Original Article
Gynecol Obstet Invest 2003;56:225–230
DOI: 10.1159/000074825
Comparison between Different Types of
Surveillance Samples for the Detection of GBS
Colonization in Both Parturient Mothers and
Their Infants
Majeda S. Hammoud
a,e
Majed Al-Shemmari
b
Lukman Thalib
c
Noora Al-Sweih
d
Nabeel Rashwan
e
Lakshami V. Devarajan
a,e
Hassan Elsori
f
Departments of
a
Pediatrics,
b
Obstetrics and Gynecology,
c
Community Medicine (Biostatistics), and
d
Microbiology,
Faculty of Medicine, Kuwait University,
e
Department of Neonatology, Maternity Hospital, and
f
Department of Pediatrics, Al-Adan Hospital, Kuwait, Kuwait
Received: November 7, 2002
Accepted after revision: September 22, 2003
Published online: November 12, 2003
Dr. Majeda S. Hammoud, Kuwait University
Department of Pediatrics, Faculty of Medicine, Kuwait
PO Box 24923, Safat, 13110 (Kuwait)
Tel. +965 5319486, Fax +965 5338940,
E-Mail m.hammoud@hsc.kuniv.edu.kw
ABC
Fax + 41 61 306 12 34
E-Mail karger@karger.ch
www.karger.com
© 2003 S. Karger AG, Basel
0378–7346/03/0564–0225$19.50/0
Accessible online at:
www.karger.com/goi
This work was conducted at Maternity Hospital, Neonatal Depart-
ment, Kuwait.
Key Words
Group B streptococcal colonization W Group B
streptococcal infection W Parturient mothers W Neonates
Abstract
Objective: To find the optimum screening method in
detecting group B streptococcal (GBS) colonization in
both mother and infant, and to identify the risk factors
that influence GBS colonization in the infants. Patients
and Methods: 1,120 singleton pregnant women were
evaluated for GBS colonization by combined lower vagi-
nal-anorectal swabs (LVRS) and urine tests, while their
infants were evaluated for colonization with skin, ear and
gastric aspirate samples. Results: LVRS swabs were pos-
itive in 14.2% of mothers while urine was positive in
7.6%. Among the infants skin, ear and gastric aspirate
samples were positive in 7.0, 6.9 and 3.5%, respectively.
Prolonged rupture of the membrane was the only signifi-
cant factor associated with colonization in these infants
(p ! 0.001). Conclusions: Lower vaginal-anorectal swab
is an effective method in detecting colonization in moth-
ers especially when combined with urine culture. Skin or
ear swabs are equally effective in detecting colonization
in neonates. GBS colonization rate in our parturient and
neonatal population is comparable to that was reported
from other countries. A well-developed screening pro-
gram and appropriate management strategies for both
GBS colonized mothers and infants are recommended.
Copyright © 2003 S. Karger AG, Basel
Introduction
Streptococcus agalactiae (group B streptococcus) is one
of the leading causes of perinatal infections [1]. It is a
major cause of bacterial sepsis and its complications
among newborn infants, account for approximately 30%
of all neonatal infections [2, 3]. The source of infection in
neonates is the colonized maternal birth canal and trans-
mission occurs before or during the birth process [4]. Esti-
mated group B streptococcus (GBS) colonization among
pregnant women have been quantified to be in the range
of 5–30% [5, 6].