Group B streptococcal colonization in elderly women.
Aged
Aged, 80 and over
Anti-Bacterial Agents
/ pharmacology
Cross-Sectional Studies
Drug Resistance, Bacterial
/ drug effects
Female
Genotype
Humans
Microbial Sensitivity Tests
Middle Aged
Pregnancy
Prevalence
Prospective Studies
Serogroup
Streptococcal Infections
/ epidemiology
Streptococcus agalactiae
/ classification
Switzerland
/ epidemiology
Vagina
/ microbiology
Colonization
Elderly women
Group B Streptococcus
Postmenopausal women
Streptococcus agalactiae
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
03 May 2021
03 May 2021
Historique:
received:
10
10
2020
accepted:
22
04
2021
entrez:
4
5
2021
pubmed:
5
5
2021
medline:
25
5
2021
Statut:
epublish
Résumé
In non-pregnant adults, the incidence of invasive Group B Streptococcus (GBS) disease is continuously increasing. Elderly and immunocompromised persons are at increased risk of infection. GBS commonly colonizes the vaginal tract, though data on colonization in the elderly are scarce. It is unknown whether the prevalence of GBS colonization is increasing in parallel to the observed rise of invasive infection. We conducted a three-year (2017-2019) prospective observational cross-sectional study in two teaching hospitals in Switzerland to determine the rate of GBS vaginal colonization in women over 60 years and i) to compare the proportions of known risk factors associated with invasive GBS diseases in colonized versus non-colonized women and ii) to evaluate the presence of GBS clusters with specific phenotypic and genotypic patterns in this population. GBS screening was performed by using vaginal swabs collected during routine examination from women willing to participate in the study and to complete a questionnaire for risk factors. Isolates were characterized for antibiotic resistance profile, serotype and sequence type (ST). The GBS positivity rate in the elderly was 17% (44/255 positive samples), and similar to the one previously reported in pregnant women (around 20%). We could not find any association between participants' characteristics, previously published risk factors and GBS colonization. All strains were susceptible to penicillin, 22% (8/36) were not susceptible to erythromycin, 14% (5/36) were not susceptible to clindamycin and 8% (3/36) showed inducible clindamycin resistance. Both M and L phenotypes were each detected in one isolate. The most prevalent serotypes were III (33%, 12/36) and V (31%, 11/36). ST1 and ST19 accounted for 11% of isolates each (4/36); ST175 for 8% (3/36); and ST23, ST249 and ST297 for 6% each (2/36). Significantly higher rates of resistance to macrolides and clindamycin were associated with the ST1 genetic background of ST1. Our findings indicate a similar colonization rate for pregnant and elderly women. Current Controlled Trial ISRCTN15468519 ; 06/01/2017.
Sections du résumé
BACKGROUND
BACKGROUND
In non-pregnant adults, the incidence of invasive Group B Streptococcus (GBS) disease is continuously increasing. Elderly and immunocompromised persons are at increased risk of infection. GBS commonly colonizes the vaginal tract, though data on colonization in the elderly are scarce. It is unknown whether the prevalence of GBS colonization is increasing in parallel to the observed rise of invasive infection. We conducted a three-year (2017-2019) prospective observational cross-sectional study in two teaching hospitals in Switzerland to determine the rate of GBS vaginal colonization in women over 60 years and i) to compare the proportions of known risk factors associated with invasive GBS diseases in colonized versus non-colonized women and ii) to evaluate the presence of GBS clusters with specific phenotypic and genotypic patterns in this population.
METHODS
METHODS
GBS screening was performed by using vaginal swabs collected during routine examination from women willing to participate in the study and to complete a questionnaire for risk factors. Isolates were characterized for antibiotic resistance profile, serotype and sequence type (ST).
