Prevalence of Group B Streptococcus Colonisation and Antimicrobial Susceptibility Pattern among Pregnant Women Attending a Tertiary Health Facility in Ogun State, Southwest Nigeria.

Background: Genital colonisation by group B Streptococcus (GBS) in pregnant women in their third trimester has been shown to be a known risk factor for morbidity and mortality among newborns. Aim: The aim of the study was to determine the prevalence of GBS colonisation among pregnant women in Abeokuta, its associated sociodemographic factors, and the neonatal outcome among exposed babies. Design: Longitudinal cohort study. Setting: Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, Ogun State. Methodology: One hundred sixty pregnant women presenting for routine antenatal care between 35 and 41 weeks were recruited consecutively. Swabs were taken from the vagina and then the rectum using a single swab. The samples were processed at the hospital's Medical Microbiology Laboratory using standard microbiological methods. Babies whose mothers were positive had their bodies swabbed and the samples sent for GBS isolates. They were also screened for early-onset neonatal sepsis with C-reactive protein. Results: Prevalence of GBS vaginal colonisation was 4.3%. There was no significant association between GBS colonisation status and age, level of education, or occupation; however, women of parity ≤1 had significantly higher prevalence of GBS colonisation than those of parity ≥2. There was no incidence of GBS infection observed in the babies. The GBS isolates were 100% sensitive to cefuroxime and 83.3% resistant to ampicillin. Conclusion: The prevalence of GBS is low in our environment. The organisms were highly sensitive to cefuroxime, erythromycin, and ceftriaxone. Routine screening of all pregnant women may be unnecessary. However, women at risk of GBS who present in labour without a recent GBS screening should be offered intrapartum prophylactic cefuroxime.

Contexte: La colonisation génitale par le streptocoque du groupe B (SGB) chez les femmes enceintes au cours de leur troisième trimestre s'est avérée être un facteur de risque connu de morbidité et de mortalité chez les nouveau-nés. Objectif: Déterminer la prévalence de la colonisation par le SGB chez les femmes enceintes à Abeokuta, ses facteurs sociodémographiques associés et l'issue néonatale chez les bébés exposés. Conception: Étude de cohorte longitudinale. Cadre: Département d'obstétrique et de gynécologie, Centre médical fédéral, Abeokuta, État d'Ogun. Méthodologie: Cent soixante femmes enceintes se présentant pour des soins prénatals de routine entre 35 et 41 semaines ont été recrutées consécutivement. Des écouvillons ont été prélevés du vagin puis du rectum à l'aide d'un seul écouvillon. Les échantillons ont été traités au laboratoire de microbiologie médicale de l'hôpital à l'aide de méthodes microbiologiques standard. Les bébés dont les mères étaient positives ont eu leur corps écouvillonné et les échantillons envoyés pour les isolats de SGB. Ils ont également été dépistés pour une septicémie néonatale d'apparition précoce avec la protéine C-réactive. Résultats: La prévalence de la colonisation vaginale par SGB était de 4,3%. Il n'y avait pas d'association significative entre le statut de colonisation par SGB et l'âge, le niveau d'éducation ou la profession; cependant, les femmes de parité ≤1 avaient une prévalence significativement plus élevée de colonisation par le SGB que celles de parité ≥2. Aucune incidence d'infection à SGB n'a été observée chez les bébés. Les isolats de SGB étaient 100% sensibles au céfuroxime et 83,3% résistants à l'ampicilline. Conclusion: La prévalence du SGB est faible dans notre environnement. Les organismes étaient très sensibles à la céfuroxime, à l'érythromycine et à la ceftriaxone. Le dépistage systématique de toutes les femmes enceintes peut être inutile. Cependant, les femmes à risque de SGB qui se présentent pendant le travail sans dépistage récent du SGB devraient se voir proposer du céfuroxime prophylactique intrapartum.

Asymptomatic bacteriuria among an obstetric population in Ibadan.

