Group B Streptococcus among Pregnant Women and Newborns in Mirzapur, Bangladesh: Colonization, Vertical Transmission, and Serotype Distribution

Abstract

Group B streptococcus (GBS) infection is a leading cause of death among newborns in developed countries. Data on the burden of GBS in Asian countries are lacking. This study aimed to understand (i) the rate of maternal rectovaginal GBS carriage, (ii) the rate of vertical transmission of GBS, as determined by culturing ear, umbilicus, and nasal swabs, and (iii) the distribution of GBS serotypes. This prospective observational study was conducted between September 2012 and November 2013 at Kumudini Women's Medical College Hospital, a secondary-level hospital in Mirzapur, Bangladesh. The study enrolled pregnant women who visited the outpatient clinic for antenatal care (ANC) and/or delivered a child in the inpatient department of Kumudini Women's Medical College Hospital and the babies born to those mothers. Among 1,151 enrolled pregnant women, 172 (15% [95% confidence interval [CI], 13 to 17%]) carried GBS; among 68 babies born to mothers with carriage, 26 (38% [95% CI, 27 to 51%]) had GBS on their body surfaces, indicating vertical transmission. Typing of the isolates (n = 172) identified all 10 GBS serotypes, most commonly types Ia (40% [69/172 isolates]), V (23% [40/172 isolates]), II (14% [24/172 isolates]), and III (12% [20/172 isolates]). This study shows that Bangladesh has all of the ingredients for invasive GBS disease, including colonization of mothers by invasive serotypes and vertical transmission to babies.

Keywords: colonization; group B streptococcus; serotype; vertical transmission.

FIG 1

Profile of GBS maternal carriage and transmission study, showing the total numbers of mothers enrolled in the study and of specimens collected and GBS isolates isolated from mothers and newborns.

FIG 2

Distribution of GBS serotypes among all mothers and mother-newborn dyads.