Streptococcus Agalactiae Infection among Parturients and their Neonates at the Cape Coast Teaching Hospital: An Evaluation of Different Diagnostic Methods, Prevalence and Risk Factors

Abstract

Streptococcus agalcatiae (GBS) is a relatively common; normal bacterium in a woman's gastrointestinal and genitourinary tract; however, implicated as a leading cause of neonatal invasive infections. Maternal GBS colonization during late pregnancy is a pre-requisite for neonatal GBS infections. This study aimed at determining the prevalence of Streptococcus agalactiae among parturients and their neonates in the Cape Coast Teaching Hospital. A total of 301;150 vaginal swabs(parturients) and 151 superficial swabs(neonates)were collected between June 2019 and August 2019 and investigated for the presence of Streptococcus agalactiae using the culture method,16S rRNA, cfb, scpB, and atr genes targeting assays. Prevalence of GBS infection observed among the mothers was 36(24.0%),34(22.7%),32(21.3%),20(13.3%), and 2(1.3%) for atr gene, ScpB gene, cfb gene,16SrRNA gene, and culture technique respectively. Using the atr as the standard, sensitivities 55.6% for scp, 47.2% for cfb,47.2% for 16s rRNA gene and 5.6%, for culture were reported. Among the neonates, prevalence was 57(37.5%), 43(28.3%), 42(27.6%) 40(26.3%) and 0(0.0%) for atr gene, cfb gene, scpB gene, 16s rRNA and culture technique respectively. Sensitivites of 64.9%,70.2%, 64.9%,0.0% were also reported among the neonates for 16s rRNA, ScpB, cfb, and culture respectively comparing with the standard, atr gene. Specificity for the culture method and assays used in this study were above 85.0% and 90% for parturients and neonates respectively. A significant relationship was observed between GBS infection and ≤37 weeks gestation among the parturients. Also, among the neonates, a statistically significant relationship was found between GBS infection and the risk of intrauterine fetal death (IUFD). A comparative analysis of the PCR assays and the culture method revealed a relatively high prevalence of GBS among parturients and their neonates. Therefore, the use of PCR assays in combination with the culture method is recommended to increase the diagnosis of Group B streptococcal infection. A systematic national guideline is therefore recommended for the prevention, diagnosis and treatment of GBS infection and its related complications among parturients and their neonates.