Carriage and antibiotic susceptibility profile of group B streptococcus during late pregnancy in selected hospitals in Greater Accra

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2015-04-28
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Background: Group B Streptococcus (GBS) also known as Streptococcus agalactiae colonizes the genital and gastrointestinal tract found in 15–50% of healthy adults. Its infection is a major health problem among infants and adults. In pregnancy, vertical transmission of GBS to the newborn can cause neonatal sepsis, pneumonia and meningitis. Aim: The aim of this study was to determine the prevalence of GBS in pregnant women in their third trimester, its antibiotic susceptibility profile and serotype distribution in two districts in Greater Accra. Methods: Rectovaginal swabs were collected from a total number of 400 third trimester pregnant women between 35 - 37 weeks of gestation attending routine antenatal clinics at Mamprobi Polyclinic, Accra and Dangme West District Hospital between August 2012 and March 2013. The samples were cultured in Todd Hewitt Broth with 5% sheep blood, sub cultured on sheep blood agar and incubated at 37ºc for 24 hours. Identification was based on the Gram staining, presence of β-haemolysis, absence of catalase production, and agglutination with group-specific and serotype antiserum. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk-diffusion method. Results: GBS colonization on average was confirmed in 26.8% of pregnant women and proportion of GBS isolated from the vagina (77.4%) as compared to the rectum (17.9%) and both vagina and rectum (5.7%). The prevailing serotype were Ia, II, III, IV, V, VII, VIII, IX (0.9, 0.9, 6.6, 9.4, 6.6, 40.2, 6.6 and 29.8 %) respectively. Area of residence has not shown, significantly, to have any influence on GBS colonization (MPC = 28.0%, DWDH = 25.5%) P < 0.05. All isolates were found to be resistant to vancomycin, penicillin, ampicillin, erythromycin, ceftrixone and cefotaxime (15, 50, 26, 42, 33 and 38%) respectively. Conclusion: A high prevalence of 26.8 % was detected among the pregnant women. There is a need for screening of pregnant women attending antenatal care for this bacterium, including knowing the antibiotic susceptibility so an appropriate intrapartum antimicrobial prophylaxis can be offered. Further studies are required to verify the presence of antibodies to the serotype and their immunobiological function in the pregnant women.
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A thesis submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in fulfilment of the requirements for the degree of Master of Philosophy in Clinical Microbiology, 2014
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