Macrolide-resistance, capsular genotyping and associated factors of group B Streptococci colonized pregnant women in Isfahan, Iran
-
Soodabeh Rostami
,
Leila Moeineddini
,
Fereshteh Ghandehari
,
Marzieh Rahim Khorasani
,
Parisa Shoaei
,
Nasim Ebrahimi
Abstract
Background and Objectives: Group B streptococcus (GBS) can cause severe and invasive infections in pregnant women, infants, and adults. This study aimed to investigate the risk factors of GBS colonization in pregnant women and determine the macrolide resistance and capsular type of isolates.
Materials and Methods: In a cross-sectional study, a total of 200 pregnant women were screened for GBS colonization by phenotypic methods. Antibiotic susceptibility pattern of colonizing isolates and ermB, ermTR, mefA/E genes were detected. Also, molecular capsular types of isolates were distinguished.
Results: The overall prevalence of colonization of participates with GBS was 13.5%. Statistical analysis showed that there was no association between risk factors and colonization with GBS. The highest resistance was observed to erythromycin (44.4%) followed by clindamycin (29.6%), penicillin, ampicillin, and ceftriaxone (18.5%), levofloxacin (11.1%), and 29.6% isolates were multidrug-resistant. ermTR and mefA/E genes were detected in 37% and 11.1% isolates; respectively and the ermB gene was not detected. The most common capsular type was type Ib (44.4%) followed by type III (40.7%), type II (11.1), and type Ia (3.7%).
Conclusion: In the present study, the prevalence of GBS was in the medium range. Resistance to key antibiotic agents was relatively high. Also, capsular serotype Ib was the predominant serotype, which emphasizes the importance of monitoring the molecular typing of the GBS isolates regularly.
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19. Darabi R, Tadi S, Mohit M, Sadeghi E, Hatamizadeh G, Kardeh B, et al. The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women. Electron Physician 2017; 9:4399-4404.
20. Ahmadi A, Farhadifar F, Rezaii M, Zandvakili F, Seyedoshohadaei F, Zarei M, et al. Group B Streptococci and Trichomonas vaginalis infections in pregnant women and those with spontaneous abortion at Sanandaj, Iran. Iran J Microbiol 2018; 10:166-170.
21. Yasini M, Moniri R, Ghorbaali Z, Ansaripour L, Movahedinejad M, Yadegarsalehi M. Prevalence rate, antibiotic susceptibility and colonization risk factors of group B Streptococcus in genital tract of pregnant women. MJMS 2014; 57:676-683.
22. Assefa S, Desta K, Lema T. Group B streptococci vaginal colonization and drug susceptibility pattern among pregnant women attending in selected public antenatal care centers in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth 2018; 18:135.
23. Moroi H, Kimura K, Kotani T, Tsuda H, Banno H, Jin W, et al. Isolation of group B Streptococcus with reduced beta-lactam susceptibility from pregnant women. Emerg Microbes Infect 2019; 8:2-7.
24. Campo CH, Martinez MF, Otero JC, Rincon G. Vagino-rectal colonization prevalence by Streptococcus agalactiae and its susceptibility profile in pregnant women attending a third-level hospital. Biomedica 2019; 39:689-698.
25. Raabe VN, Shane AL. Group B Streptococcus (Streptococcus agalactiae). Microbiol Spectr 2019; 7: 10.1128/microbiolspec.GPP3-0007-2018.
26. Sahraee S, Milani F, Atrkar Roushan Z, Hedayati Ch M, Rostami S, Shoja S, et al. The prevalence of rectovaginal colonization and antibiotic susceptibility pattern of Streptococcus agalactiae in pregnant women in Al-Zahra hospital, Rasht, Iran. Infect Dis Clin Pract 2019; 27:143-147.
27. Emaneini M, Jabalameli F, Mirsalehian A, Ghasemi A, Beigverdi R. Characterization of virulence factors, antimicrobial resistance pattern and clonal complexes of group B streptococci isolated from neonates. Microb Pathog 2016; 99:119-122.
28. Malek-Jafarian M, Hosseini FS, Ahmadi AR. Pattern of infection and antibiotic activity among Streptococcus agalactiae isolates from adults in Mashhad, Iran. Rep Biochem Mol Biol 2015; 3:89-93.
29. Khodaei F, Najafi M, Hasani A, Kalantar E, Sharifi E, Amini A, et al. Pilus-encoding islets in S. agalactiae and its association with antibacterial resistance and serotype distribution. Microb Pathog 2018; 116:189-194.
30. Mousavi SM, Nasaj M, Hosseini SM, Arabestani MR. Survey of strain distribution and antibiotic resistance pattern of group B streptococci (Streptococcus agalactiae) isolated from clinical specimens. GMS Hyg Infect Control 2016; 11: Doc18.
