Prevalence, Antimicrobial Susceptibility Pattern and Associated Factors of Group B Streptococcus Among Pregnant Women Attending Antenatal Care at Bule Hora University Teaching Hospital, Southern Ethiopia

Abstract

Background

In many parts of the world, Group B Streptococcus (GBS) is a major cause of maternal and neonatal illness and mortality. It has a negative impact on neonatal and pregnancy outcomes. A worrisome problem in Ethiopia is the unknown rate of antibiotic resistance and the risk factors connected to GBS infections.

Objective

This study was to determine the prevalence, antibiotic susceptibility pattern, and related variables of Group B Streptococcus among pregnant women receiving prenatal treatment conducted at Bule Hora University Teaching Hospital, Southern Ethiopia, between June 1 and August 30, 2022.

Methods

An institutional-based cross-sectional study was conducted among 213 pregnant women attending antenatal care at Bule Hora University Teaching Hospital. Data on sociodemographic and related factors were gathered using structured questionnaires. The study’s participants were selected using the consecutive sampling method. The lower vaginal/rectum area was brushed with a sterile cotton swab to capture the vaginal/rectum swab sample, which was then examined using microbiological techniques. The Kirby-Bauer disc diffusion method was used to assess antibiotic susceptibility in GBS isolates. Logistic regression analysis was performed on the data using SPSS version 26. It was deemed statistically significant when the p-value was 0.05 with a 95% confidence interval (CI).

Results

The overall prevalence of GBS was 16.9% (CI: 0.12–0.23). A history of prematurity of the membrane (AOR: 3.35, 95% CI: 1.19–9.45), a history of stillbirth (AOR: 2.88, 95% CI: 1.07–7.71), and preterm delivery history (AOR: 3.41, 95% CI: 1.31–8.89) (p 0.05) were independent predictors of GBS infection. Cefepime had the highest resistance at 58.3%. Most GBS isolates showed high susceptibility to vancomycin (97.2%) and ampicillin (91.7%). Multidrug resistance was 13.9%.

Conclusion

The prevalence of GBS was considerably high among pregnant women in this study. This finding emphasises the need for routine screening and testing of antimicrobial susceptibility to provide antibiotic prophylaxis and minimise newborn infection and comorbidity.

Keywords:

• Group B Streptococcus
• antimicrobial susceptibility pattern
• pregnant women

Abbreviations

ANC, Antenatal Care; AST, Antimicrobial Susceptibility Test; BHUTH, Bule Hora University Teaching Hospital; CDC, Center for disease prevention and control; CLSI, Clinical and laboratory standard institute guidelines; GBS, Group B Streptococcus; HIV, Human immunodeficiency virus; IAP, Intrapartum antibiotic prophylaxis; IHRERC, Institutional health research ethics review committee; SE, Standard error; SBA, Sheep blood agar; SOP, Standard operating procedure; STI, Sexually transmitted infection; UTI, Urinary tract infection; WHO, World Health Organization.

Data Sharing Statement

Data for this research are available for this work and can be accessed from the corresponding author.

Ethical Approval and Consent to Participate

The Institutional Health Research Ethics Review Committee of Bulehora University (IHRERC/2022) examined and approved the study protocol. Bule Hora University Teaching Hospital received a formal letter of support. All procedures were carried out per the necessary standards and laws (Declarations of Helsinki). All subjects, and/or their parent, husband, or legal guardian for those under the age of 18, provided informed, voluntary, written, and signed consent throughout the study. Every participant received information on the study, including its goals, methods, potential risks, and advantages. Participants in the study were made aware of their right to decline or leave the study at any time. The study participants were unaffected by their decision to decline participation. By omitting names and other identifiers from the questionnaire, participants’ data were kept secret. Women who tested positive for GBS were connected to their doctors and given the recommended treatments.

Acknowledgments

First of all, we want to express our gratitude to Bule Hora University for providing us with the opportunity to develop a research project. We also like to thank the medical laboratory science staff for their help and thoughtful approach. Last but not least, we want to convey our sincere gratitude to the study participants who had ANC at Bule Hora University Teaching Hospital.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no potential conflicts of interest concerning the research, authorship, and publication of this paper.