Dilrukshi G N, Kottahachchi J, Dissanayake D M B T, Pathiraja R P, Karunasingha J, Sampath M K A, Vidanage U A, Fernando S S N
Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.
School of Medical Laboratory Technology, Medical Research Institute, Colombo, Sri Lanka.
J Obstet Gynaecol. 2021 Jan;41(1):1-6. doi: 10.1080/01443615.2020.1716313. Epub 2020 Mar 16.
The proportion of Group B (GBS) colonisation in pregnant women >35 weeks of gestation was 18% and 49% by culture and real-time PCR respectively in selected hospitals from the Western Province of Sri Lanka. A Descriptive cross-sectional study was conducted from January to April 2019. Two low vaginal and rectal swabs were collected from 100 pregnant women. Identification of GBS was done by culture and real-time PCR. GBS isolates were found to be sensitive to penicillin, ampicillin, cefotaxime, vancomycin, while 5 and 4 isolates out of 18 were resistant to erythromycin and clindamycin, respectively. Further, there was a significant association between GBS colonisation and a history of vaginal discharge and unemployment.IMPACT STATEMENT Prevalence of GBS colonisation in the vagina and rectum of pregnant women in developing countries ranges from 8.5% to 22%. The Conventional method of culture has been considered the gold standard for diagnosis, however, the culture method does not give positive results for all cases of GBS. Polymerase chain reaction (PCR) has been found to be more sensitive for the detection of GBS than culture. In Sri Lanka, ante-natal screening for GBS is not practiced as the prevalence of GBS is still unlcear due to non-availably of data. Only a few scattered studies have been conducted using culture in Sri Lanka. Thus there is an urgent need to determine the magnitude of the GBS colonisers of ante-natal women in order to set up guidelines for screening and management of GBS. In this study, the overall GBS colonisation rate which was detected using both culture and PCR was 50% in Western Province of Sri Lanka. That was a high figure when compared to the figures which were detected previously in Sri Lanka using only conventional culture methods. The risk factors for GBS colonisation were found to have a significant relationship with the history of abnormal vaginal discharge. Further, it was found that when species coexisted with GBS, the existence of GBS was enhanced. Penicillin remains the antibiotic of choice for GBS. This study emphasises the importance of establishing national policies for screening of pregnant women of >35 weeks of gestation to reduce the risk of neonatal infection. Further, it gives an insight into the options of antibiotics that can be used for treatment of these GBS colonisers from Sri Lanka.
在斯里兰卡西部省份的部分医院中，孕周>35周的孕妇中B组链球菌（GBS）定植率，通过培养法为18%，通过实时荧光定量PCR法为49%。2019年1月至4月开展了一项描述性横断面研究。从100名孕妇中采集两份阴道下段和直肠拭子。通过培养和实时荧光定量PCR鉴定GBS。发现GBS分离株对青霉素、氨苄西林、头孢噻肟、万古霉素敏感，而18株中有5株和4株分别对红霉素和克林霉素耐药。此外，GBS定植与白带病史和失业之间存在显著关联。影响声明发展中国家孕妇阴道和直肠中GBS定植率在8.5%至22%之间。传统的培养方法一直被视为诊断的金标准，然而，培养方法并非对所有GBS病例都能得出阳性结果。已发现聚合酶链反应（PCR）检测GBS比培养法更敏感。在斯里兰卡，由于缺乏数据，GBS的患病率仍不明确，因此未开展GBS的产前筛查。在斯里兰卡仅进行了少数几项使用培养法的零散研究。因此，迫切需要确定产前妇女GBS定植者的数量，以便制定GBS筛查和管理指南。在本研究中，斯里兰卡西部省份使用培养法和PCR法检测到的GBS总体定植率为50%。与此前在斯里兰卡仅使用传统培养方法检测到的数据相比，这一数字较高。发现GBS定植的危险因素与异常白带病史有显著关系。此外，发现当其他菌种与GBS共存时，GBS的存在会增加。青霉素仍然是GBS的首选抗生素。本研究强调了制定针对孕周>35周孕妇进行筛查的国家政策以降低新生儿感染风险的重要性。此外，它还深入了解了可用于治疗这些来自斯里兰卡的GBS定植者的抗生素选择。
