Department of Bacteriology, University Hospitals Paris Centre Cochin Port Royal, French National Reference Centre for Streptococci, AP-HP, Paris, France.
FHU Prema, Paris, France.
Eur J Clin Microbiol Infect Dis. 2021 Jan;40(1):133-140. doi: 10.1007/s10096-020-04011-6. Epub 2020 Aug 18.
To identify factors associated with vaginal colonization and persistence by group B Streptococcus (GBS) and by the hypervirulent neonatal CC-17 clone in late pregnancy and after delivery, a multicentre prospective observational cohort with 3-month follow-up was established in two university hospitals, Paris area, France. Pregnant women were recruited when antenatal screening for GBS vaginal colonization at 34-38 weeks of gestational age was positive. Vaginal samples were analysed by conventional culture methods at antenatal screening, delivery, and 21 and 60 days following delivery. Identification of the hypervirulent neonatal GBS CC-17 was performed. Colonization was defined as persistent when all vaginal samples were positive for GBS. A total of 754 women were included. GBS vaginal colonization was persistent in 63% of the cases (95% CI 59%-67%). Persistent colonization was more likely in women born in Sub-Saharan Africa compared with women born in France (OR = 1.88, 95% CI 1.05-3.52), and GBS CC-17 was overrepresented in women born in Sub-Saharan Africa (OR = 2.09, 95% CI 1.20-3.57). Women born in Sub-Saharan Africa are at higher risk for GBS vaginal persistence than women born in France. This observation correlates with an increased prevalence of the hypervirulent GBS CC-17 in the former group, which likely reflect variations linked to ethnicity and vaginal community-state types and might account for the increased susceptibility of black neonates to GBS infections.
为了确定与妊娠晚期和分娩后 B 组链球菌(GBS)以及高毒力新生儿 CC-17 克隆阴道定植和持续存在相关的因素,在法国巴黎地区的两家大学医院建立了一个多中心前瞻性观察队列,随访时间为 3 个月。当在妊娠 34-38 周的产前 GBS 阴道定植筛查中呈阳性时,招募孕妇。在产前筛查、分娩时以及分娩后 21 天和 60 天,通过常规培养方法分析阴道样本。进行新生儿高毒力 GBS CC-17 的鉴定。当所有阴道样本均为 GBS 阳性时,将定植定义为持续性。共纳入 754 名妇女。63%(95%CI 59%-67%)的病例存在 GBS 阴道定植持续性。与法国出生的妇女相比,撒哈拉以南非洲出生的妇女持续性定植的可能性更高(OR=1.88,95%CI 1.05-3.52),并且撒哈拉以南非洲出生的妇女中 GBS CC-17 过度表达(OR=2.09,95%CI 1.20-3.57)。与法国出生的妇女相比,撒哈拉以南非洲出生的妇女发生 GBS 阴道持续性定植的风险更高。这一观察结果与高毒力 GBS CC-17 在前者中更为普遍的现象相关,这可能反映了与种族和阴道群落状态类型相关的差异,并可能解释了黑人新生儿对 GBS 感染易感性增加的原因。