RESULTS
RESULTS
The GBS positivity rate in the elderly was 17% (44/255 positive samples), and similar to the one previously reported in pregnant women (around 20%). We could not find any association between participants' characteristics, previously published risk factors and GBS colonization. All strains were susceptible to penicillin, 22% (8/36) were not susceptible to erythromycin, 14% (5/36) were not susceptible to clindamycin and 8% (3/36) showed inducible clindamycin resistance. Both M and L phenotypes were each detected in one isolate. The most prevalent serotypes were III (33%, 12/36) and V (31%, 11/36). ST1 and ST19 accounted for 11% of isolates each (4/36); ST175 for 8% (3/36); and ST23, ST249 and ST297 for 6% each (2/36). Significantly higher rates of resistance to macrolides and clindamycin were associated with the ST1 genetic background of ST1.
CONCLUSIONS
CONCLUSIONS
Our findings indicate a similar colonization rate for pregnant and elderly women.
TRIAL REGISTRATION
BACKGROUND
Current Controlled Trial ISRCTN15468519 ; 06/01/2017.
Identifiants
pubmed: 33941088
doi: 10.1186/s12879-021-06102-x
pii: 10.1186/s12879-021-06102-x
pmc: PMC8091692
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
408Références
Swiss Med Wkly. 2014 Mar 20;144:w13935
pubmed: 24652673
J Antimicrob Chemother. 2004 Dec;54(6):1040-4
pubmed: 15537693
Emerg Infect Dis. 2009 Aug;15(8):1279-81
pubmed: 19751591
Euro Surveill. 2018 May;23(21):
pubmed: 29845930
J Clin Microbiol. 2005 Aug;43(8):3727-33
pubmed: 16081902
Clin Infect Dis. 2005 Sep 15;41(6):839-47
pubmed: 16107984
Clin Infect Dis. 2004 Aug 1;39(3):380-8
pubmed: 15307006
Infect Dis (Lond). 2016;48(5):386-91
pubmed: 26759190
Antimicrob Agents Chemother. 2011 Apr;55(4):1470-4
pubmed: 21245447
Front Public Health. 2020 Mar 10;8:40
pubmed: 32211361
Front Microbiol. 2018 Mar 14;9:437
pubmed: 29593684
Antimicrob Agents Chemother. 2005 Jul;49(7):2716-9
pubmed: 15980341
Eur J Clin Microbiol Infect Dis. 2008 Dec;27(12):1193-9
pubmed: 18560908
J Clin Microbiol. 2007 Jun;45(6):1985-8
pubmed: 17376884
Antimicrob Resist Infect Control. 2019 Jul 15;8:117
pubmed: 31346458
Ann Epidemiol. 2007 Nov;17(11):854-62
pubmed: 17689259
J Clin Microbiol. 2003 Jun;41(6):2530-6
pubmed: 12791877
Clin Infect Dis. 2005 Feb 1;40(3):352-7
pubmed: 15668856
Clin Infect Dis. 2001 Aug 15;33(4):556-61
pubmed: 11462195
J Sex Med. 2014 Feb;11(2):401-10
pubmed: 24251617
J Pediatr Nurs. 2004 Oct;19(5):357-63
pubmed: 15614260
J Infect Dis. 1983 Dec;148(6):1120
pubmed: 6361172
Clin Infect Dis. 2017 Nov 6;65(suppl_2):S100-S111
pubmed: 29117327
Am J Obstet Gynecol. 2009 Jul;201(1):76.e1-7
pubmed: 19371857
J Clin Microbiol. 2016 Jul;54(7):1774-1781
pubmed: 27098960
Clin Infect Dis. 2013 Sep;57(5):682-8
pubmed: 23845950
Clin Infect Dis. 2009 Jul 1;49(1):85-92
pubmed: 19480572
J Antimicrob Chemother. 2017 Jul 1;72(7):1886-1892
pubmed: 28333320
PLoS One. 2011;6(5):e20256
pubmed: 21633509
Pediatr Infect Dis J. 2009 Dec;28(12):1115-8
pubmed: 19935273
Ann Lab Med. 2020 Sep;40(5):370-381
pubmed: 32311850
MMWR Recomm Rep. 2010 Nov 19;59(RR-10):1-36
pubmed: 21088663
Maturitas. 2016 Mar;85:5-10
pubmed: 26857873
Clin Microbiol Infect. 2016 Apr;22(4):379.e9-379.e16
pubmed: 26691681
Rev Esp Quimioter. 2014 Jun;27(2):106-9
pubmed: 24940891