Dynamics of colonization with group B streptococci in relation to normal flora in women during subsequent trimesters of pregnancy.

The main objective of the study was to compare the qualitative and quantitative composition of vaginal and rectal flora in GBS-positive (n=15) and GBS-negative (n=27) pregnant women examined in three subsequent trimesters of their pregnancy. Study samples consisted of vaginal and rectal smears and urine samples. GBS numbers were determined by the quantitatively cultured method [cfu/ml] and with the use of qPCR. Five GBS colonies were isolated per each positive sample and genotyped by PFGE and serotyping. The normal flora components: Lactobacillus, Bifidobacterium and Candida were quantitatively cultured. Carriage of GBS in subsequent trimesters in vagina/anus was variable and fluctuated between 17% and 28%. Quantitative GBS analyses showed that the vaginal population was at a constant level with the mean value equal to 3.94×104 cfu/ml, in contrast to the rectal population where the highest values appeared in the third trimester 4.37×105. The use of qPCR gave 7% more positive results for vaginal/rectal swabs. Genetic similarity analysis showed that one GBS clone was present in 73% of carriers during pregnancy, while in 27% of patients, 2 clones were found. H2O2-positive vaginal lactobacilli were detected in all women, while H2O2-negative lactobacilli and Bifidobacterium occurred more frequently in the anus in about 50% of women. Candida was present in the vagina in 30% of women. The analysis of women in three consecutive trimesters of pregnancy on the basis of a study group and control group showed no statistically significant differences in either the species (qualitative) or quantitative composition in vaginal and rectal flora in both of the groups. Therefore, GBS should be considered as a component of the microbiota and an opportunistic microorganism rather than a typical pathogen, because it does not distort the composition of women's normal genital tract flora.