Polymerase chain reaction for Group B Streptococci (GBS) at labor highly correlates with vaginal GBS load

OBJECTIVE

To explore factors associated with a high vaginal GBS load during labor considering (1) the recto-vaginal GBS load at 35-37 weeks' gestation determined by culture and (2) the vaginal GBS colonization determined by a polymerase chain reaction (PCR) assay during labor.

METHODS

From an unselected cohort of 902 pregnant women, we obtained (1) recto-vaginal swabs for culture of GBS at 35-37 weeks' gestation (GBS_rectovag-36), (2) vaginal swabs for GBS PCR detection at labor (PCR_vag-labor), and (3) vaginal swabs for culture of GBS at labor (GBS_vag-labor). The GBS load was classified semi quantitatively according to a culture protocol without prior broth enrichment of the swab samples: none (0), few (+), some (++), or many (+++) GBS colonies.

RESULTS

Among 902 unselected pregnant women, 859 (95%) had a vaginal swab culture taken at labor, which was classified semi quantitatively. High load GBS_vag-labor (+++) were found in 31 participants. GBS_rectovag-36 showed a sensitivity of 90% (28/31) and a PPV of 23% (28/121), whereas PCR_vag-labor had a sensitivity of 98% (30/31, non-significant difference) and a PPV of 42% (30/71, p < .01). PCR at labor had a lower sensitivity (78%) for detection of vaginal colonization with GBS at labor (any load) compared to recto/vaginal colonization with GBS at 36 weeks (92%). Vaginal colonization with GBS at 36 weeks seemed to have a lower sensitivity for detecting GBS in vagina at labor for high load (48%) and for any load (39%).

CONCLUSION

PCR at labor has higher detection rate (non-significant) and PPV in identification of laboring women with a high load of vaginal GBS compared with recto-vaginal culture at 36 weeks' gestation.

Group B Streptococcus in Indian pregnant women: Its prevalence and risk factors

Purpose

To study the prevalence of group B streptococci (GBS) in Indian pregnant women and associated risk factors.

Methods

Four hundred and fifty pregnant women attending antenatal outpatient/inpatient department between 35-38 weeks of gestation were enrolled in the study. All enrolled subjects were assessed by a predefined proforma for their demographics, socio-economic characteristics, education, toilet habits, obstetric history and clinical outcome. Two cotton swabs each from lower vagina and rectum were collected and plated on selective solid media CHROM agar Strept B (CHROMagarTM) and selective Enrichment Broth LIM RambaQUICK StreptB broth (CHROMagarTM). Presumptive identification of GBS was growth of 1-3 mm grayish white β-hemolytic colonies on BAP or mauve coloured colonies on CHROM agar Strept B. All presumptively identified GBS were confirmed as group B streptococcus by automated identification system-Vitek MS (Bio Merieux).

Results

The recto vaginal colonization rate of GBS in this study was observed as 3.3% (n=15). GBS colonization was significantly associated with nulliparous women (p= 0.026) and use of western style toilet (p=0.017). GBS urinary tract infections was also seen more commonly in women with GBS rectovaginal colonization (p=0.002).

Conclusion

Due to the low GBS prevalence and no significant association with major risk factors, we recommend to institute universal screening of GBS in pregnant women, instead of risk based screening. Since this was a single centric study with low prevalence of GBS, its applicability may be limited, therefore further larger multi-centric prospective studies are required to understand the true GBS prevalence in Indian society.

Determination of surface proteins profile, capsular genotyping, and antibiotic susceptibility patterns of Group B Streptococcus isolated from urinary tract infection of Iranian patients

Objectives

Group B Streptococcus (GBS) is an important opportunistic bacteria that causes a wide range of infections including neonatal sepsis, meningitis, pneumonia, soft tissue and urinary tract infections (UTI). The aim of this study was to evaluate the antimicrobial susceptibility patterns, surface proteins and capsular types of GBS isolates.

Results

100 of UTI isolates were confirmed as GBS. Antimicrobial susceptibility pattern showed that 95% of GBS isolates were resistant to tetracycline, followed by erythromycin (52%), clindamycin (47%), levofloxacin (9%) and penicillin, cefepime, cefotaxime, and ceftriaxone each with (8%), and vancomycin 1%. Common capsular types were III, Ib, V, II, Ia and IV respectively and the distribution of surface protein genes was as follows: rib (40%), alpha-c (22%), alp2/3 (18%) and epsilon (15%), and alp4 gene was not detected in the isolates. Our findings showed the relationship between capsular types with Alpha-like proteins, as well as reduced sensitivity to antibiotics, so the performance of antibiotic surveillance programs is recommended.

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4428-4) contains supplementary material, which is available to authorized users.

