Saha Samir K, Ahmed Zabed B, Modak Joyanta K, Naziat Hakka, Saha Shampa, Uddin Mohammad A, Islam Maksuda, Baqui Abdullah H, Darmstadt Gary L, Schrag Stephanie J
Bangladesh Institute of Child Health, Department of Microbiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
Child Health Research Foundation, Department of Microbiology, Dhaka Shishu Hospital, Dhaka, Bangladesh.
J Clin Microbiol. 2017 Aug;55(8):2406-2412. doi: 10.1128/JCM.00380-17. Epub 2017 May 17.
Group B streptococcus (GBS) infection is a leading cause of death among newborns in developed countries. Data on the burden of GBS in Asian countries are lacking. This study aimed to understand (i) the rate of maternal rectovaginal GBS carriage, (ii) the rate of vertical transmission of GBS, as determined by culturing ear, umbilicus, and nasal swabs, and (iii) the distribution of GBS serotypes. This prospective observational study was conducted between September 2012 and November 2013 at Kumudini Women's Medical College Hospital, a secondary-level hospital in Mirzapur, Bangladesh. The study enrolled pregnant women who visited the outpatient clinic for antenatal care (ANC) and/or delivered a child in the inpatient department of Kumudini Women's Medical College Hospital and the babies born to those mothers. Among 1,151 enrolled pregnant women, 172 (15% [95% confidence interval [CI], 13 to 17%]) carried GBS; among 68 babies born to mothers with carriage, 26 (38% [95% CI, 27 to 51%]) had GBS on their body surfaces, indicating vertical transmission. Typing of the isolates ( = 172) identified all 10 GBS serotypes, most commonly types Ia (40% [69/172 isolates]), V (23% [40/172 isolates]), II (14% [24/172 isolates]), and III (12% [20/172 isolates]). This study shows that Bangladesh has all of the ingredients for invasive GBS disease, including colonization of mothers by invasive serotypes and vertical transmission to babies.
B族链球菌(GBS)感染是发达国家新生儿死亡的主要原因。亚洲国家缺乏关于GBS负担的数据。本研究旨在了解:(i)孕产妇直肠阴道GBS携带率;(ii)通过对耳、脐和鼻拭子进行培养确定的GBS垂直传播率;以及(iii)GBS血清型的分布。这项前瞻性观察性研究于2012年9月至2013年11月在孟加拉国米尔扎布尔的一家二级医院——库穆迪尼女子医学院医院进行。该研究纳入了到门诊进行产前检查(ANC)和/或在库穆迪尼女子医学院医院住院部分娩的孕妇以及这些母亲所生的婴儿。在1151名纳入研究的孕妇中,172名(15%[95%置信区间(CI),13%至17%])携带GBS;在携带GBS的母亲所生的68名婴儿中,26名(38%[95%CI,27%至51%])体表有GBS,表明存在垂直传播。对分离株(n = 172)进行分型鉴定出了所有10种GBS血清型,最常见的是Ia型(40%[69/172株分离株])、V型(23%[40/172株分离株])、II型(14%[24/172株分离株])和III型(12%[20/172株分离株])。这项研究表明,孟加拉国具备侵袭性GBS疾病的所有要素,包括侵袭性血清型在母亲中的定植以及向婴儿的垂直传播。