تعیین سروتیپ‌های کپسولی و مقاومت آنتی‌بیوتیکی ایزوله‌های Streptococcus agalactiae جدا شده از زنان باردار

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه میکروب‌شناسی، دانشکده‌ی پزشکی و مرکز تحقیقات ایمنی‌شناسی تولید مثل، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران

2 استادیار باکتری‌شناسی، گروه علوم آزمایشگاهی، دانشکده‌ی پیراپزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران

3 دانشیار میکروب‌شناسی، گروه میکروب‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران

4 دانشیار، گروه پزشکی اجتماعی، دانشکده‌ی پزشکی و مرکز تحقیقات پایش سلامت، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران

چکیده

مقدمه: Streptococcus agalactiae (استرپتوکوکوس گروه B یا GBS)، ساکن طبیعی دستگاه گوارش و ادراری- تناسلی افراد سالم است و به عنوان شایع‌ترین علت سپسیس، مننژیت، پنومونی و بیماری‌های شدید در نوزادان تازه متولد شده است. مقاومت به پنی‌سیلین و ماکرولیدها به عنوان آنتی‌بیوتیک‌های انتخابی درمان عفونت‌های GBS رو به افزایش است. مطالعه‌ی حاضر با هدف تعیین سروتیپ‌های کپسولی و مقاومت آنتی‌بیوتیکی جدایه‌های Streptococcus agalactiae در زنان باردار مراجعه کننده به بیمارستان ولیعصر (عج) شهرستان بروجن انجام شد.روش‌ها: این مطالعه‌ی توصیفی- مقطعی بر روی 760 نمونه‌ی سواپ واژینال خانم‌های باردار (هفته‌های 37-35 بارداری) انجام شد. باکتری‌های جدا شده با روش‌های فنوتیپی شناسایی و بعد از تأیید GBS، مقاومت آنتی‌بیوتیکی جدایه‌های GBS نسبت به دیسک‌های آنتی‌بیوتیکی به روش دیسک دیفیوژن انجام و سپس، سروتیپ‌های کپسولی جدایه‌ها به روش Multiplex polymerase chain reaction (Multiplex PCR) تعیین شد.یافته‌ها: از 760 زن باردار شرکت کننده در این مطالعه، 70 نفر (2/9 درصد) حامل GBS بودند. بیشترین مقاومت جدایه‌ها مربوط به تتراسیکلین (85/92 درصد) و کمترین مقاومت نسبت به پنی‌سیلین (0) بود. فراوان‌ترین سروتیپ کپسولی سروتیپ III (71/45 درصد)، سپس سروتیپ‌های II (14/17 درصد)، VI (28/14 درصد)، Ib (42/11 درصد)، V (57/8 درصد) و Ia (85/2 درصد) بود.نتیجه‌گیری: شیوع این باکتری و میزان مقاومت آنتی‌بیوتیکی نسبت به ماکرولیدها در این مطالعه پایین و همانند سایر مطالعات سروتیپ کپسولی III غالب بود

کلیدواژه‌ها


عنوان مقاله [English]

Identification of Capsular Serotype and Antibiotic Resistance of Streptococcus Agalactiae Isolated from Pregnant Women

نویسندگان [English]

  • Jalal Ahmadi 1
  • Maryam Sadeh 2
  • Mohammad Bagher Khalili 3
  • Mahmood Vakili 4
1 MSc Student, Department of Microbiology, School of Medicine AND Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Yazd, Iran
2 Assistant Professor, Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Yazd, Iran
3 Associate Professor, Department of Microbiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Yazd, Iran
4 Associate Professor, Department of Community Medicine, School of Medicine AND Health Monitoring Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
چکیده [English]

Background: Streptococcus agalactiae (Group B Streptococcus or GBS) is a natural resident of the gastrointestinal tract of healthy individuals, and is the most common cause of sepsis, meningitis, pneumonia, and severe diseases in newborns. Resistance to penicillin and macrolides, as selective antibiotics for the treatment of GBS infections, is increasing. In this study, we aimed to determine the capsule serotypes and antibiotic resistance pattern of Streptococcus agalactiae isolated from pregnant women referred to the Valiasr hospital in Borujen City, Iran.Methods: In this descriptive cross-sectional study, a total of 760 vaginal samples were collected from pregnant women in the period between 35-37 weeks of gestation. Following conventional phenotypic evaluation and GBS confirmation, GBS isolates resistance to antibiotic disc was assessed through disk diffusion test. Finally, capsular serotypes were determined using multiplex polymerase chain reaction (multiplex PCR) method.Findings: Out of 760 pregnant women participating in this study, 70 (9.2%) were carriers of GBS. Our finding disclosed that the lowest and highest resistance among GBS isolates were related to penicillin (0%), and tetracycline (92.85%), respectively. The most common capsular serotypes were III (45.71%), followed by II (17.14%), VI (14.28%), Ib (11.42%), V (8.57%), and Ia (2.85%), respectively.Conclusion: In this study, we detected low prevalence of GBS, as well as low level resistance to macrolides. In addition, predominant capsular serotype was III.

