High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan.
GBS
Group B Streptococcus
Jordan
Middle East
Pregnancy
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
20 May 2019
20 May 2019
Historique:
received:
10
01
2019
accepted:
25
04
2019
entrez:
22
5
2019
pubmed:
22
5
2019
medline:
1
1
2020
Statut:
epublish
Résumé
Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test. We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected. In April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23-32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38 weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women. Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.
Sections du résumé
BACKGROUND
BACKGROUND
Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test.
METHODS
METHODS
We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected.
RESULTS
RESULTS
In April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23-32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38 weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women.
CONCLUSIONS
CONCLUSIONS
Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.
Identifiants
pubmed: 31109301
doi: 10.1186/s12884-019-2317-4
pii: 10.1186/s12884-019-2317-4
pmc: PMC6528311
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
177Subventions
Organisme : National Institute of Mental Health
ID : K01 MH107256
Organisme : NCATS NIH HHS
ID : UL1 TR000445
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD090061
Pays : United States
Organisme : National Center for Advancing Translational Sciences
ID : UL1 TR000445
Organisme : NIMH NIH HHS
ID : K01 MH107256
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI134036
Pays : United States
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : R01 HD090061
Organisme : NIAID NIH HHS
ID : R56 AI136499
Pays : United States
Organisme : National Institute of Allergy and Infectious Diseases
ID : R56 AI136499
Organisme : National Institute of Allergy and Infectious Diseases
ID : R01 AI134036
Références
Pediatrics. 1999 Jun;103(6):e77
pubmed: 10353974
Saudi Med J. 2002 Jan;23(1):56-61
pubmed: 11938365
J Infect. 2002 Jul;45(1):42-6
pubmed: 12217731
J Obstet Gynaecol. 2002 Mar;22(2):179-80
pubmed: 12521703
J Reprod Med. 2003 Sep;48(9):697-702
pubmed: 14562634
Pediatr Int. 2005 Feb;47(1):64-6
pubmed: 15693869
Arch Gynecol Obstet. 2005 Jul;272(2):131-5
pubmed: 15702324
Int J Clin Pract. 2005 Apr;59(4):437-40
pubmed: 15853861
Turk J Pediatr. 2005 Jan-Mar;47(1):28-33
pubmed: 15884626
J Clin Microbiol. 2006 Mar;44(3):725-8
pubmed: 16517846
BMC Infect Dis. 2006 Mar 20;6:57
pubmed: 16549015
Bull Soc Pathol Exot. 2006 May;99(2):99-102
pubmed: 16821439
Isr Med Assoc J. 2006 Oct;8(10):698-702
pubmed: 17125117
Gynecol Obstet Fertil. 2007 Apr;35(4):312-6
pubmed: 17344086
Trop Geogr Med. 1991 Jan-Apr;43(1-2):161-4
pubmed: 1750107
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Arch Iran Med. 2008 Nov;11(6):654-7
pubmed: 18976037
Indian J Med Microbiol. 2009 Jan-Mar;27(1):17-21
pubmed: 19172053
Clin Infect Dis. 2009 Aug 1;49(3):417-23
pubmed: 19580414
Acta Obstet Gynecol Scand. 2010 Mar;89(3):399-403
pubmed: 20199356
J Infect Public Health. 2009;2(2):86-90
pubmed: 20701866
Arch Gynecol Obstet. 2011 Sep;284(3):677-9
pubmed: 21079981
MMWR Recomm Rep. 2010 Nov 19;59(RR-10):1-36
pubmed: 21088663
PLoS One. 2011 Mar 21;6(3):e17861
pubmed: 21445302
Med Princ Pract. 2011;20(3):277-82
pubmed: 21455000
N Engl J Med. 2011 May 26;364(21):2016-25
pubmed: 21612470
Isr J Med Sci. 1990 Feb;26(2):71-3
pubmed: 2180850
Lancet. 2012 Feb 11;379(9815):547-56
pubmed: 22226047
Obstet Gynecol. 2012 Mar;119(3):626-9
pubmed: 22353962
J Obstet Gynaecol. 2012 Jul;32(5):458-60
pubmed: 22663318
Vaccine. 2013 Aug 28;31 Suppl 4:D20-6
pubmed: 23219695
Acta Med Iran. 2012;50(12):805-8
pubmed: 23456521
Med J Islam Repub Iran. 2013 Feb;27(1):7-11
pubmed: 23483827
Epidemiol Infect. 2014 Jan;142(1):208-10
pubmed: 23561305
Vaccine. 2013 Aug 28;31 Suppl 4:D31-42
pubmed: 23973345
BMC Infect Dis. 2013 Sep 08;13:420
pubmed: 24010831
Int J Fertil Steril. 2014 Jan;7(4):267-70
pubmed: 24520495
J Clin Diagn Res. 2014 Feb;8(2):47-9
pubmed: 24701479
Obstet Gynecol. 1989 Apr;73(4):583-7
pubmed: 2494620
J Med Microbiol. 2014 Oct;63(Pt 10):1395-9
pubmed: 25082944
J Matern Fetal Neonatal Med. 2015 May;28(7):766-82
pubmed: 25162923
Int J Gynaecol Obstet. 2015 Apr;129(1):13-6
pubmed: 25585859
Glob J Health Sci. 2015 Apr 19;7(6):233-9
pubmed: 26153188
BJOG. 2015 Oct;122(11):1437-45
pubmed: 26177561
Iran J Pathol. 2015 Spring;10(2):120-6
pubmed: 26351472
Ann Saudi Med. 2015 Nov-Dec;35(6):423-7
pubmed: 26657224
PLoS One. 2015 Dec 31;10(12):e0145905
pubmed: 26719985
J Chin Med Assoc. 2016 Mar;79(3):141-5
pubmed: 26803202
J Infect Dev Ctries. 2016 Mar 31;10(3):222-6
pubmed: 27031453
Jundishapur J Microbiol. 2016 Feb 15;9(2):e30412
pubmed: 27127592
Pan Afr Med J. 2016 Mar 16;23:107
pubmed: 27222693
Lancet Infect Dis. 2016 Sep;16(9):1076-1084
pubmed: 27236858
J Matern Fetal Neonatal Med. 2017 Jul;30(13):1540-1543
pubmed: 27642669
F1000Res. 2016 Sep 22;5:2355
pubmed: 27803803
Isr J Health Policy Res. 2016 Nov 15;5:42
pubmed: 27879969
Acta Med Iran. 2016 Dec;54(12):765-770
pubmed: 28120587
Acta Obstet Gynecol Scand. 2017 Sep;96(9):1070-1074
pubmed: 28504863
Pediatr Neonatol. 2018 Feb;59(1):35-41
pubmed: 28642139
Electron Physician. 2017 May 25;9(5):4399-4404
pubmed: 28713513
Clin Infect Dis. 2017 Nov 6;65(suppl_2):S160-S172
pubmed: 29117326
Clin Infect Dis. 2017 Nov 6;65(suppl_2):S100-S111
pubmed: 29117327
J Med Microbiol. 2018 Mar 15;:null
pubmed: 29543148
Isr Med Assoc J. 2018 May;5(20):291-294
pubmed: 29761674
Open Forum Infect Dis. 2018 Jul 07;5(7):ofy164
pubmed: 30038931
Vaccine. 2019 Jan 14;37(3):409-411
pubmed: 30528847
N Engl J Med. 1986 Jun 26;314(26):1665-9
pubmed: 3520319