The trends of isolation and antimicrobial susceptibility of group B Streptococcus in urine culture: a 7-years cross sectional study

Rachana  Kannambath; Shruthi Vasanthaiah; Imola Jamir; Haritha Sagili; Jharna Mandal

doi:10.18203/2320-1770.ijrcog20231555

Authors

Rachana Kannambath Department of Microbiology, JIPMER, Puducherry, India
Shruthi Vasanthaiah Department of Microbiology, JIPMER, Puducherry, India
Imola Jamir Department of Microbiology, JIPMER, Puducherry, India
Haritha Sagili Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India
Jharna Mandal Department of Microbiology, JIPMER, Puducherry, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231555

Keywords:

Antimicrobial susceptibility testing, Streptococcus agalactiae, Urine, Urinary tract infection

Abstract

Background: Group B Streptococcus (GBS)/Streptococcus agalactiae (S. agalactiae) is a common rectovaginal colonizer, thereby a potential agent of neonatal and maternal infection. This study estimates the trends of isolation of GBS, its antimicrobial profile in urine culture and the demographic characteristics of these patients over a 7-year period.

Methods: A record-based study was conducted, which included all the urine culture reports of GBS/S. agalactiae from January 2014 to December 2020. The trend of occurrence of GBS bacteriuria, demographic characteristics and antimicrobial susceptibility pattern were analyzed.

Results: Out of 137 urine samples which grew GBS/S. agalactiae, 55(40.15%) were from antenatal women. Most of the isolates were from females (72.26%), with a male preponderance noted among the elderly population (age>60 years). The predominant age group affected were adults between 20 to 59 years. The majority of the isolates (60.58%) were susceptible to all the four tested antibiotics, namely, ciprofloxacin, nitrofurantoin, ampicillin and vancomycin. Ciprofloxacin resistance was observed in 32.85% (45/137) isolates, 5.84% (8/137) isolates were resistant to ampicillin and 2.92% (4/137) were resistant to nitrofurantoin.

Conclusions: All the isolates were susceptible to vancomycin. GBS/S. agalactiae is an important agent of bacteriuria in antenatal women as well as in non-pregnant population, especially the elderly males. Emerging resistance to various group of antibiotics warrants routine susceptibility testing.

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References

Lancefield RC. A serological differentiation of human and other groups of hemolytic Streptococci. J Exp Med. 1933;57(4):571-95.

Fry RM. Fatal infections by haemolytic Streptococcus group B. The Lancet. 1938;231:199-201.

Schuchat A. Epidemiology of group B streptococcal disease in the United States: shifting paradigms. Clin Microbiol Rev. 1998;11(3):497-513.

Raabe VN, Shane AL. Group B Streptococcus (Streptococcus agalactiae). Microbiol Spectr. 2019;7(2):7-2.

Committee on Obstetric Practice. Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 797. Obstet Gynecol. 2020;135:e51-72.

Safari D, Gultom SM, Tafroji W, Azzahidah A, Soesanti F, Khoeri MM, et al. Prevalence, serotype and antibiotic susceptibility of Group B Streptococcus isolated from pregnant women in Jakarta, Indonesia. PLoS ONE. 2021;16(5):e0252328.

Steer PJ, Russell AB, Kochhar S, Cox P, Plumb J, Rao GG. Group B streptococcal disease in the mother and newborn-A review. Eur J Obstet Gynecol Reprod Biol. 2020;252:526-33.

Ulett GC, Webb RI, Ulett KB, Cui X, Benjamin WH, Crowley M, et al. Group B Streptococcus (GBS) urinary tract infection involves binding of GBS to bladder uroepithelium and potent but GBS-specific induction of interleukin 1alpha. J Infect Dis. 2010;201(6):866-70.

Muñoz P, Coque T, Créixems MR, Bernaldo de Quirós JCL, Moreno S, et al. Group B Streptococcus: A Cause of Urinary Tract Infection in Nonpregnant Adults. Clin Infect Dis. 1992;14(2):492-6.

Ulett KB, Benjamin WH, Zhuo F, Xiao M, Kong F, Gilbert GL, et al. Diversity of group B streptococcus serotypes causing urinary tract infection in adults. J Clin Microbiol. 2009;47(7):2055-60.

Rosenberger KD, Seibert A, Hormig S. Asymptomatic GBS bacteriuria during antenatal visits: To treat or not to treat?. Nurse Pract. 2020;45(7):18.

Zhu Y, Lin X-Z. Updates in prevention policies of early-onset group B streptococcal infection in newborns. Pediatr Neonatol. 2021;62(5):465-75.

Goel N, Wattal C, Gujral K, Dhaduk N, Mansukhani C, Garg P. Group B Streptococcus in Indian pregnant women: Its prevalence and risk factors. Indian J. Med. Microbiol. 2020;38(3-4):357-61.

Ashary N, Singh A, Chhabria K, Modi D. Meta-analysis on prevalence of vaginal group B streptococcus colonization and preterm births in India. J Matern-Fetal Neonatal Med. 2022;35(15):2923-31.

Farley MM. Group B streptococcal disease in nonpregnant adults. Clin Infect Dis Off Publ Infect Dis Soc Am. 2001;33(4):556-61.

Farley MM, Harvey RC, Stull T, Smith JD, Schuchat A, Wenger JD, et al. A population-based assessment of invasive disease due to group B Streptococcus in nonpregnant adults. N Engl J Med. 1993;328(25):1807-11.

Muñoz P, Llancaqueo A, Rodríguez-Créixems M, Peláez T, Martin L, Bouza E. Group B streptococcus bacteremia in nonpregnant adults. Arch Intern Med. 1997;157(2):213-6.

Bayer AS, Chow AW, Anthony BF, Guze LB. Serious infections in adults due to group B streptococci: clinical and serotypic characterization. Am J of Med. 1976;61(4):498-503.

Francois Watkins LK, McGee L, Schrag SJ, Beall B, Jain JH, Pondo T, et al. Epidemiology of invasive group B streptococcal infections among nonpregnant adults in the United States, 2008-2016. JAMA Intern Med. 2019;179(4):479-88.

Hayes K, O’Halloran F, Cotter L. A review of antibiotic resistance in Group B Streptococcus: the story so far. Crit Rev Microbiol. 2020;46(3):253-69.

Kimura K, Nishiyama Y, Shimizu S, Wachino J, Matsui M, Suzuki S, et al. Screening for group B streptococci with reduced penicillin susceptibility in clinical isolates obtained between 1977 and 2005. Jpn J Infect Dis. 2013;66(3):222-5.

Seki T, Kimura K, Reid ME, Miyazaki A, Banno H, Jin W, et al. High isolation rate of MDR group B streptococci with reduced penicillin susceptibility in Japan. J Antimicrob Chemother. 2015;70(10):2725-8.

Nagano N, Nagano Y, Toyama M, Kimura K, Shibayama K, Arakawa Y. Penicillin-Susceptible Group B Streptococcal Clinical Isolates with Reduced Cephalosporin Susceptibility. J Clin Microbiol. 2014;52(9):3406-10.

Park C, Nichols M, Schrag SJ. Two cases of invasive vancomycin-resistant group B streptococcus infection. N Engl J Med. 2014;370(9):885-6.