Abstract:
Background: During pregnancy, Group B Streptococcus (GBS) colonization contributes to maternal, fetal, neonatal, and later morbidity and mortality by ascending intrauterine infection or vertical transmission at the time of birth. Despite many efforts to reduce the potential risk of vertical transmission, GBS remains the main cause of serious disease (neonatal sepsis and/or meningitis and pneumonia) in the vulnerable newborn during the first week of life. The increasing rate of resistance and the differences in resistance pattern among countries suggest that a data from surveillance at the institutional level is important to highlights new insights on the epidemiology of GBS to support efforts to implement prevention strategy in low resource country like Ethiopia. Objective: The aim of this study was to assess GBS colonization, antimicrobial susceptibility patterns and associated factors among mother-neonate pairs at AMGH, in 2021. Methods: Hospital based cross-sectional study was conducted among mother-neonate pairs, in AMGH, from February to May, 2021. From a total of 804 pregnant women attending normal vaginal delivery 201 were enrolled. Mother-neonates GBS colonization was confirmed by using culture standard methods recommended by CDC; from vaginal swab before delivery and neonatal nasal and ear canal swab samples as soon as after delivery within 30 minutes. Face to face interview questionnaires were used to collect sociodemographic and clinical/obstetrics data of pregnant women and newborns. Data was analyzed using SPSS version 21. Logistic regression was used for data analysis. Odds ratio along with 95% CI was estimated to examine factors associated with maternal-neonatal GBS colonization using bivariate and multivariate analysis. P < 0.05 was considered statistically significant.
Result: Prevalence of GBS colonization among pregnant women, newborns, and vertical transmission rate at Arba Minch General Hospital were 11.9%(CI=7.5-16.9), 5.5% (CI=2.5-9.0) and 11/24(45.8%) respectively. History of Prolonged rapture of membrane (AOR= 3.5, CI=2.2-18.8) and UTI (AOR=2.9, CI=1.7-16.3) were associated factors for maternal GBS colonization; while low birth weight (AOR=2.5, CI=1.3-12.8), history of vaginal discharge (AOR=1.8, CI=2.6-6.6) and preterm (AOR=2.2, CI=1.9-5.4) were associated factors for neonatal GBS colonization. Low antibiotics resistance was found for erythromycin, clindamycin and Chloramphenicol. Conclusion: Prevalence of vaginal GBS colonization of women and vertical transmission of GBS at delivery in the study area was significantly high among mother-neonates. Antimicrobial resistance patter of isolates especially for the prophylactic drug such as erythromycin and clindamycin is alarming. hence, the study findings suggest that, the need for antenatal culture based GBS screening and antimicrobial resistance surveillance.
