Group B streptococcus colonization in pregnant women and group B streptococcus infection in their preterm infants
HUANG Jing1, LIN Xin-Zhu1, LAI Ji-Dong1, FAN Yan-Feng2
Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University/Xiamen Maternal and Child Care Hospital, Xiamen, Fujian 361001, China
Abstract Objective To study the incidences of group B streptococcus (GBS) colonization in pregnant women and GBS infection in their preterm infants, and to investigate the risk factors for GBS colonization in preterm infants. Methods A total of 859 women who delivered before term from January 2017 to January 2018 were enrolled in this prospective cohort study. Bacterial culture was performed for GBS using the swabs collected from the rectum and the lower 1/3 of the vagina of the pregnant women on admission. A total of 515 of the above cases underwent real-time PCR assay for testing of GBS DNA. Bacterial culture was performed for GBS using the oropharyngeal secretion, gastric fluid or blood samples in preterm infants born to the 859 pregnant women. Peripheral blood samples from the pregnant women and umbilical cord blood samples from their preterm infants were collected to determine the level of anti-GBS capsular polysaccharide antibody. The incidence of GBS infection and perinatal risk factors for GBS colonization in the preterm infants were examined. Results The positive rate for GBS in the rectal and vaginal cultures was 14.8% (127/859) among the 859 pregnant women, and the positive rate in the GBS DNA testing was 15.1% (78/515). There were 976 live-birth preterm infants delivered by 859 pregnant women, and 4.4% (43/976) of whom were GBS positive. Four preterm infants had early-onset GBS diseases, including pneumonia in two cases and sepsis in two cases. In 127 preterm infants delivered by 127 GBS-positive pregnant women, the preterm infant group with a gestational age between 34 and 37 weeks had a significantly lower GBS positive rate and a significantly higher level of anti-GBS capsular polysaccharide antibody compared with the preterm infant group with a gestational age of less than 34 weeks (P=0.013 and 0.001 respectively). A multivariate logistic regression analysis revealed that premature rupture of membranes time > 18 hours and chorioamnionitis were independent risk factors for GBS colonization in preterm infants (OR=6.556 and 6.160 respectively; P Conclusions GBS positive rate and anti-GBS capsular polysaccharide antibody level in preterm infants are correlated with gestational age. premature rupture of membranes time > 18 hours and chorioamnionitis may increase the risk of GBS colonization in preterm infants.
HUANG Jing,LIN Xin-Zhu,LAI Ji-Dong et al. Group B streptococcus colonization in pregnant women and group B streptococcus infection in their preterm infants[J]. CJCP, 2019, 21(6): 567-572.
HUANG Jing,LIN Xin-Zhu,LAI Ji-Dong et al. Group B streptococcus colonization in pregnant women and group B streptococcus infection in their preterm infants[J]. CJCP, 2019, 21(6): 567-572.
Verani JR, McGee L, Schrag SJ, et al. Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010[J]. MMWR Recomm Rep, 2010, 59(RR-10):1-36.
[3]
Phares CR, Lynfield R, Farley MM, et al. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005[J]. JAMA, 2008, 299(17):2056-2065.
Committee on Infectious Diseases; Committee on Fetus and Newborn; Baker CJ, et al. Policy statement-Recommendations for the prevention of perinatal group B streptococcal (GBS) disease[J]. Pediatrics, 2011, 128(3):611-616.
Madrid L, Seale AC, Kohli-Lynch M, et al. Infant group B streptococcal disease incidence and serotypes worldwide:systematic review and meta-analyses[J]. Clin Infect Dis, 2017, 65(Suppl 2):S160-S172.
Carrillo-Ávila JA, Gutiérrez-Fernández J, González-Espín AI, et al. Comparison of qPCR and culture methods for group B Streptococcus colonization detection in pregnant women:evaluation of a new qPCR assay[J]. BMC Infect Dis, 2018, 18(1):305.
Van Dyke MK, Phares CR, Lynfield R, et al. Evaluation of universal antenatal screening for group B streptococcus[J]. N Engl J Med, 2009, 360(25):2626-2636.
[12]
Todorova-Christova M, Vacheva R, Decheva A, et al. A study on early-onset neonatal group B streptococcal infection, Bulgaria, 2007-2011[J]. Arch Pediatr, 2014, 21(9):953-960.
[13]
Currie AJ, Curtis S, Strunk T, et al. Preterm infants have deficient monocyte and lymphocyte cytokine responses to group B streptococcus[J]. Infect Immun, 2011, 79(4):1588-1596.
[14]
Dangor Z, Kwatra G, Izu A, et al. Review on the association of Group B Streptococcus capsular antibody and protection against invasive disease in infants[J]. Expert Rev Vaccines, 2015, 14(1):135-149.
[15]
Baker CJ, Carey VJ, Rench MA, et al. Maternal antibody at delivery protects neonates from early onset group B streptococcal disease[J]. J Infect Dis, 2014, 209(5):781-788.
[16]
Christensen KK, Christensen P, Duc G, et al. Correlation between serum antibody-levels against group B streptococci and gestational age in newborns[J]. Eur J Pediatr, 1984, 142(2):86-88.
Chen J, Fu J, Du W, et al. Group B streptococcal colonization in mothers and infants in western China:prevalence and risk factors[J]. BMC Infect Dis, 2018, 18(1):291.
[19]
Surve MV, Anil A, Kamath KG, et al. Membrane vesicles of group B streptococcus disrupt feto-maternal barrier leading to preterm Birth[J]. PLoS Pathog, 2016, 12(9):e1005816.
ZHANG Ji-Yong, ZHOU Shao-Ming, WANG Shao-Hua, SUI Feng-Xuan, GAO Wu-Hong, LIU Qing, CAI Hua-Bo, JIANG Hong-Ying, LI Wei-Yan, WANG Li-Ting, LI Li, ZHAO Wei, YING Jing, WU Qian-Zhen, WENG Bi-Xia, ZENG Yong-Mei. Risk factors for cow's milk protein allergy in infants: a multicenter survey[J]. CJCP, 2020, 22(1): 42-46.
