Detection of Streptococcus agalactiae colonization in pregnant women by using combined swab cultures

cross-sectional prevalence study

Authors

  • Camila Marconi Faculdade de Medicina de Botucatu and Universidade Estadual Paulista
  • Talita Trevizani Rocchetti Faculdade de Medicina de Botucatu and Universidade Estadual Paulista
  • Vera Lúcia Mores Rall Faculdade de Medicina de Botucatu and Universidade Estadual Paulista
  • Lidia Raquel de Carvalho Faculdade de Medicina de Botucatu and Universidade Estadual Paulista
  • Vera Terezinha Medeiros Borges Faculdade de Medicina de Botucatu and Universidade Estadual Paulista
  • Márcia Guimarães da Silva Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

Keywords:

Streptococcus agalactiae, Pregnancy, Infant, newborn, Patient isolation, Culture media

Abstract

CONTEXT AND OBJECTIVE: Maternal Streptococcus agalactiae colonization and early-onset neonatal sepsis have aroused interest in the worldwide literature. Streptococcal neonatal disease is associated with significant morbidity and mortality in the perinatal period, especially among premature neonates. The aim of this study was to assess the prevalence of maternal streptococcal colonization by using combined swab cultures, compared with swab collection from a single site. DESIGN AND SETTING: Cross-sectional study at Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Samples were obtained from 405 patients at gestational ages of 35 to 37 weeks. Swabs from the perianal (rectal) region, vaginal introitus and upper lateral vaginal vault were cultured in Todd-Hewitt selective broth. Colonies suggestive of Streptococcus agalactiae were subjected to the catalase and CAMP (Christie, Atkins, Munch-Petersen) tests. To evaluate the positivity of combined swab cultures, Tukey’s test was used for comparison of proportions. RESULTS: The prevalence of streptococcal colonization was 25.4%. Among the patients with positive cultures, 28.1% had this at only one collection site, 24.2% simultaneously at two sites and 47.5% at all three sites. Associating the swabs from two collection sites significantly increased streptococcal isolation, compared with a single swab (P < 0.05), except for perianal (rectal) collection. Use of combined swabs from three collection sites showed statistically higher isolation rates. CONCLUSION: In combined swab cultures collected from three collection sites, the prevalence of maternal Streptococcus agalactiae colonization was higher than in swabs collected from a single site.

Downloads

Download data is not yet available.

Author Biographies

Camila Marconi, Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

Undergraduate student, Department of Pathology, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil.

Talita Trevizani Rocchetti, Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

Undergraduate student, Department of Pathology, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil.

Vera Lúcia Mores Rall, Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

PhD. Assistant professor, Department of Microbiology and Immunology, Institute of Biosciences, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil.

Lidia Raquel de Carvalho, Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

PhD. Assistant professor, Department of Biostatistics, Institute of Biosciences, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil.

Vera Terezinha Medeiros Borges, Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

PhD. Assistant professor, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil.

Márcia Guimarães da Silva, Faculdade de Medicina de Botucatu and Universidade Estadual Paulista

PhD. Assistant professor, Department of Pathology, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, Brazil.

References

Centers for Disease Control and Prevention (CDC). Perinatal group B streptococcal disease after universal screening recommendations--United States, 2003-2005. MMWR Morb Mor- tal Wkly Rep. 2007;56(28):701-5.

Schrag SJ, Zywicki S, Farley MM, et al. Group B streptococcal disease in the era of intrapar- tum antibiotic prophylaxis. N Engl J Med. 2000;342(1):15-20.

Winn HN. Group B streptococcus infection in pregnancy. Clin Perinatol. 2007;34(3): 387-92.

Yancey MK, Duff P, Clark P, Kurtzer T, Frentzen BH, Kubilis P. Peripartum infection associated with vaginal group B streptococcal colonization. Obstet Gynecol. 1994;84(5):816-9.

Heath PT, Balfour G, Weisner AM, et al. Group B streptococcal disease in UK and Irish infants younger than 90 days. Lancet. 2004;363(9405):292-4.