BACKGROUND: Asymptomatic bacteriuria in pregnancy is the major risk factor for symptomatic urinary tract infection during pregnancy. Screening and identification of bacteriuria during pregnancy have been recommended. OBJECTIVE: To determine the prevalence and pattern of asymptomatic bacteriuria associated with pregnancy. METHODS: The study was a descriptive, cross sectional survey of pattern of asymptomatic bacteriuria among consecutive patients presenting for the first antenatal visit at a University College Hospital, during a period of two months. Relevant information obtained from all the patients recruited for the study included age, parity, educational level, gestational age and occupation of participant. Haemoglobin electrophoresis patterns were also retrieved and recorded. Main outcome measures were prevalence of asymptomatic bacteriuria, bacterial isolates and their antibiotic sensitivities. RESULTS: There were 205 eligible participants with a mean age of 30.6 ± 4.3 years and a mean gestational age at booking of 20.9 ±7.0 weeks. The prevalence of asymptomatic bacteriuria was 22(10.7%). The isolated pathogens were predominantly coliforms (Klebsiella and E. coli) accounting for 45.5% and Staphylococcus saprophyticus (27.3%). Only gentamycin, nitrofurantoin and ofloxacin demonstrated high efficacy against these uropathogens with antibiotic sensitivity rates of 72.7%-81.8%. CONCLUSION: Prevalence of asymptomatic bacteriuria in this centre is relatively high. This underscores the need for routine screening of pregnant women for bacteriuria.

Asymptomatic bacteriuria in pregnancy: evaluation of reagent strips in comparison to microbiological culture.

Screening for asymptomatic bacteriuria during pregnancy, the major risk factor for symptomatic urinary tract infection during pregnancy have been recommended. This cross sectional study was conducted to determine prevalence of asymptomatic bacteriuria in Ibadan and evaluate the diagnostic accuracy and relative cost effectiveness of dipstick tests for nitrite and leucocyte esterase in comparison to laboratory culture. Two hundred and five patients, presenting for their first antenatal visit at the University College Hospital, Ibadan, participated in the study. Urine samples obtained from the participants were subjected to two tests; reagent dipstick test for nitrite and leucocyte esterase and routine laboratory culture, which is the gold standard for diagnosis. Main outcome measures were sensitivity, specificity, positive and negative predictive values of the reagent dipstick tests as well as likelihood ratios. The prevalence of asymptomatic bacteriuria in pregnancy with routine laboratory culture and using combined leucocyte esterase and nitrite strip tests were 10.7% and 11.7% respectively. Compared with laboratory culture, combined strip tests had sensitivity, specificity and negative predictive values of 50%, 92.9% and 93.9% respectively, indicating a statistically significant lower level of accuracy (P < 0.05). The corresponding likelihood ratios for positive and negative strip tests (LR+ and LR-) were 7 and 0.5 respectively. The study concludes that combined Leucocyte esterase-nitrite dipstick test is not sufficiently sensitive and specific to be used for routine screening of bacteriuria in pregnancy in place of laboratory culture, though may be more cost effective in low resource settings.

Predictors of asymptomatic bacteriuria among obstetric population in Ibadan.

BACKGROUND: Asymptomatic bacteriuria in pregnancy is the major risk factor for symptomatic urinary tract infection during pregnancy. Screening and identification of bacteriuria during pregnancy have been recommended. The general objective of the study was to determine the pattern as well as possible predictors of asymptomatic bacteriuria at the University College Hospital, Ibadan. METHODS: The study was a descriptive, cross sectional, exploratory survey of the pattern of asymptomatic bacteriuria among all consecutive patients presenting for the first antenatal visit at the University College Hospital, Ibadan during the study period. RESULTS: The prevalence of asymptomatic bacteriuria was 10.7%. Although no statistically significant association was found, the prevalence was higher among women aged between 26 - 35 years (11.5%) and those with only secondary education (14.6%). Other demographic parameters characterized by high rates of bacteriuria were Christian women (12.7% compared to 4.3% among Muslims) and genotypes AS and AC (16.4% and 16.7% respectively). Low parity (para 1-2), 2nd and 3rd trimesters of pregnancy were the identified possible obstetric predictors of bacteriuria in pregnancy. Staphylococcus species constitute the predominant isolates in 3rd trimester and among Muslim pregnant women. CONCLUSION: Since no statistically significant predictors for bacteriuria in pregnancy were found, routine screening of all our pregnant women for this condition in 2nd trimester is recommended.