An enzyme-free electrochemiluminescence biosensor for ultrasensitive assay of Group B Streptococci based on self-enhanced luminol complex functionalized CuMn-CeO2 nanospheres

Herein, a novel and pragmatic electrochemiluminescence (ECL) biosensing method was developed for ultrasensitive and specific detection of Group B Streptococci (GBS) by combining self-enhanced luminol complex functionalized CuMn-CeO₂ (CuMn-CeO₂-PEI-luminol) with MNAzyme-mediated target-recycling amplification. First, the efficient self-enhanced PEI-luminol luminophore was prepared by combining PEI co-reactant with luminol in one molecular, which shortened electron transfer distance and enhanced ECL signal. And CuMn-CeO₂ was applied to load a large number of PEI-luminol and strengthen luminous efficiency of luminol by the high catalytic activity toward H₂O₂ oxidation. Then, target-driven MNAzyme system was used to realize the circulation of GBS nucleic acid sequence, producing plentiful triggers to initiate the hybridization reaction on the surface of electrode. The developed enzyme-free ECL biosensor showed ultra-sensitivity for target DNA detection with detection limits of 68 aM (synthetic DNA) and 5 × 10² CFU mL^-1 (genomic DNA extracted from GBS strain). More importantly, this biosensor was successfully applied for detection of genomic DNA of GBS extracted from clinical vaginal/anal swabs as low as 320 copies. Thus, this proposed strategy might be an pragmatic ECL platform for ultrasensitive and specific detection of GBS in clinical vaginal/anal swabs.

Group B Streptococci and Trichomonas vaginalis infections in pregnant women and those with spontaneous abortion at Sanandaj, Iran

BACKGROUND AND OBJECTIVES

Group B Streptococcali (GBS) is an important factor in newborn deaths in developed and developing countries. Trichomoniasis is one of the most prevalent sexually transmitted diseases (STDs) in the world, which is caused by protozoan Trichomonas vaginalis (T. vaginalis). The present study compares the frequency of GBS and T. vaginalis genital infections in pregnant women, women with spontaneous abortion, as well as its role in spontaneous abortion.

MATERIALS AND METHODS

In this case-control study, 109 women were included with spontaneous abortion with gestational ages between 11-20 weeks and 109 pregnant women with gestational ages between 35-37 weeks in Sanandaj, Iran. DNA was extracted by endocervical swabs and subjected to PCR assays. The independent t-test was used; and for comparing other qualitative variables in each group, the Chi-Square Test was used.

RESULTS

The age of the women ranged from 19-43 years (29.6 ± 5.9) and in the control group the age range was from 19-42 years (27.8 ± 4.87). The rate of prevalence of Group B Streptococcal infection in the control group was 3.6%; and in the patient group there were 7.2% with the rate of prevalence of T. vaginalis in both groups as zero.

CONCLUSION

The present study showed that there is no relationship between GBS infections (P-value = 0.235) and T. vaginalis.

Comparison of molecular serotyping approaches of Streptococcus agalactiae from genomic sequences

BACKGROUND

Group B streptococcus (GBS) capsular polysaccharide is one of the major virulence factors underlying invasive GBS disease and a component of forthcoming vaccines. Serotype classification of GBS is based on the capsule polysaccharide of which ten variants are known to exist (Ia, Ib, II-IX). Current methods for GBS serotype assignment rely on latex agglutination or PCR while more recently a whole genome sequencing method was reported. In this study, three distinct algorithms for serotype assignment from genomic data were assessed using a panel of 790 clinical isolates.

METHODS

The first approach utilised the entire capsular locus coupled with a mapping methodology. The second approach continues from the first and utilised a SNP-based methodology across the conserved cpsD-G region to differentiate serotypes Ia-VII and IX. Finally the third approach used the variable cpsG -K region coupled with a mapping methodology. All three approaches were assessed for typeability (percentage of isolates assigned a serotype) and concordance to the latex agglutination methodology.

RESULTS

Following comparisons, the third approach using the variable cpsG-K region demonstrated the best performance with 99.9% typeability and 86.7% concordance. Overall, of the 105 discordant isolates, 71 were resolved following retesting of latex agglutination and whole genome sequencing, 20 failed to assign a serotype using latex agglutination and only 14 were found to be truly discordant on re-testing. Comparison of this final approach with the previously described assembly-based approach returned identical results.

CONCLUSIONS

These results demonstrated that molecular capsular typing using whole genome sequencing and a mapping-based approach is a viable alternative to the traditional, latex agglutination-based serotyping method and can be implemented in a public health microbiology setting.

Immunomodulation of Lactobacillus reuteri CRL1324 on Group B Streptococcus Vaginal Colonization in a Murine Experimental Model

PROBLEM

Maternal Group B Streptococcus (GBS) colonization is a risk factor for infectious disease in newborns. One promising strategy is the modulation of vaginal defense to increase the host's ability to combat infection.