31. Goudarzi G, Ghafarzadeh M, Shakib P, Anbari K. Culture and real-time PCR based maternal screening and antibiotic susceptibility for group B Streptococcus: an Iranian experience. Glob J Health Sci 2015; 7:233-239.
32. Jalalifar S, Havaei SA, Motallebirad T, Moghim S, Fazeli H, Esfahani BN. Determination of surface proteins profile, capsular genotyping, and antibiotic susceptibility patterns of Group B Streptococcus isolated from urinary tract infection of Iranian patients. BMC Res Notes 2019; 12:437.
33. Saffar H, Rajabiani A, Abdollahi A, Habibi S, Baseri Z. Frequency of inducible clindamycin resistance among Gram-positive cocci in a tertiary hospital, Tehran, Iran. Iran J Microbiol 2016; 8:243-248.
34. Emaneini M, Mirsalehian A, Beigvierdi R, Fooladi AA, Asadi F, Jabalameli F, et al. High incidence of macrolide and tetracycline resistance among Streptococcus agalactiae strains isolated from clinical samples in Tehran, Iran. Maedica (Bucur) 2014; 9:157-161.
2. McCord N, Owen P, Powls A, Lunan B. A complete audit cycle of intrapartum group B streptococcus prophylaxis. Health Bull (Edinb) 2001; 59:263-267.
3. Verani JR, Schrag SJ. Group B streptococcal disease in infants: progress in prevention and continued challenges. Clin Perinatol 2010; 37:375-392.
4. Heath PT, Feldman RG. Vaccination against group B streptococcus. Expert Rev Vaccines 2005; 4:207-218.
5. Picard FJ, Bergeron MG. Laboratory detection of group B Streptococcus for prevention of perinatal disease. Eur J Clin Microbiol Infect Dis 2004; 23:665-671.
6. Brozanski BS, Jones JG, Krohn MA, Sweet RL. Effect of a screening-based prevention policy on prevalence of early-onset group B streptococcal sepsis. Obstet Gynecol 2000; 95:496-501.
7. Verani JR, McGee L, Schrag SJ, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59:1-36.
8. Capanna F, Emonet SP, Cherkaoui A, Irion O, Schrenzel J, Martinez de Tejada B. Antibiotic resistance patterns among group B Streptococcus isolates: implications for antibiotic prophylaxis for early-onset neonatal sepsis. Swiss Med Wkly 2013; 143:w13778.
9. De Francesco MA, Caracciolo S, Gargiulo F, Manca N. Phenotypes, genotypes, serotypes and molecular epidemiology of erythromycin-resistant Streptococcus agalactiae in Italy. Eur J Clin Microbiol Infect Dis 2012; 31:1741-1747.
10. Gajic I, Plainvert C, Kekic D, Dmytruk N, Mijac V, Tazi A, et al. Molecular epidemiology of invasive and non-invasive group B Streptococcus circulating in Serbia. Int J Med Microbiol 2019; 309:19-25.
11. Ke D, Menard C, Picard FJ, Boissinot M, Ouellette M, Roy PH, et al. Development of conventional and real-time PCR assays for the rapid detection of group B streptococci. Clin Chem 2000; 46:324-331.
12. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 27th ed. CLSI supplement M100. Wayne, Pennsylvania 2017.
13. Imperi M, Pataracchia M, Alfarone G, Baldassarri L, Orefici G, Creti R. A multiplex PCR assay for the direct identification of the capsular type (Ia to IX) of Streptococcus agalactiae. J Microbiol Methods 2010; 80:212-214.
14. de la Pedrosa EG, Morosini MI, van der Linden M, Ruiz-Garbajosa P, Galan JC, Baquero F, et al. Polyclonal population structure of Streptococcus pneumoniae isolates in Spain carrying mef and mef plus erm(B). Antimicrob Agents Chemother 2008; 52:1964-1969.
15. Florindo C, Viegas S, Paulino A, Rodrigues E, Gomes JP, Borrego MJ. Molecular characterization and antimicrobial susceptibility profiles in Streptococcus agalactiae colonizing strains: association of erythromycin resistance with subtype III-1 genetic clone family. Clin Microbiol Infect 2010; 16:1458-1463.
16. Reinert RR, Franken C, van der Linden M, Lutticken R, Cil M, Al-Lahham A. Molecular characterisation of macrolide resistance mechanisms of Streptococcus pneumoniae and Streptococcus pyogenes isolated in Germany, 2002-2003. Int J Antimicrob Agents 2004; 24:43-47.
17. Hossein YektaKooshali M, Hamidi M, Mohammad Taghi Razavi Tousi S, Nikokar I. Prevalence of group B streptococcus colonization in Iranian pregnant women: A systematic review and meta-analysis. Int J Reprod Biomed 2019; 16(12): ijrm.v16i12.3679.
18. Russell NJ, Seale AC, O'Driscoll M, O'Sullivan C, Bianchi-Jassir F, Gonzalez-Guarin J, et al. Maternal colonization with group B Streptococcus and serotype distribution worldwide: systematic review and meta-analyses. Clin Infect Dis 2017; 65(suppl_2):S100-S111.
