Molecular Serotyping and Antibiotic Resistance Profile of Group B Streptococcus Strains Isolated from Iranian Pregnant Women with Urinary Tract Infection

Iran J Med Sci. 2023 Nov 1;48(6):542-550. doi: 10.30476/ijms.2023.96346.2787. eCollection 2023 Nov.

Abstract

Background: Group B Streptococcus (GBS) can cause serious infections in neonates and pregnant women. GBS may cause urinary tract infections (UTIs). However, molecular epidemiology of such infections is rarely reported. The present study aimed to determine drug resistance patterns and molecular serotyping of GBS isolates in a population of pregnant Iranian women with UTIs.

Methods: A cross-sectional study was conducted during the first half of 2021 in the Department of Biology, East Tehran Branch, Islamic Azad University (Tehran, Iran). Sixty GBS strains isolated from the urine and placenta samples of pregnant women with UTIs were evaluated. The women were aged 19-46 years old at 35 to 37 weeks of gestation. The molecular serotype of GBS isolates was determined using a multiplex polymerase chain reaction, and the disc diffusion method was used to determine the antibiotic susceptibility pattern of isolates for different antibiotics. The association of the GBS serotype with the phenotype of antibiotic resistance was statistically analyzed using SPSS software (version 22.0) with a Chi square test and Cramer's V test. P<0.05 was considered statistically significant.

Results: GBS capsular serotype II was most prevalent (66.7%) followed by serotypes Ib (21.7%), Ia (3.3%), and III (1.7%). The prevalence of non-typeable isolates was significantly low (6.6%). Of the 60 GBS isolates, 18.3% were resistant to penicillin, 81.6% to ampicillin, 23.3% to clindamycin, and 30% to vancomycin; indicating the need for treatment alternatives.

Conclusion: Region-specific information on antibiotic resistance and molecular characteristics of GBS is essential for epidemiological investigations, effective treatment, and vaccine development.

Keywords: Drug resistance; Pregnant women; Serotyping; Urinary tract infection; Streptococcus agalactiae.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Infant, Newborn
  • Iran / epidemiology
  • Microbial Sensitivity Tests
  • Middle Aged
  • Pregnancy
  • Pregnant Women
  • Serotyping
  • Streptococcal Infections* / drug therapy
  • Streptococcal Infections* / epidemiology
  • Streptococcus agalactiae / genetics
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / epidemiology
  • Young Adult