Prevalence of group B streptococcus anogenital colonization and feasibility of an intrapartum screening and antibiotic prophylaxis protocol in Cameroon, Africa

摘要

Abstract Objective To evaluate group B streptococcus ( GBS ) colonization prevalence and feasibility of intrapartum GBS screening/antibiotic prophylaxis ( IAP ) in Cameroon, Africa. Methods Prospective cohort in the Cameroon Baptist Convention Health Services network. Maternity providers collected anogenital swabs from consenting term women in labor for testing by a rapid GBS ‐polymerase chain reaction ( PCR ) system. Positive tests ( GBS +) resulted in initiation of intravenous ampicillin until delivery. Primary outcomes were GBS prevalence and proportion of GBS + women receiving ampicillin before delivery and more than 4?hours before delivery. Results A total of 219 women were enrolled from January 10 to April 27, 2017. GBS prevalence was 12.3% (95% confidence interval [ CI ] 7.9–16.7) with GBS + women more likely to reside in urban areas (19.6% vs 9.7%, P =0.004). Of 27 GBS + women, 19 (70.4%) received ampicillin before delivery and 14 (51.9%) 4?hours or longer before delivery. A median two doses of ampicillin (interquartile range [ IQR ] 1–5) were given and started at a median of 105?minutes ( IQR 90–155) after swab collection and 20?minutes ( IQR 10–45) after GBS result. Of the 8 women who did not receive ampicillin, 7 (87.5%) delivered before test results. Conclusion A GBS IAP protocol is feasible in Cameroon and should be evaluated for widespread implementation in Cameroon and other low‐income countries to decrease GBS ‐related morbidity.