Improving neonatal outcome by studying the incidence of maternal group B streptococcus colonization among pregnant...

Group B streptococcus (GBS) colonization during pregnancy can lead to invasive infections in neonates including meningitis or sepsis. The major risk factor for neonatal disease is the rectovaginal colonization of GBS during pregnancy and delivery. The objectives of this study were as follows: 1) to screen antenatal patients at 35-37 weeks of gestation for GBS colonization, 2) to determine the prevalence of GBS among pregnant women, 3) to formulate an antibiotic policy with respect to antepartum antibiotic prophylaxis and empiric choice of antibiotics for early onset neonatal sepsis, and 4) to ascertain the maternal and neonatal outcomes in pregnant women with positive GBS colonization.

A prospective observational study was conducted among 50 obstetric patients at 35-37 weeks of gestation attending the outpatient and inpatient departments of a tertiary care hospital. High vaginal and rectal swabs were collected and immediately transported to the microbiology lab and were sent for culture and sensitivity testing using the standard culture methods. The incidence of positive cultures was noted and was taken up as a reference for statistical calculations.

Out of the 50 vaginal samples, one sample showed GBS positivity having a prevalence of 2%. Rectal swabs did not grow GBS for all samples. Neither the pregnant woman nor the newborn showed any symptoms or signs due to GBS. GBS grown in vaginal culture was highly sensitive to benzyl penicillin and other penicillins, cephalosporins, clindamycin, daptomycin, vancomycin, meropenem, and linezolid.

Based on our findings, screening the patients with routine rectovaginal swabs may not be necessary in our population. Also, empiric treatment with antibiotics for GBS in symptomatic mothers cannot be justified, and hence, GBS should be considered as an insignificant pathogen.