Group B Streptococcus (GBS) remains a significant cause of neonatal infection, but the maternal risk factors for GBS colonization remain poorly defined. We hypothesized that there may be an association between antibiotic exposure during pregnancy and GBS colonization and/or the presence of inducible clindamycin resistance (iCLI-R) in GBS isolates from GBS-colonized pregnant women. A retrospective cohort study was performed at Louisiana State University Health Sciences Center – Shreveport including demographic and clinical data from 1513 pregnant women who were screened for GBS between July 1, 2009 and December 31, 2010. Among 526 (34.8%) women who screened positive for GBS, 124 (23.6%) carried GBS strains with iCLI-R (GBS-iCLI-R). While antibiotic exposure, race, sexually-transmitted infection (STI) in pregnancy, GBS colonization in prior pregnancy and BMI were identified as risk factors for GBS colonization in univariate analyses, the only independent risk factors for GBS colonization were African–American race (AOR = 2.142; 95% CI = 2.092–3.861) and STI during pregnancy (AOR = 1.309; 95% CI = 1.035–1.653). Independent risk factors for GBS-iCLI-R among women colonized with GBS were non-African–American race (AOR = 2.13; 95% CI = 1.20–3.78) and younger age (AOR = 0.94; 95% CI = 0.91–0.98). Among GBS-colonized women with an STI in the current pregnancy, the only independent risk factor for iCLI-R was Chlamydia trachomatis infection (AOR = 4.31; 95% CI = 1.78–10.41). This study identified novel associations for GBS colonization and colonization with GBS-iCLI-R. Prospective studies will improve our understanding of the epidemiology of GBS colonization during pregnancy and the role of antibiotic exposure in alterations of the maternal microbiome.

中文翻译：

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性传播感染和非裔美国人种族与妊娠期无乳链球菌定植的关联

B 组链球菌 (GBS) 仍然是新生儿感染的一个重要原因，但 GBS 定植的母体风险因素仍然不明确。我们假设妊娠期间抗生素暴露与 GBS 定植和/或 GBS 定植孕妇的 GBS 分离株中存在诱导型克林霉素耐药性 (iCLI-R) 之间可能存在关联。在路易斯安那州立大学健康科学中心 - 什里夫波特进行了一项回顾性队列研究，包括 2009 年 7 月 1 日至 2010 年 12 月 31 日期间接受 GBS 筛查的 1513 名孕妇的人口统计学和临床​​数据。其中 526 名 (34.8%) 筛查呈阳性的女性对于 GBS，124 个 (23.6%) 携带带有 iCLI-R (GBS-iCLI-R) 的 GBS 菌株。虽然抗生素暴露、种族、怀孕期间的性传播感染 (STI)，在单变量分析中，既往妊娠中的 GBS 定植和 BMI 被确定为 GBS 定植的危险因素，GBS 定植的唯一独立危险因素是非裔美国人种族（AOR = 2.142；95% CI = 2.092-3.861）和妊娠期间的 STI（ AOR = 1.309；95% CI = 1.035–1.653）。GBS 定植女性中 GBS-iCLI-R 的独立危险因素是非非洲裔美国人（AOR = 2.13；95% CI = 1.20–3.78）和年龄较小（AOR = 0.94；95% CI = 0.91–0.98） . 在当前妊娠患有 STI 的 GBS 定植女性中，iCLI-R 的唯一独立危险因素是沙眼衣原体感染（AOR = 4.31；95% CI = 1.78–10.41）。该研究确定了 GBS 定植和定植与 GBS-iCLI-R 的新关联。