کلیدواژه‌ها [English]

  • Streptococcus agalactiae
  • Antibiotic Resistance
  • Pregnant Women
  • Serotyping, Streptococcus group B
  1. Kim EJ, Oh KY, Kim MY, Seo YS, Shin JH, Song YR, et al. Risk factors for group B streptococcus colonization among pregnant women in Korea. Epidemiol Health 2011; 33: e2011010.
  2. Absalan M, Eslami G, Zandi H, Mosaddegh A, Vakili M, Khalili MB. Prevalence of recto-vaginal colonization of group b streptococcus in pregnant women. J Isfahan Med Sch 2013; 30(220): 2367-75. [In Persian].
  3. Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59(RR-10): 1-36.
  4. Salehi F, Eslami G, Sadh M, Khalili MB. Determination of Streptococcus agalactiae resistance to selective antibiotics and detection of resistance gene to erythromycin isolated from vagina of carrier women in Yazd, Iran, 2015. J Isfahan Med Sch 2016; 34(389): 780-5. [In Persian].
  5. Seo YS, Srinivasan U, Oh KY, Shin JH, Chae JD, Kim MY, et al. Changing molecular epidemiology of group B streptococcus in Korea. J Korean Med Sci 2010; 25(6): 817-23.
  6. Hall GS. Bailey and Scott's Diagnostic Microbiology. 13th ed. Chicago,IL: American Society for Clinical Pathology; 2013. p. 885-6.
  7. Nabavinia M, Khalili MB, Sadeh M, Eslami G, Vakili M, Azartoos N, et al. Distribution of Pilus island and antibiotic resistance genes in Streptococcus agalactiae obtained from vagina of pregnant women in Yazd, Iran. Iran J Microbiol 2020; 12(5): 411-6.
  8. Poyart C, Tazi A, Reglier-Poupet H, Billoet A, Tavares N, Raymond J, et al. Multiplex PCR assay for rapid and accurate capsular typing of group B streptococci. J Clin Microbiol 2007; 45(6): 1985-8.
  9. Sadeh M, Salehi Abargouei A, Azartoos N, Mirzaei F, Khalili MB. Distribution of Streptococcus agalactiae among Iranian women from 1992 to 2018: A systematic review and meta-analysis. Jundishapur J Microbiol 2020; 13(7): e102314.
  10. Ippolito DL, James WA, Tinnemore D, Huang RR, Dehart MJ, Williams J, et al. Group B streptococcus serotype prevalence in reproductive-age women at a tertiary care military medical center relative to global serotype distribution. BMC Infect Dis 2010; 10: 336.
  11. Mee-Marquet N, Jouannet C, Domelier AS, Arnault L, Lartigue MF, Quentin R. Genetic diversity of Streptococcus agalactiae strains and density of vaginal carriage. J Med Microbiol 2009; 58(Pt 2): 169-73.
  12. Brimil N, Barthell E, Heindrichs U, Kuhn M, Lutticken R, Spellerberg B. Epidemiology of Streptococcus agalactiae colonization in Germany. Int J Med Microbiol 2006; 296(1): 39-44.
  13. Seoud M, Nassar AH, Zalloua P, Boghossian N, Ezeddine J, Fakhoury H, et al. Prenatal and neonatal Group B Streptococcus screening and serotyping in Lebanon: Incidence and implications. Acta Obstet Gynecol Scand 2010; 89(3): 399-403.
  14. Lee BK, Song YR, Kim MY, Yang JH, Shin JH, Seo YS, et al. Epidemiology of group B streptococcus in Korean pregnant women. Epidemiol Infect 2010; 138(2): 292-8.
  15. Milyani R, Abu Rokbah R. Incidence of vaginal and rectal carriage of Streptococcus agalactiae among pregnant and non pregnant women in Jeddah city, Saudi Arabia. Advanced Scholars in Medicine 2011; 1(4): 37-44.
  16. Sahraee S, Milani F, Roushan Z, Hedayati M, Rostami S, Shoja S, et al. The prevalence of rectovaginal colonization and antibiotic susceptibility pattern of Streptococcus agalactiae in pregnant women in Al-Zahra Hospital, Rasht, Iran. Infect Dis Clin Pract 2019; 27(3): 143-7.
