Department of Medical Microbiology and Parasitology, National Hospital Abuja, Abuja, Nigeria.
Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, USA.
Clin Microbiol Infect. 2017 Sep;23(9):673.e9-673.e16. doi: 10.1016/j.cmi.2017.02.029. Epub 2017 Mar 6.
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.
GBS strains were characterized for antibiotic susceptibilities, capsule (cps) genotype, pilus island profile and multilocus sequence type (ST).
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.
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.
由于在尼日利亚开展的关于 B 群链球菌（GBS）的研究较少，我们旨在评估 500 名妇女及其新生儿的 GBS 定植和传播频率，并确定这两种结局的危险因素。
对 GBS 菌株的抗生素敏感性、荚膜（cps）基因型、菌毛岛谱和多位点序列型（ST）进行了特征分析。
共有 171 名（34.2%）母亲及其 95 名（19.0%）新生儿被 GBS 定植；垂直传播率为 48.5%。有 1 名新生儿发生早发性疾病，发病率为每 1000 例活产 2.0 例（95%CI 0.50-7.30）。直肠母亲定植（OR 26.6；95%CI 13.69-51.58）和胎膜破裂时间延长（OR 4.2；95%CI 1.03-17.17）与新生儿定植相关，而胎膜破裂时间延长（OR 3.4；95%CI 1.04-11.39）和母亲年龄较小（OR 2.0；95%CI 1.22-3.39）与母亲定植相关。报告分娩过程中有 4 次或更多次阴道检查（OR 6.1；95%CI 3.41-10.93）和冲洗（OR 3.7；95%CI 2.26-6.11）的女性也更有可能定植。在有传播证据的 35 对母婴中发现了 12 种 ST 型；cpsV ST-19 型（n=9；25.7%）和 cpsIII ST-182 型（n=7；20.0%）菌株占优势。
这些数据表明，在一个不使用抗生素预防新生儿感染的人群中，定植和传播率很高，未来应考虑这种策略。
