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DOI: 10.1055/s-0041-1739356
Group B Streptococcus Rectovaginal Colonization and Resistance Patterns in HIV-Positive Compared to HIV-Negative Pregnant Patients
Funding The study was supported by Louisiana State University Health Sciences Center Shreveport Department of Obstetrics and Gynecology.![](https://www.thieme-connect.de/media/ajp/202314/lookinside/thumbnails/10-1055-s-0041-1739356_200993-1.jpg)
Abstract
Objective The objective of our study is to determine if human immunodeficiency virus (HIV)-positive pregnant patients have a higher rate of group B streptococcus (GBS) rectovaginal colonization compared with HIV-negative pregnant patients.
Study Design Our study is a multi-site retrospective study performed at Ochsner Louisiana State University-Health Shreveport and Monroe campuses including patients who delivered between December 2011and June 2019. Rates of GBS rectovaginal colonization between HIV-positive pregnant patients were compared with a control group of HIV-negative patients. The control group was age and race matched in a 2:1 fashion. The primary outcome was to investigate rates of GBS rectovaginal colonization. Secondary outcomes included GBS culture antibiotic sensitivities, presence of GBS urinary tract infection, GBS positivity based on HIV viral load, and GBS positivity based on new vs established diagnosis of HIV. Continuous data were analyzed using an unpaired t-test, and categorical data were analyzed using a Chi-squared test. The probability level of <0.05 was set as statistically significant.
Results A total of 225 patients were included in the final analysis, 75 HIV-positive and 150 HIV-negative controls. Demographic differences were noted. HIV-positive patients were more likely to deliver preterm and were more likely to deliver via cesarean section. Our primary outcome showed no significant differences in incidence of GBS colonization between HIV-positive patients and control group (n = 31, 41.3% vs n = 46, 30.6%, p = 0.136). Antibiotic resistance patterns showed no significant difference between the two groups. There were no significant differences in GBS positivity based on HIV viral load.
Conclusion Our study does not show a statistically significant difference in the incidence of GBS colonization between HIV-positive patients and HIV-negative controls.
Key Points
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HIV-positive pregnant patients do not have an increased risk of GBS rectovaginal colonization.
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HIV-positive pregnant patients have similar rates of GBS colonization regardless of viral load.
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GBS antibiotic sensitivities are similar in HIV-positive and HIV-negative pregnant patients.
Keywords
group B Streptococcus - Streptococcus agalactiae - human immunodeficiency virus - pregnancy - neonatal sepsisNote
Findings were accepted as an oral presentation at the 87th Annual Meeting of Central Association of Obstetricians and Gynecologists and awarded with the Community Hospital Award. Due to the COVID-19 pandemic, the meeting was canceled, but the findings were presented virtually on Saturday November 7th, 2020.
Publication History
Received: 07 August 2020
Accepted: 04 October 2021
Article published online:
16 November 2021
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References
- 1 Prevention of group B streptococcal early-onset disease in newborns. ACOG Committee Opinion No. 797. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020; 135 (02) e51-e72
- 2 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 (RR-10): 1-36
- 3 Cools P, van de Wijgert JHHM, Jespers V. et al. Role of HIV exposure and infection in relation to neonatal GBS disease and rectovaginal GBS carriage: a systematic review and meta-analysis. Sci Rep 2017; 7 (01) 13820
- 4 Puopolo KM, Lynfield R, Cummings JJ. COMMITTEE ON FETUS AND NEWBORN, COMMITTEE ON INFECTIOUS DISEASES. Management of infants at risk for group B streptococcal disease. Pediatrics 2019; 144 (02) e20191881
- 5 Liu J, Williams B, Frank D, Dillon SM, Wilson CC, Landay AL. Inside out: HIV, the gut microbiome, and the mucosal immune system. J Immunol 2017; 198 (02) 605-614
- 6 Bandera A, De Benedetto I, Bozzi G, Gori A. Altered gut microbiome composition in HIV infection: causes, effects and potential intervention. Curr Opin HIV AIDS 2018; 13 (01) 73-80
- 7 Shah M, Aziz N, Leva N, Cohan D. Group B streptococcus colonization by HIV status in pregnant women: prevalence and risk factors. J Womens Health (Larchmt) 2011; 20 (11) 1737-1741
- 8 Mitima KT, Ntamako S, Birindwa AM. et al. Prevalence of colonization by Streptococcus agalactiae among pregnant women in Bukavu, Democratic Republic of the Congo. J Infect Dev Ctries 2014; 8 (09) 1195-1200
- 9 Dauby N, Adler C, Miendje Deyi VY. et al. Prevalence, risk factors, and serotype distribution of group B streptococcus colonization in HIV-infected pregnant women living in Belgium: a prospective cohort study. Open Forum Infect Dis 2018; 5 (12) ofy320
- 10 Joao EC, Gouvêa MI, Menezes JA. et al. Group B streptococcus in a cohort of HIV-infected pregnant women: prevalence of colonization, identification and antimicrobial susceptibility profile. Scand J Infect Dis 2011; 43 (09) 742-746