METHOD OF STUDY

The effect of intravaginal (i.va.) Lactobacillus reuteri CRL1324 inoculation on different immune cell populations, cytokines, and immunoglobulin isotypes in a murine model of GBS vaginal colonization was evaluated.

RESULTS

Seven i.va. inoculations of L. reuteri CRL1324 previous to GBS challenge showed an immunomodulatory effect on the cells and mediators of innate immunity, decreasing the number of neutrophils induced by the pathogen and increasing the activated macrophage population. Moreover, increases in B lymphocytes and IgA and IgG subclasses were observed in mice inoculated with L. reuteri CRL1324 and then challenged with GBS.

CONCLUSION

Lactobacillus reuteri CRL1324 shows a protective effect against GBS colonization that could be mediated by the modulation of the immune response.

Aortic valve streptococcus group B endocarditis post-extracorporeal shock wave lithotripsy

BACKGROUND

Sub-acute left-sided bacterial endocarditis is a serious condition that may present with variable clinical manifestations. Its symptoms include both sterile and infected emboli, and various immunological phenomena.

CASE REPORT

This report presents a 55 year old man with frequency and dysuria after a lithotripsy and several admissions with urosepsis. Due to the suspicion of infective endocarditis echocardiography was done which confirmed streptococcus group B endocarditis.

CONCLUSION

Streptococci group B is one of the rare causes of infective endocarditis, but it was observed after various producers such as lithotripsy.

Prevalence of positive recto-vaginal culture for Group B streptococcus in pregnant women at 35-37 weeks of gestation

BACKGROUND

Recto-vaginal colonization of Group B streptococcus (GBS) has been known as an important issue in mother and newborn's health, which is getting frequent in developing countries. Screening test have been introduced and utilized in many countries and is recommended by many researchers. However, due to lack of information in prevalence of GBS, especially in Iran, there are doubts and controversies regarding whether it is necessary to execute any effort to run screening tests. The aim of this study is to determine the prevalence of positive recto-vaginal culture for GBS in pregnant women between 35-37 weeks of pregnancy in Tehran.

METHODS

In this cross-sectional study, pregnant women in 35(th)-37(th) week of pregnancy were included. All hospitals in Tehran, Iran, were stratified and clustered, and the sampling was done randomly. All recto-vaginal samples were referred to Firoozgar Hospital's pathology laboratory in less than an hour and the results were reported afterwards. Other demographic information and pregnancy and neonatal-related complications such as previous pre-term delivery, PROM (Premature rupture of membrane) and neonatal sepsis and maternal infection were evaluated.

RESULTS

The prevalence of positive GBS cultures was 22.76% (234 Out of 1028). No significant difference was found in positive cultures with mother's age, educational level, and history of pregnancy, maternal complications, and previous neonatal sepsis.

CONCLUSION

Due to similar results with other countries, recto-vaginal GBS culture screening is recommended in Iranian urban pregnant women regarding high prevalence and higher neonatal complication.

Capsular serotype and antibiotic resistance of group B streptococci isolated from pregnant women in Ardabil, Iran

BACKGROUND AND OBJECTIVES

Group B Streptococci (GBS) is a major cause of neonatal and maternal infections. The aim of this study was to determine the serotype distribution and antibiotic resistance profile of GBS strains isolated from pregnant women in Ardabil.

MATERIALS AND METHODS

Antibiotic resistance of 56 GBS isolates was investigated using E-test strips and disk-diffusion method. Serotyping was performed using capsular antiserum.

RESULTS

The results of MIC tests showed all isolates were susceptible to ampicillin, vancomycin and penicillin. One isolate (1.7%) showed reduced susceptibility pattern to penicillin (MIC; 0.25 µg/ml). There were 3 (5.3%) isolates semi-sensitive (0.25-1 µg/ml) to erythromycin (2; 0.5 µg/ml and 1; 0.38 µg/ml) and 2 (3.5%) isolates to clindamycin (1; 0.5 µg/ml, 1; 0.38 µg/ml). Additionally, 2 (3.5%) isolates were resistant to clindamycin (1; 16 µg/ml, 1; 2 µg/ml). According to the disk diffusion test, 47 (83.9%), 8 (14.2%) and 7 (12.5%) isolates were resistant to Co-trimoxazole, ciprofloxacin and ceftriaxone respectively. Serotypes V (19.6%), II (12.5%) and IV (12.5%) were the most frequent followed by serotypes III (10.7%) and VI (10.7%), Ib (8.9%), Ia (7/1%), VII (5/3%) and VIII (5/3%); 7.1% of strains were nontypeable.

CONCLUSIONS

In this study, most isolates were sensitive to common antibiotics, but increased resistance to other antibiotics indicates the importance of monitoring of antibiotic resistance in group B streptococci over time.