Group B streptococcal colonization and transmission dynamics in pregnant women and their newborns in Nigeria

implications for prevention strategies

N. Medugu, K. C. Iregbu, R. E. Parker, J. Plemmons, P. Singh, L. I. Audu, E. Efetie, Herbert Dele Davies, S. D. Manning

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives Because few studies have been conducted on group B Streptococcus (GBS) in Nigeria, we sought to estimate GBS colonization and transmission frequencies for 500 women and their newborns and identify risk factors for both outcomes. Methods GBS strains were characterized for antibiotic susceptibilities, capsule (cps) genotype, pilus island profile and multilocus sequence type (ST). Results In all, 171 (34.2%) mothers and 95 (19.0%) of their newborns were colonized with GBS; the vertical transmission rate was 48.5%. One newborn developed early-onset disease, yielding an incidence of 2.0 cases per 1000 live births (95% CI 0.50–7.30). Rectal maternal colonization (OR 26.6; 95% CI 13.69–51.58) and prolonged rupture of membranes (OR 4.2; 95% CI 1.03–17.17) were associated with neonatal colonization, whereas prolonged membrane rupture (OR 3.4; 95% CI 1.04–11.39) and young maternal age (OR 2.0; 95% CI 1.22–3.39) were associated with maternal colonization. Women reporting four or more intrapartum vaginal examinations (OR 6.1; 95% CI 3.41–10.93) and douching (OR 3.7; 95% CI 2.26–6.11) were also more likely to be colonized. Twelve STs were identified among 35 mother–baby pairs with evidence of transmission; strains of cpsV ST-19 (n = 9; 25.7%) and cpsIII ST-182 (n = 7; 20.0%) predominated. Conclusions These data demonstrate high rates of colonization and transmission in a population that does not use antibiotics to prevent neonatal infections, a strategy that should be considered in the future.

Original languageEnglish (US)
Pages (from-to)673.e9-673.e16
JournalClinical Microbiology and Infection
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2017

Fingerprint

Streptococcus agalactiae
Nigeria
Pregnant Women
Newborn Infant
Mothers
Rupture
Anti-Bacterial Agents
Gynecological Examination
Membranes
Therapeutic Irrigation
Maternal Age
Live Birth
Islands
Capsules
Genotype
Incidence
Infection
Population

Keywords

  • Colonization
  • Molecular epidemiology
  • Neonatal disease
  • Risk factors
  • Sepsis
  • Streptococcus agalactiae

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Group B streptococcal colonization and transmission dynamics in pregnant women and their newborns in Nigeria : implications for prevention strategies. / Medugu, N.; Iregbu, K. C.; Parker, R. E.; Plemmons, J.; Singh, P.; Audu, L. I.; Efetie, E.; Davies, Herbert Dele; Manning, S. D.

In: Clinical Microbiology and Infection, Vol. 23, No. 9, 01.09.2017, p. 673.e9-673.e16.

Research output: Contribution to journalArticle

Medugu, N. ; Iregbu, K. C. ; Parker, R. E. ; Plemmons, J. ; Singh, P. ; Audu, L. I. ; Efetie, E. ; Davies, Herbert Dele ; Manning, S. D. / Group B streptococcal colonization and transmission dynamics in pregnant women and their newborns in Nigeria : implications for prevention strategies. In: Clinical Microbiology and Infection. 2017 ; Vol. 23, No. 9. pp. 673.e9-673.e16.
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abstract = "Objectives Because few studies have been conducted on group B Streptococcus (GBS) in Nigeria, we sought to estimate GBS colonization and transmission frequencies for 500 women and their newborns and identify risk factors for both outcomes. Methods GBS strains were characterized for antibiotic susceptibilities, capsule (cps) genotype, pilus island profile and multilocus sequence type (ST). Results In all, 171 (34.2{\%}) mothers and 95 (19.0{\%}) of their newborns were colonized with GBS; the vertical transmission rate was 48.5{\%}. One newborn developed early-onset disease, yielding an incidence of 2.0 cases per 1000 live births (95{\%} CI 0.50–7.30). Rectal maternal colonization (OR 26.6; 95{\%} CI 13.69–51.58) and prolonged rupture of membranes (OR 4.2; 95{\%} CI 1.03–17.17) were associated with neonatal colonization, whereas prolonged membrane rupture (OR 3.4; 95{\%} CI 1.04–11.39) and young maternal age (OR 2.0; 95{\%} CI 1.22–3.39) were associated with maternal colonization. Women reporting four or more intrapartum vaginal examinations (OR 6.1; 95{\%} CI 3.41–10.93) and douching (OR 3.7; 95{\%} CI 2.26–6.11) were also more likely to be colonized. Twelve STs were identified among 35 mother–baby pairs with evidence of transmission; strains of cpsV ST-19 (n = 9; 25.7{\%}) and cpsIII ST-182 (n = 7; 20.0{\%}) predominated. Conclusions These data demonstrate high rates of colonization and transmission in a population that does not use antibiotics to prevent neonatal infections, a strategy that should be considered in the future.",
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T1 - Group B streptococcal colonization and transmission dynamics in pregnant women and their newborns in Nigeria

T2 - implications for prevention strategies

AU - Medugu, N.

AU - Iregbu, K. C.

AU - Parker, R. E.

AU - Plemmons, J.

AU - Singh, P.

AU - Audu, L. I.

AU - Efetie, E.

AU - Davies, Herbert Dele

AU - Manning, S. D.

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AB - Objectives Because few studies have been conducted on group B Streptococcus (GBS) in Nigeria, we sought to estimate GBS colonization and transmission frequencies for 500 women and their newborns and identify risk factors for both outcomes. Methods GBS strains were characterized for antibiotic susceptibilities, capsule (cps) genotype, pilus island profile and multilocus sequence type (ST). Results In all, 171 (34.2%) mothers and 95 (19.0%) of their newborns were colonized with GBS; the vertical transmission rate was 48.5%. One newborn developed early-onset disease, yielding an incidence of 2.0 cases per 1000 live births (95% CI 0.50–7.30). Rectal maternal colonization (OR 26.6; 95% CI 13.69–51.58) and prolonged rupture of membranes (OR 4.2; 95% CI 1.03–17.17) were associated with neonatal colonization, whereas prolonged membrane rupture (OR 3.4; 95% CI 1.04–11.39) and young maternal age (OR 2.0; 95% CI 1.22–3.39) were associated with maternal colonization. Women reporting four or more intrapartum vaginal examinations (OR 6.1; 95% CI 3.41–10.93) and douching (OR 3.7; 95% CI 2.26–6.11) were also more likely to be colonized. Twelve STs were identified among 35 mother–baby pairs with evidence of transmission; strains of cpsV ST-19 (n = 9; 25.7%) and cpsIII ST-182 (n = 7; 20.0%) predominated. Conclusions These data demonstrate high rates of colonization and transmission in a population that does not use antibiotics to prevent neonatal infections, a strategy that should be considered in the future.

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