19. Darabi R, Tadi S, Mohit M, Sadeghi E, Hatamizadeh G, Kardeh B, et al. The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women. Electron Physician 2017; 9:4399-4404.
20. Ahmadi A, Farhadifar F, Rezaii M, Zandvakili F, Seyedoshohadaei F, Zarei M, et al. Group B Streptococci and Trichomonas vaginalis infections in pregnant women and those with spontaneous abortion at Sanandaj, Iran. Iran J Microbiol 2018; 10:166-170.
21. Yasini M, Moniri R, Ghorbaali Z, Ansaripour L, Movahedinejad M, Yadegarsalehi M. Prevalence rate, antibiotic susceptibility and colonization risk factors of group B Streptococcus in genital tract of pregnant women. MJMS 2014; 57:676-683.
22. Assefa S, Desta K, Lema T. Group B streptococci vaginal colonization and drug susceptibility pattern among pregnant women attending in selected public antenatal care centers in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth 2018; 18:135.
23. Moroi H, Kimura K, Kotani T, Tsuda H, Banno H, Jin W, et al. Isolation of group B Streptococcus with reduced beta-lactam susceptibility from pregnant women. Emerg Microbes Infect 2019; 8:2-7.
24. Campo CH, Martinez MF, Otero JC, Rincon G. Vagino-rectal colonization prevalence by Streptococcus agalactiae and its susceptibility profile in pregnant women attending a third-level hospital. Biomedica 2019; 39:689-698.
25. Raabe VN, Shane AL. Group B Streptococcus (Streptococcus agalactiae). Microbiol Spectr 2019; 7: 10.1128/microbiolspec.GPP3-0007-2018.
26. Sahraee S, Milani F, Atrkar Roushan Z, Hedayati Ch M, Rostami S, Shoja S, et al. The prevalence of rectovaginal colonization and antibiotic susceptibility pattern of Streptococcus agalactiae in pregnant women in Al-Zahra hospital, Rasht, Iran. Infect Dis Clin Pract 2019; 27:143-147.
27. Emaneini M, Jabalameli F, Mirsalehian A, Ghasemi A, Beigverdi R. Characterization of virulence factors, antimicrobial resistance pattern and clonal complexes of group B streptococci isolated from neonates. Microb Pathog 2016; 99:119-122.
28. Malek-Jafarian M, Hosseini FS, Ahmadi AR. Pattern of infection and antibiotic activity among Streptococcus agalactiae isolates from adults in Mashhad, Iran. Rep Biochem Mol Biol 2015; 3:89-93.
29. Khodaei F, Najafi M, Hasani A, Kalantar E, Sharifi E, Amini A, et al. Pilus-encoding islets in S. agalactiae and its association with antibacterial resistance and serotype distribution. Microb Pathog 2018; 116:189-194.
30. Mousavi SM, Nasaj M, Hosseini SM, Arabestani MR. Survey of strain distribution and antibiotic resistance pattern of group B streptococci (Streptococcus agalactiae) isolated from clinical specimens. GMS Hyg Infect Control 2016; 11: Doc18.
31. Goudarzi G, Ghafarzadeh M, Shakib P, Anbari K. Culture and real-time PCR based maternal screening and antibiotic susceptibility for group B Streptococcus: an Iranian experience. Glob J Health Sci 2015; 7:233-239.
32. Jalalifar S, Havaei SA, Motallebirad T, Moghim S, Fazeli H, Esfahani BN. Determination of surface proteins profile, capsular genotyping, and antibiotic susceptibility patterns of Group B Streptococcus isolated from urinary tract infection of Iranian patients. BMC Res Notes 2019; 12:437.
33. Saffar H, Rajabiani A, Abdollahi A, Habibi S, Baseri Z. Frequency of inducible clindamycin resistance among Gram-positive cocci in a tertiary hospital, Tehran, Iran. Iran J Microbiol 2016; 8:243-248.
34. Emaneini M, Mirsalehian A, Beigvierdi R, Fooladi AA, Asadi F, Jabalameli F, et al. High incidence of macrolide and tetracycline resistance among Streptococcus agalactiae strains isolated from clinical samples in Tehran, Iran. Maedica (Bucur) 2014; 9:157-161.
| Files | ||
| Issue | Vol 13 No 2 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v13i2.5979 | |
| Keywords | ||
| Streptococcus agalactiae; Drug resistance; Pregnant women; Bacterial capsules; Iran | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Rostami S, Moeineddini L, Ghandehari F, Rahim Khorasani M, Shoaei P, Ebrahimi N. Macrolide-resistance, capsular genotyping and associated factors of group B Streptococci colonized pregnant women in Isfahan, Iran. Iran J Microbiol. 2021;13(2):183-189.
