Maternal colonization with Streptococcus agalactiae and associated stillbirth and neonatal disease in coastal Kenya.

摘要: Streptococcus agalactiae (group B streptococcus, GBS) causes neonatal disease and stillbirth, but its burden in sub-Saharan Africa is uncertain. We assessed maternal recto-vaginal GBS colonization (7,967 women), stillbirth disease. Whole-genome sequencing was used to determine serotypes, sequence types phylogeny. found low prevalence (934/7,967, 12%), comparatively high incidence of GBS-associated early onset (EOD) hospital (0.91 (0.25-2.3)/1,000 births 0.76 (0.25-1.77)/1,000 live births, respectively). However, using a population denominator, EOD considerably reduced (0.13 (0.07-0.21)/1,000 births). Treated cases had very case fatality (17/36, 47%), especially within 24 h birth, making under-ascertainment community-born highly likely, both here similar facility-based studies. Maternal less common women with socio-economic status, HIV infection undernutrition, when GBS-colonized, they were more probably colonized by the most virulent clone, CC17. CC17 accounted for 267/915 (29%) colonizing (265/267 (99%) serotype III; 2/267 (0.7%) IV) 51/73 (70%) (all III). Trivalent (Ia/II/III) pentavalent (Ia/Ib/II/III/V) vaccines would cover 71/73 (97%) 72/73 disease-causing respectively. Serotype IV should be considered inclusion, evidence capsular switching strains.