Schuchat A. Group B streptococcal disease in newborns: a global perspective on prevention. Biomed Pharmacother. 1995;49(1):19-25.

Prevention of perinatal group B streptococcal disease: a public health perspective. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1996;45(RR-7):1-24.

Baltimore RS. Consequences of prophylaxis for group B streptococcal infections of the neo- nate. Semin Perinatol. 2007;31(1):33-8.

Yücesoy G, Caliskan E, Karadenizli A, et al. Maternal colonisation with group B streptococcus and effectiveness of a culture-based protocol to prevent early-onset neonatal sepsis. Int J Clin Pract. 2004;58(8):735-9.

Gavino M, Wang E. A comparison of a new rapid real-time polymerase chain reaction system to traditional culture in determining group B streptococcus colonization. Am J Obstet Gyne- col. 2007;197(4):388.e1-4.

Davies HD, Adair CE, Partlow ES, Sauve R, Low DE, McGeer A. Two-year survey of Alberta laboratories processing of antenatal group B streptococcal (GBS) screening specimens: implications for GBS screening programs. Diagn Microbiol Infect Dis. 1999;35(3):169-76.

Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep. 2002;51(RR-11):1-22.

Heelan JS, Struminsky J, Lauro P, Sung CJ. Evaluation of a new selective enrichment broth for detection of group B streptococci in pregnant women. J Clin Microbiol. 2005;43(2):896-7.

Bland ML, Vermillion ST, Soper DE, Austin M. Antibiotic resistance patterns of group B streptococci in late third-trimester rectovaginal cultures. Am J Obstet Gynecol. 2001;184(6):1125-6.

Kubota T. Relationship between maternal group B streptococcal colonization and pregnancy outcome. Obstet Gynecol. 1998;92(6):926-30.

El-Kersh TA, Al-Nuaim LA, Kharfy TA, Al-Shammary FJ, Al-Saleh SS, Al-Zamel FA. Detec- tion of genital colonization of group B streptococci during late pregnancy. Saudi Med J. 2002;23(1):56-61.

Moyo SR, Mudzori J, Tswana SA, Maeland JA. Prevalence, capsular type distribution, an- thropometric and obstetric factors of group B Streptococcus (Streptococcus agalactiae) colonization in pregnancy. Cent Afr J Med. 2000;46(5):115-20.

Platt MW, McLaughlin JC, Gilson GJ, Wellhoner MF, Nims LJ. Increased recovery of group B Streptococcus by the inclusion of rectal culturing and enrichment. Diagn Microbiol Infect Dis. 1995;21(2):65-8.

Costa ALR, Lamy Filho F, Chen MBC, Brito LMO, Lamy ZC, Andrade KL. Prevalência de colo- nização por estreptococos do grupo B em gestantes atendidas em maternidade pública da região Nordeste do Brasil [Prevalence of colonization by group B Streptococcus in pregnant women from a public maternity of Northwest region of Brazil]. Rev Bras Ginecol Obstet. 2008;30(6):274-80.

El Beitune P, Duarte G, Maffei CM. Colonization by Streptococcus agalactiae during preg- nancy: maternal and perinatal prognosis. Braz J Infect Dis. 2005;9(4):276-82.

American College of Obstetricians and Gynecologists. ACOG Committee Opinion: number 279, December 2002. Prevention of early-onset group B streptococcal disease in new- borns. Obstet Gynecol. 2002;100(6):1405-12.

Downloads

Published

2010-03-03

How to Cite

1.
Marconi C, Rocchetti TT, Rall VLM, Carvalho LR de, Borges VTM, Silva MG da. Detection of Streptococcus agalactiae colonization in pregnant women by using combined swab cultures: cross-sectional prevalence study. Sao Paulo Med J [Internet]. 2010 Mar. 3 [cited 2025 Mar. 16];128(2):60-2. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1708

Issue

Section

Original Article