Differentiating Streptococcus pseudoporcinus from GBS: could this have implications in pregnancy?


Journal

American journal of obstetrics and gynecology
ISSN: 1097-6868
Titre abrégé: Am J Obstet Gynecol
Pays: United States
ID NLM: 0370476

Informations de publication

Date de publication:
05 2019
Historique:
received: 09 11 2018
revised: 13 01 2019
accepted: 21 01 2019
pubmed: 29 1 2019
medline: 18 12 2019
entrez: 29 1 2019
Statut: ppublish

Résumé

Streptococcus agalactiae (GBS) is a common pathogen known to cause neonatal and maternal infectious morbidity. Streptococcus pseudoporcinus (S pseudoporcinus) is a separate, recently identified β-hemolytic gram-positive coccus that can cause false-positive results on standard GBS agglutination testing assays. To determine the prevalence and clinical implications of Streptococcus pseudoporcinus colonization in pregnancy. This is a 2-year retrospective cohort study comparing pregnant women colonized with GBS to those colonized with S. pseudoporcinus. A proteomics method of identification, namely, matrix-assisted laser desorption ionization time-of-flight mass spectrometry, was used to distinguish between S. pseudoporcinus and GBS colonization. Antibiotic susceptibility testing was carried out on all specimens. Maternal and neonatal chart reviews were conducted to identify predictors of S. pseudoporcinus colonization and to compare maternal and neonatal outcomes. S. pseudoporcinus colonization occurred in 1.6% of all pregnancies. A total of 2.5% of all GBS-positive results by agglutination assay were false positive, instead reflecting S. pseudoporcinus colonization. Clindamycin resistance among S. pseudoporcinus isolates is uncommon. S. pseudoporcinus colonization in pregnancy is independently associated with African American race, tobacco use, and body mass index ≥35. Preterm premature rupture of membranes or spontaneous preterm birth was more common in patients colonized with S. pseudoporcinus. Although the prevalence of S. pseudoporcinus colonization is low, it primarily occurs in African American women and is associated with preterm premature rupture of membranes or spontaneous preterm birth when compared to individuals colonized with GBS.

Sections du résumé

BACKGROUND
Streptococcus agalactiae (GBS) is a common pathogen known to cause neonatal and maternal infectious morbidity. Streptococcus pseudoporcinus (S pseudoporcinus) is a separate, recently identified β-hemolytic gram-positive coccus that can cause false-positive results on standard GBS agglutination testing assays.
OBJECTIVE
To determine the prevalence and clinical implications of Streptococcus pseudoporcinus colonization in pregnancy.
MATERIALS AND METHODS
This is a 2-year retrospective cohort study comparing pregnant women colonized with GBS to those colonized with S. pseudoporcinus. A proteomics method of identification, namely, matrix-assisted laser desorption ionization time-of-flight mass spectrometry, was used to distinguish between S. pseudoporcinus and GBS colonization. Antibiotic susceptibility testing was carried out on all specimens. Maternal and neonatal chart reviews were conducted to identify predictors of S. pseudoporcinus colonization and to compare maternal and neonatal outcomes.
RESULTS
S. pseudoporcinus colonization occurred in 1.6% of all pregnancies. A total of 2.5% of all GBS-positive results by agglutination assay were false positive, instead reflecting S. pseudoporcinus colonization. Clindamycin resistance among S. pseudoporcinus isolates is uncommon. S. pseudoporcinus colonization in pregnancy is independently associated with African American race, tobacco use, and body mass index ≥35. Preterm premature rupture of membranes or spontaneous preterm birth was more common in patients colonized with S. pseudoporcinus.
CONCLUSION
Although the prevalence of S. pseudoporcinus colonization is low, it primarily occurs in African American women and is associated with preterm premature rupture of membranes or spontaneous preterm birth when compared to individuals colonized with GBS.

Identifiants

pubmed: 30690012
pii: S0002-9378(19)30249-2
doi: 10.1016/j.ajog.2019.01.219
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
Clindamycin 3U02EL437C

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

490.e1-490.e7

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Maureen Grundy (M)

Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, St. Joseph Medical Center, Towson, MD. Electronic address: maureen.grundy@umm.edu.

Nuntra Suwantarat (N)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD; Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand.

Mayer Rubin (M)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD.

Renee Harris (R)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD.

Ann Hanlon (A)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD.

Tsigereda Tekle (T)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD.

Brandon Ellis (B)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD.

Karen Carroll (K)

Department of Pathology, Division of Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD.

Frank Witter (F)

Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

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