Presence and resistance of Streptococcus agalactiae in vaginal specimens of pregnant and adult non-pregnant women and association with other aerobic bacteria
Aim To determine the prevalence rate and resistance profile of Streptococcus agalactiae (S. agalactiae) in vaginal swabs of pregnant and adult non-pregnant women in the Tuzla region, Bosnia and Herzegovina (B&H), as well as its association with other aerobic bacteria. Methods This prospective study included 200 women, 100 pregnant and 100 adult non-pregnant. The research was conducted at the Institute of Microbiology, University Clinical Center Tuzla from October to December 2015. Standard aerobic microbiological techniques were used for isolation and identification of S. agalactiae and other aerobic bacteria. Antimicrobial susceptibility was determined by the disk diffusion and microdilution method (VITEK 2/AES instrument). Results Among 200 vaginal swabs, 17 (8.50%) were positive for S. agalactiae, e. g., 7% (7/100) of pregnant and 10% (10/100) of adult non-pregnant women. In the pregnant group, 71.4% (5/7) of S. agalactiae isolates were susceptible to clindamycin and 85.7% (6/7) to erythromycin. In the adult non-pregnant group, only resistance to clindamycin was observed in one patient (1/10; 10%). S. agalactiae as single pathogen was isolated in 57.14% (4/7) of pregnant and 60% (6/10) of adult non-pregnant S. agalactiae positive women. In mixed microbial cultures S. agalactiae was most frequently associated with Enterococcus faecalis and Escherichia coli. Conclusion The rate of S. agalactiae positive women in the population of pregnant and adult non-pregnant women of Tuzla Canton, B&H is comparable with other European countries. Large studies are needed to develop a common national strategy for the prevention of S. agalactiae infection in B&H, especially during pregnancy.
Rajagopal L. Understanding the regulation of Group B Streptococcal virulence factors. Future Microbiol. 2009;201–21.
2.
Edwards M, Baker C. Group B streptococcal infections in elderly adults. Clin Infect Dis. 2005;839–47.
3.
Landwehr-Kenzel S, Henneke P. Interaction of Streptococcus agalactiae and cellular innate immunity in colonization and disease. Front Immunol. 2014;1–11.
4.
Maisey H, Doran K, Nizet V. Recent advances in understanding the molecular basis of group B Streptococcus virulence. Expert Rev Mol Med. 2008;27.
5.
Skoff T, Farley M, Petit S, Craig A, Schaffner W, Gershman K, et al. Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990-2007. Clin Infect Dis. 2009;85–92.
6.
Simoes J, Aoutcheva A, Heimler I, Faro S. Antibiotic resistance patterns of group B streptococcal clinical isolates. Infect Dis Obstet Gynecol. 2004;1–8.
7.
Muller-Vranješ A, Puntarić D, Čuržik D, Šijanović S, Topolovec Z, Kasač Z, et al. Prevalence and significance of vaginal group B Streptococcus colonization in pregnant women from Osijek. Croatia Coll Antropol. 2011;21–6.
8.
Mavenyengwa R, Afset J, Schei B, Berg S, Caspersen T, Bergseng H, et al. Group B Streptococcus colonization during pregnancy and maternal-fetal transmission in Zimbabwe. Acta Obstet Gynecol Scand. 2010;250–5.
9.
Arif D, Urehkar A, Chaundhary K, Nissar B, Singh J, S. Prevalence of Streptococcus agalactiae in pregnant women and it antibiotic sensitivity pattern. Int J Curr Microbiol App Sci. 2015;315–20.
10.
Garland S, Cottrill E, Markowski L, Pearce C, Clifford V, Ndisang D, et al. Antimicrobial resistance in group B streptococcus: the Australian experience. J Med Microbiol. 2011;230–5.
11.
Helmig R, Halaburt J, Uldbjert M, Thomsen A, Stenderup A. Increased cell adherence of group B streptococci from preterm infants with neonatal sepsis. Obstet Gynecol. 1990;825–7.
12.
Hansen S, Uldbjerg N, Kilian M, Sørensen U. Dynamics of Streptococcus agalactiae colonization in women during and after pregnancy and in their Infants. J Clin Microbiol. 2004;83–9.
13.
Verani J, Mcgee L, Schrag S. Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Center for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease-revised guidelines from CDC. MMWR Recomm Rep. 2010;1–36.
14.
Strus M, Pawlik D, Brzychczy-Wloch M, Gosiewski T, Rytlewski K, Lauterbach R, et al. Group B streptococcus colonization of pregnant women and their children observed in obstetric and neonatal wards of the University Hospital in Krakow, Poland. J Med Microbiol. 2009;228–33.
15.
Earlyonset group B streptococcal disease-United States, 1998-1999. MMWR Morb Mortal Wkly Rep. 2000;793–6.
16.
Pinheiro S, Radhouani H, Coelho C, Gonçalves A, Carvalho E, Carvalho J, et al. Prevalence and mechanisms of erythromycin resistance in Streptococcus agalactiae from healthy pregnant women. Microb Drug Resist. 2009;121–4.
17.
Women and health: today’s evidence tomorrow’s agenda. 2009;
18.
Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, et al. Manual of Clinical Microbiology. 11 th Edition. 2015;
19.
Performance standards for antimicrobial disk susceptibility testing -20th informational supplement. Approved Standard M100-S20. CLSI. 2010;
20.
Larsen B, Monif G. Understanding the bacterial flora of the female genital tract. Clin Infect Dis. 2001;69-e77.
21.
Reid G, Burton J. Use of Lactobacillus to prevent infection by pathogenic bacteria. Microbes Infect. 2002;319–24.
22.
Ronnqvist P, Ub FB. Grahn-Hakansson EE. Lactobacilli in the female genital tract in relation to other genital microbes and vaginal pH. Acta Obstet Gynecol Scand. 2006;726–35.
23.
Carson H, Lapoint P, Monif G. Interrelationships within the bacterial flora of the female genital tract. Infect Dis Obstet Gynecol. 1997;305–9.
24.
Donders G, Vereecken A, Bosmans E, Dekeersmaecker A, Salembier G, Spitz B. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. Br J Obstet Gynecol. 2002;34–43.
25.
Numanović F, Hukić M, Nurkić M, Gegić M, Delibegović Z, Imamović A, et al. Bacterial vaginosis presence in sexually active women in Tuzla Canton area. BJBMS. 2008;323–30.
26.
Shabayek S, Abdalla S, Abouzeid A. Vaginal carriage and antibiotic susceptibility profile of group B Streptococcus during late pregnancy in Ismailia. Egypt J Infect Public Health. 2009;86–90.
27.
Arisoy A, Altinişik B, Tünger O, Kurutepe S. Ispahi C. Maternal carriage and antimicrobial resistance profile of group B Streptococcus. Infection. 2003;244–6.
28.
El Beitune P, Duarte G. Leite Maffei CM. Colonization by Streptococcus agalactiae during pregnancy: maternal and perinatal prognosis. BJID. 2005;276–82.
29.
Eschenbach D. Specific bacterial infections: group B streptococcus. The Global Library of Women’s Medicine.
30.
B%20Streptococcus/item/179. 27AD;
31.
Phares C, Lynfield R, Farley M, Mohle-Boetani J, Harrison L, Petit S, et al. Active Bacterial Core surveillance/Emerging Infections Program Network. Epidemiology of invasive group B streptococcal disease in the United States. JAMA. 1999;2056–65.
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