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Open Forum Infect Dis. 2017 Feb 8;4(1):ofx020. doi: 10.1093/ofid/ofx020. eCollection 2017 Winter.

Group B Streptococci Colonization in Pregnant Guatemalan Women: Prevalence, Risk Factors, and Vaginal Microbiome.

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Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora.
Facultad de Medicina, Universidad Francisco Marroquín, Guatemala City.
Department of Pediatrics and Microbiology, Hospital Roosevelt, Guatemala City.
Department of Microbiology and Immunology, University of Colorado, Aurora.
Division of Infectious Diseases, School of Medicine, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora.
Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora.



Infection causes 1 of every 5 neonatal deaths globally. Group B Streptococcus (GBS) is the most significant pathogen, although little is known about its epidemiology and risk in low-income countries.


A cross-sectional study in 2015 at a public hospital in Guatemala City enrolled women ≥35 weeks' gestation. Vaginal and rectal swabs were processed using Lim broth and GBS CHROMagar then agglutination testing. Risk factors were assessed using multivariate analysis. Vaginal microbiota were profiled by 16S ribosomal ribonucleic acid sequencing in a subset of 94 women.


Of 896 pregnant women, 155 (17.3%; 95% confidence interval [CI], 14.9-19.9) were GBS colonized. Colonization was associated with history of previous infant with poor outcome (odds ratio [OR], 1.94; 95% CI, 1.15-3.27) and increasing maternal age (OR, 1.05; 95% CI, 1.02-1.09). Multiparity was protective (OR, .39; 95% CI, .21-.72). Four (6%) GBS-exposed infants had early-onset neonatal sepsis. Vaginal microbiome composition was associated with previous antibiotic exposure (P = .003) and previous low birth weight infant (P = .03), but not GBS colonization (P = .72). Several individual taxa differed in abundance between colonized and noncolonized women.


Group B Streptococcus is prevalent in pregnant women from Guatemala with different risk factors than previously described. Although the vaginal microbiome was not altered significantly in GBS-colonized women, use of antibiotics had an effect on its composition.


GBS; Streptococcus agalactiae; colonization; pregnancy; vaginal microbiome.

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