  17. Mengist A, Kannan H, Abdissa A. Prevalence and antimicrobial susceptibility pattern of anorectal and vaginal group B Streptococci isolates among pregnant women in Jimma, Ethiopia. BMC Res Notes 2016; 9: 351.
  18. Tsai MH, Hsu JF, Lai MY, Lin LC, Chu SM, Huang HR, et al. Molecular characteristics and antimicrobial resistance of group B streptococcus strains causing invasive disease in neonates and adults. Front Microbiol 2019; 10: 264.
  19. Shadbad MA, Kafil HS, Rezaee MA, Farzami MR, Dehkharghani AD, Sadeghi J, et al. Streptococcus agalactiae clinical isolates in Northwest Iran: Antibiotic susceptibility, molecular typing, and biofilm formation. GMS Hyg Infect Control 2020; 15: Doc23.
  20. Dashtizade M, Zolfaghari MR, Yousefi M, Nazari-Alam A. Antibiotic susceptibility patterns and prevalence of streptococcus Agalactiae rectovaginal colonization among pregnant women in Iran. Rev Bras Ginecol Obstet 2020; 42(8): 454-9.
  21. Sadeh M, Firouzi R, Derakhshandeh A, Bagher KM, Kong F, Kudinha T. Molecular characterization of Streptococcus agalactiae isolates from pregnant and non-pregnant women at Yazd University Hospital, Iran. Jundishapur J Microbiol 2016; 9(2): e30412.
  22. Hanh TQ, Van Du V, Hien PT, Chinh DD, Loi CB, Dung NM, et al. Prevalence and capsular type distribution of group B Streptococcus isolated from vagina of pregnant women in Nghe An province, Vietnam. Iran J Microbiol 2020; 12(1): 11-7.
  23. Sadowy E, Matynia B, Hryniewicz W. Population structure, virulence factors and resistance determinants of invasive, non-invasive and colonizing Streptococcus agalactiae in Poland. J Antimicrob Chemother 2010; 65(9): 1907-14.
  24. Yasini M, Safari M, Khorshidi A, Moniri R, Mousavi SGA, Samimi M. Frequency of group B capsular serotypes of Streptococcus using the multiplex PCR among the pregnant women in Kashan during 2011-2013. Feyz 2013; 17(2): 173-80. [In Persian].
  25. Jannati E, Roshani M, Arzanlou M, Habibzadeh S, Rahimi G, Shapuri R. Capsular serotype and antibiotic resistance of group B streptococci isolated from pregnant women in Ardabil, Iran. Iran J Microbiol 2012; 4(3): 130-5.
  26. Kao Y, Tsai MH, Lai MY, Chu SM, Huang HR, Chiang MC, et al. Emerging serotype III sequence type 17 group B streptococcus invasive infection in infants: the clinical characteristics and impacts on outcomes. BMC Infectious Diseases 2019; 19(1): 538.
  27. Lee MC, Kuo KC. The clinical implication of serotype distribution and drug resistance of invasive pneumococcal disease in children: A single center study in southern Taiwan during 2010-2016. J Microbiol Immunol Infect 2019; 52(6): 937-46.
  28. Zhao Z, Kong F, Zeng X, Gidding HF, Morgan J, Gilbert GL. Distribution of genotypes and antibiotic resistance genes among invasive Streptococcus agalactiae (group B streptococcus) isolates from Australasian patients belonging to different age groups. Clin Microbiol Infect 2008; 14(3): 260-7.
  29. Genovese C, D'Angeli F, Di Salvatore V, Tempera G, Nicolosi D. Streptococcus agalactiae in pregnant women: Serotype and antimicrobial susceptibility patterns over five years in Eastern Sicily (Italy). Eur J Clin Microbiol Infect Dis 2020; 39(12): 2387-96.
  30. Dutra VG, Alves VM, Olendzki AN, Dias CA, de Bastos AF, Santos GO, et al. Streptococcus agalactiae in Brazil: Serotype distribution, virulence determinants and antimicrobial susceptibility. BMC Infect Dis 2014; 14: 323.