Prevalence of Group B Streptococcus Colonization among Pregnant Women in Gaza strip, Palestine

Abstract

Streptococcus agalactiae (group B Streptococcus; GBS) is a significant cause of perinatal and neonatal infections worldwide. The aim of this study was to evaluate the prevalence of GBS colonization among pregnant women in Gaza strip. A total of 200 rectovaginal swabs collected from pregnant women from Al Shifa hospital were screened for GBS colonization. Standard microbiological methods according to the Centers for Disease Control and Prevention (CDC) recommendations were used to isolate and identify GBS. Selective and chromogenic culture in addition to PCR were employed for the detection of GBS. Antimicrobial susceptibility testing (AST) was performed according to CLSI guidelines. Out of 200 pregnant women, 42 (21%) were colonized by GBS. The sensitivity, specificity, positive predictive value and negative predictive value of PCR were 54%, 88%, 76%, and 72%, respectively. Of the GBS isolates examined 76%, 57%, 50%, 48% and 31% were susceptible to vancomycin, penicillin, erythromycin, tetracycline and clindamycin, respectively. There was no statistically significant association between GBS colonization and chronic diseases, complications (previous abortion, delivery at <37 weeks gestation, premature birth, intrauterine death and endometrtitis), and previous antibiotic intake (p>0.05). In conclusion, this study showed high prevalence of GBS colonization among pregnant women in Gaza strip. Despite the fact that PCR is well known for its high sensitivity, low sensitivity was obtained in this study which may be due to the collection methods. Vancomycin was the most effective antibiotic against GBS isolates. We recommend a screening-based strategy to detect GBS in Palestinian pregnant women.