regard to specimen type. Resistance or reduced susceptibility to erythromycin and clindamycin was 23,1 % (n=62) and 20,9 % (n=56), respectively. No resistance to penicillin and vancomycin was detected.
Conclusions: Few pregnant women get screened for S. agalactiae in Slovenia. Nevertheless, high colonisation rate was detected on a large sample size. Most samples were taken during the proposed period between 35-37 week of pregnancy. Recommended combined vaginal-rectal were less frequently taken for screening than vaginal swabs only. Penicillin and vancomycin remains universally active against S. agalactiae. However, erythromycin and clindamycin resistance was high.Downloads
References
Edmond KM, Kortsalioudaki C, Scott S, Schrag SJ, Zaidi AKM, Cousens S, et al. Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. Lancet. 2012; 379: 547–56.
Krivec Lozar J, Mueller-Premru M, Jeverica S. Izbira antibiotikov in novosti pri zdravljenju neonatalne sepse. In: Paro-Panjan D, ed. Neonatalne okužbe in imunski odziv pri novorojenčkih: znanstvena monografja. Ljubljana: UKC Ljubljana, Pediatrična klinika, Klinični oddelek za neonatologijo; 2013. p.43–57.
Verani JR, McGee L, Schrag SJ, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010; 59: 1–36.
Boyer KM, Gotoff SP. Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N Engl J Med. 1986; 314: 1665–9.
Guilbert J, Levy C, Cohen R, Bacterial meningitis group, Delacourt C, Renolleau S, et al. Late and ultra late onset Streptococcus B meningitis: clinical and bacteriological data over 6 years in France. Acta Paediatr. 2010; 99: 47–51.
van Dyke MK, Phares CR, Lynfeld R, Tomas AR, Arnold KE, Craig AS, et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009; 360: 2626–36.
Di Renzo GC, Melin P, Berardi A, Blennow M, Carbonell-Estrany X, Donzelli GP, et al. Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference. J Matern Fetal Neonatal Med. 2015; 28: 766–82
Schrag SJ, Zell ER, Lynfeld R, Roome A, Arnold KE, Craig AS, et al. A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates. N Engl J Med. 2002; 347: 233–9.
American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee Opinion No. 485: Prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol. 2011; 117: 1019–27.
Money DM, Dobson S, Canadian Paediatric Society, Infectious Diseases Commitee. Te prevention of early-onset neonatal group B streptococcal disease. J Obstet Gynaecol Can. 2004; 26: 826–40.
Te prevention of early-onset neonatal group B streptococcal disease. 2nd ed. London: Royal College of Obstetricians and Gynaecologists; 2012.
Te prevention of early-onset neonatal group B streptococcus infection. Victoria: Royal Australian and New Zealand College of Obstetricians and Gynaecologists; 2014.
Uradni list Republike Slovenije. Navodilo o spremembah in dopolnitvah navodila za izvajanje preventivnega zdravstvenega varstva na primarni ravni. Ur l RS. 2002; 33: 3122–9.
Couturier BA, Weight T, Elmer H, Schlaberg R. Antepartum screening for group B streptococcus by three FDA-cleared molecular tests and effect of shortened enrichment culture on molecular detection rates. J Clin Microbiol. 2014; 52: 3429–32.
Fišer J, Špacapan S, Prinčič D, Frelig T. Odkrivanje kolonizacije nosečnic z bakterijo Streptococcus agalactiae v severnoprimorski regiji. Zdrav Vestn. 2001; 70: 623–6.
Štrumbelj I, Gubina M, Jeverica S, Troha BN, Golle A, Zdolšek B, et al. Občutljivost slovenskih izolatov Streptococcus agalactiae iz rodil za izbrane antibiotike. Med Razgl. 2006; 45 suppl 3: s57–s63.
Clinical and Labortory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: CLSI document M100-S24. CLSI; Wayne, Pennsilvania; 2014.
Te European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0. EUCAST; 2014.
Nacionalni inštitut za javno zdravje. Preliminarni podatki o številu rojstev v letu 2014. Nacionalni inštitut za javno zdravje. Dosegljivo 17. 3. 2015 s spletne strani: http://www.ivz.si/Mp.aspx?ni=0π=19&_19_view=item&_19_newsid=2708&pl=0–19.0.
Platt MW, McLaughlin JC, Gilson GJ, Wellhoner MF, Nims LJ. Increased recovery of group B streptococcus by the inclusion of rectal culturing and enrichment. Diagn Microbiol Infect Dis. 1995; 21: 65–8.
Buchan BW, Olson WJ, Mackey T-LA, Ledeboer NA. Clinical evaluation of the walk-away specimen processor and ESwab for recovery of Streptococcus agalactiae isolates in prenatal screening specimens. J Clin Microbiol. 2014; 52: 2166–8.
Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L, Nadisauskiene R. Prevalence of maternal group B streptococcal colonisation in European countries. Acta Obstet Gynecol Scand. 2008; 87: 260–71.
Nagano N, Nagano Y, Toyama M, Kimura K, Shibayama K, Arakawa Y. Penicillin-susceptible group B streptococcal clinical isolates with reduced cephalosporin susceptibility. J Clin Microbiol. 2014; 52: 3406–10.
Kimura K, Suzuki S, Wachino J-I, Kurokawa H, Yamane K, Shibata N, et al. First molecular characterization of group B streptococci with reduced penicillin susceptibility. Antimicrob Agents Chemother. 2008; 52: 2890–7.
Towers CV, Carr MH, Padilla G, Asrat T. Potential consequences of widespread antepartal use of ampicillin. Am J Obstet Gynecol. 1998; 179:879–83
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
