Prospective analysis of risk factors associated with group B streptococcal colonisation in neonates born at a tertiary care centre in India

Abstract

Background:

Bacterial colonisation of neonates and the birth canal by group B streptococci (GBS) plays a significant role in the development of neonatal infections.

Objectives:

To determine the rate of GBS colonisation in neonates in the first 48 hours of life and to identify the risk factors associated with GBS colonisation.

Methods:

To estimate GBS colonisation, a prospective cross-sectional analysis of 1050 neonates delivered at a tertiary care hospital in India was undertaken. Swabs were taken from the neonates’ skin and/or mucus membranes of the external ear canal, anterior nares, umbilicus, throat and ano-rectal sites between 24 and 48 hours of age. Data regarding the various risk factors were collected on a predesigned performa.

Results:

338 (32·2%) of 1050 neonates had bacterial colonisation. Escherichia coli (25·9%), was the bacteria most commonly isolated, followed by Staphylococcus aureus (16·3%) and coagulase-negative Staphylococci (CONS) (12·6%). The overall rate of GBS colonisation was 3·23%. Preterm birth, respiratory distress at birth, prolonged rupture of membranes (≧18 hrs), intrapartum antibiotics, underlying medical illness in the mother, prolonged labour, maternal fever and other obstetric complications were identified as significant risk factors associated with neonatal GBS colonisation (P<0·05).

Conclusion:

Multi-centre and community-based studies in India are recommended to identify the true colonisation rates for GBS, and it is necessary to perform cultures from multiple body sites of neonates in order to obtain an accurate bacteriological evaluation.

Keywords:

• Group B streptococci
• Group B streptococcus
• GBS
• Neonatal colonisation
• Risk factors in neonatal colonisation
• Streptococcus agalactiae
• GBS colonisation

Acknowledgments

We thank the parents and children for their co-operation during data collection, Dr Ashok Dutta, Head of the Department of Pediatrics, Kalawati Saran Children’s Hospital, and Dr Atul Murari, Director of Lady Hardinge Medical College, New Delhi for administrative support during the project which was undertaken as part of an MD thesis by DS at LHMC, Delhi University, New Delhi.