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Saudi Med J ; 23(1): 56-61, 2002 Jan.
Article in English | MEDLINE | ID: mdl-11938365

ABSTRACT

OBJECTIVE: To detect group B streptococcal carrier state of Saudi females during 3rd trimester of pregnancy and to assess type of specimens and the techniques used for the organism detection. METHODS: A total of 867 consecutive vaginal and rectal swabs were obtained from 217 pregnant women at > 28 weeks of gestation and their follow up testing from King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. Swab-specimens were cultured comparatively on Islam and Edwards blood agar plates, and into selective Lim broth. Enrichment Lim broth cultures (>12 hours) with and without positive modified coagglutination test were then subcultured on Islam and Edwards sheep blood agar plates. Presumptive colonies were then tested for group B streptococcus identity by convential biochemical reactions, serogrouping and serotyping. Collected neonatal swab-specimens (184) were also treated similarly. RESULTS: In comparison to Lim broth enrichment culture, the direct swab specimen culture on Edwards blood agar or Islam agar plates technique revealed 84% sensitivity and 100% specificity, whereas modified coagglutination test after selective Lim broth enrichment revealed 100% sensitivity and 96% specificity. Group B streptococcus was isolated in at least one of the specimens from the 217 patients in 66 cases. Of these 66 cases, group B streptococcus was isolated from both vaginal and rectal swabs in 33 (50%) cases and only from vaginal swabs in 22 (33%) and rectal swabs in 11 (17%) cases. Of the group B streptococcus positive cases, 10 (15%) cases had spontaneously lost their carriage, upon follow up testing, whereas out of the 151 negative cases, 4 (2.6%) cases became positive for group B streptococcus colonization upon follow up testing with an overall carriage rate of (60/217) 27.6%. Certain demographic factors were found to alter such rate of carriage. Additionally, 50% of group B streptococcal colonized mothers vertically transmitted the homologous serotypes of the organism to their newborns, but clinical infection was not recorded during the study period. CONCLUSION: Group B streptococci colonization rate among term Saudi pregnant women is relatively high (27.6%); and thereby constitutes a group of women whose infants are at great risk of early-onset invasive disease. The modified coagglutination test after growth amplification seems rapid and cost-effective to detect lightly or heavily group B streptococcal colonized women. Vaginal and rectal swab specimens at late pregnancy appeared necessary to accurately identify group B streptococcus maternal colonization.


Subject(s)
Carrier State/microbiology , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/diagnosis , Streptococcal Infections/diagnosis , Streptococcal Infections/transmission , Streptococcus agalactiae/isolation & purification , Adolescent , Adult , Carrier State/epidemiology , Colony Count, Microbial , Female , Humans , Incidence , Infant, Newborn , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Third , Probability , Risk Factors , Saudi Arabia/epidemiology , Sensitivity and Specificity , Streptococcal Infections/epidemiology , Vaginal Smears
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