High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan

Kate Clouse, Asem Shehabi, Abel Mani Suleimat, Samir Faouri, Najwa Khuri-Bulos, Abeer Al Jammal, James Chappell, Kimberly Fortner, Anna B. Chamby, Tara M. Randis, Adam J. Ratner, David M. Aronoff, Natasha Halasa

Research output: Contribution to journalArticle

Abstract

Background: Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test. Methods: We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected. Results: In April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23-32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38 weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women. Conclusions: Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.

Original languageEnglish (US)
Article number177
JournalBMC pregnancy and childbirth
Volume19
Issue number1
DOIs
StatePublished - May 20 2019

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Jordan
Streptococcus agalactiae
Pregnant Women
Agar
Latex
Streptococcus
Routine Diagnostic Tests
Demography
Antigens
Sensitivity and Specificity
Serotyping
Pregnancy Induced Hypertension
Prenatal Care
Gestational Diabetes
Agglutination
Parity
Gestational Age
Obstetrics

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Clouse, K., Shehabi, A., Suleimat, A. M., Faouri, S., Khuri-Bulos, N., Al Jammal, A., ... Halasa, N. (2019). High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan. BMC pregnancy and childbirth, 19(1), [177]. https://doi.org/10.1186/s12884-019-2317-4

High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan. / Clouse, Kate; Shehabi, Asem; Suleimat, Abel Mani; Faouri, Samir; Khuri-Bulos, Najwa; Al Jammal, Abeer; Chappell, James; Fortner, Kimberly; Chamby, Anna B.; Randis, Tara M.; Ratner, Adam J.; Aronoff, David M.; Halasa, Natasha.

In: BMC pregnancy and childbirth, Vol. 19, No. 1, 177, 20.05.2019.

Research output: Contribution to journalArticle

Clouse, K, Shehabi, A, Suleimat, AM, Faouri, S, Khuri-Bulos, N, Al Jammal, A, Chappell, J, Fortner, K, Chamby, AB, Randis, TM, Ratner, AJ, Aronoff, DM & Halasa, N 2019, 'High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan', BMC pregnancy and childbirth, vol. 19, no. 1, 177. https://doi.org/10.1186/s12884-019-2317-4
Clouse, Kate ; Shehabi, Asem ; Suleimat, Abel Mani ; Faouri, Samir ; Khuri-Bulos, Najwa ; Al Jammal, Abeer ; Chappell, James ; Fortner, Kimberly ; Chamby, Anna B. ; Randis, Tara M. ; Ratner, Adam J. ; Aronoff, David M. ; Halasa, Natasha. / High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan. In: BMC pregnancy and childbirth. 2019 ; Vol. 19, No. 1.
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title = "High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan",
abstract = "Background: Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test. Methods: We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected. Results: In April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23-32); 89.0{\%} were Jordanian nationals and 71.9{\%} completed secondary school. Median gestational age was 38 weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5{\%} reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5{\%}), gestational diabetes (6.0{\%}), and UTI (53.5{\%}), of which 84.5{\%} reported treatment. Overall, 39 (19.5{\%}) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5{\%}) were positive by rapid test (36{\%} sensitivity, 67{\%} specificity). Serotype information was available for 25 (64{\%}) isolates: III (48{\%}), Ia (24{\%}), II (20{\%}), and V (8{\%}). No demographic or clinical differences were noted between GBS+ and GBS-negative women. Conclusions: Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.",
author = "Kate Clouse and Asem Shehabi and Suleimat, {Abel Mani} and Samir Faouri and Najwa Khuri-Bulos and {Al Jammal}, Abeer and James Chappell and Kimberly Fortner and Chamby, {Anna B.} and Randis, {Tara M.} and Ratner, {Adam J.} and Aronoff, {David M.} and Natasha Halasa",
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T1 - High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan

AU - Clouse, Kate

AU - Shehabi, Asem

AU - Suleimat, Abel Mani

AU - Faouri, Samir

AU - Khuri-Bulos, Najwa

AU - Al Jammal, Abeer

AU - Chappell, James

AU - Fortner, Kimberly

AU - Chamby, Anna B.

AU - Randis, Tara M.

AU - Ratner, Adam J.

AU - Aronoff, David M.

AU - Halasa, Natasha

PY - 2019/5/20

Y1 - 2019/5/20

N2 - Background: Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test. Methods: We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected. Results: In April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23-32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38 weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women. Conclusions: Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.

AB - Background: Little is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test. Methods: We collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected. Results: In April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23-32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38 weeks (IQR: 37-40); most women reported prenatal care (median 9 visits; IQR: 8-12). Median parity was 2 births (IQR: 1-3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5-28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women. Conclusions: Nearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.

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