Group B streptococcal carriage, serotype distribution and antibiotic susceptibilities in pregnant women at the time of delivery in a refugee population on the Thai-Myanmar border
1 Shoklo Malaria Research Unit, Mae Sot 63110, Thailand
2 Mahidol-Oxford Tropical Medicine Research Unit, Bangkok 10400, Thailand
3 Centre for Tropical Medicine, University of Oxford, Oxford OX3 7LJ, UK
4 Microbiology Services Division, Colindale, Health Protection Agency, 61 Colindale Ave, London NW9 5EQ, UK
5 St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
BMC Infectious Diseases 2012, 12:34 doi:10.1186/1471-2334-12-34Published: 8 February 2012
Group B Streptococcus (GBS) is the leading cause of neonatal sepsis in the developed world. Little is known about its epidemiology in the developing world, where the majority of deaths from neonatal infections occur. Maternal carriage of GBS is a prerequisite for the development of early onset GBS neonatal sepsis but there is a paucity of carriage data published from the developing world, in particular South East Asia.
We undertook a cross sectional study over a 13 month period in a remote South East Asian setting on the Thai-Myanmar border. During labour, 549 mothers had a combined vaginal rectal swab taken for GBS culture. All swabs underwent both conventional culture as well as PCR for GBS detection. Cultured GBS isolates were serotyped by latex agglutination, those that were negative or had a weak positive reaction and those that were PCR positive but culture negative were additionally tested using multiplex PCR based on the detection of GBS capsular polysaccharide genes.
The GBS carriage rate was 12.0% (95% CI: 9.4-15.0), with 8.6% positive by both culture and PCR and an additional 3.5% positive by PCR alone. Serotypes, Ia, Ib, II, III, IV, V, VI and VII were identified, with II the predominant serotype. All GBS isolates were susceptible to penicillin, ceftriaxone and vancomycin and 43/47 (91.5%) were susceptible to erythromycin and clindamycin.
GBS carriage is not uncommon in pregnant women living on the Thai-Myanmar border with a large range of serotypes represented.