Group B Streptococci: Colonization Rate Among Pregnant Women and Their Newborn and Burden of Neonatal Disease in Selected Hospitals of Ethiopia
| dc.contributor.advisor | Woldeamanuel, Yimtubezenash (MD, M. Sc, PhD) | |
| dc.contributor.author | Mohammed, Musa | |
| dc.date.accessioned | 2018-11-28T08:59:08Z | |
| dc.date.accessioned | 2023-11-05T09:35:58Z | |
| dc.date.available | 2018-11-28T08:59:08Z | |
| dc.date.available | 2023-11-05T09:35:58Z | |
| dc.date.issued | 2018-03 | |
| dc.description.abstract | Background: The newborn of today have a good chance of survival compared to several years back. The number of worldwide child deaths has decreased, from 12.7 million in 1990 to 5.9 million in 2015. Neonatal mortality reduction is still far behind MDG4 particularly in sub Saharan Africa, including Ethiopia. About 44% of world-wide mortality in children less than five years occurs in the first month of life. Several microorganisms are involved in neonatal ill health; among them Group B streptococcus (GBS), was identified relatively recently as the leading cause of neonatal disease in developed countries. Group B streptococcus is transmitted from colonized mother to newborn during birth. The primary risk factor for development of Early Onset Diseade due to GBS (EOD-GBS) is maternal colonization with GBS during late trimester. Objective: The objectives of this study were to determine GBS colonization rate among pregnant women and their new born who were attending selected hospitals, vertical transmission rate, burden of neonatal disease due to GBS and phenotypic and genotypic characterization of GBS. Materials and Methods: A cross-sectional and follow-up study was conducted in three different Hospitals starting from June 2014 to August 2015: Adama Hospital Medical College (AHMC), Hawassa Referral Hospital (HRH), and Tikur Anbessa Specialized Hospital (TASH). A total of 1873 participants were recruited in the present study. Among them, 840 of them were pregnant women and 857 of them were their new born from three study sites. All of them were screened for GBS using standard methods recommended by Center of Disease Control and Prevention (CDC). Out of the total study participants, 176 of them were infants suspected of early and late onset disease whose age was less than 90 months from Tikur Anbesa Specialized Hospital. Their blood and CSF were cultured to isolates GBS. The isolated GBS were serotyped by using serotype specific antisera. Selected GBS isolates were further characterized by multiplex PCR, antimicrobial susceptibility pattern and Multilocus Sequence typing. Structured questionnaire was used to collect Sociodemographic and clinical data of pregnant mother and newborn. Data was analyzed using SPSS version 20; P value <0.05 was considered statistically significant. XVII Result: The overall maternal, Newborn GBS colonization and vertical transmission rate were 17.4%, 9.2% and 54.1% respectively. The overall prevalent serotypes detected in the present study include; type II (30.3%), Ia (20.2%), V (17.9%), Ib (17.1%), III (10.1%), VII (0.9%), and non typeable (3.5%). The burden of neonatal disease due to GBS was 1.7%. No significant association between maternal and newborn GBS colonization rate and measured risk factors was found (P>0.05). All GBS isolates tested were sensitive to Penicillin, Vancomycin, Cefotaxime and Linezolid. Most of the GBS isolates were resistant to Tetracycline (91.2%), majority of them were sensitive to Levofloxacin (92.8%), Daptomycin (97.6%), Erythromycin (91.2%) and Clindamycin (98.4%). Among 123 GBS tested 89.4% of them contain antibiotic resistance genes. The antibiotic resistance genes detected include; tet (M-1) (88.6%), tet (L-1) (31.7%), erm (TR-1) (5.7%), gyra (GBS-1) (4.1%), par C (GBS-1) (4.1%), erm (B-1) (0.8%), and tet (O-1) (0.8%). MLST characterization grouped all GBS strains in to 17 STs, two clonal complexes (CC-2 and CC- 249) and one singleton. ST-10, ST-19 and ST-23 are the most prevalent STs found in the study. ST-932, ST-933, ST-934, ST-935, and ST-936 were new sequence types that have been identified in this study. Conclusion: This multi center study reveals the presence of primary risk factor, maternal GBS colonization, for early onset neonatal disease due to GBS in three Referral Hospitals of Ethiopia. The study also showed significant importance of invasive neonatal disease due to GBS from selected Hospital of Ethiopia for the first time. Epidemiology of GBS serotypes, antibiotic resistance pattern, MLST profile, and population structure of GBS collection from Ethiopia is partially different from other parts of the world. Therefore, it is important to measure neonatal disease due to GBS at large scale and consider prevention strategy such as Intrapartum prophylaxis and vaccine. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/14607 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Ababa Universty | en_US |
| dc.subject | Group B Streptococcus, Colonization rate, Vertical transmission rate, Antibiotic Susceptibility, Serotype, Sequence type, Ethiopia | en_US |
| dc.title | Group B Streptococci: Colonization Rate Among Pregnant Women and Their Newborn and Burden of Neonatal Disease in Selected Hospitals of Ethiopia | en_US |
| dc.type | Thesis | en_US |