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High Rate of Serotype V Streptococcus agalactiae Carriage in Pregnant Women in Botswana

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  • 1 Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa;
  • | 2 Department of Pediatrics, New York University School of Medicine, New York, New York;
  • | 3 Department of Microbiology, New York University School of Medicine, New York, New York;
  • | 4 National Health Laboratory, Gaborone, Botswana;
  • | 5 Children’s Hospital of Philadelphia Department of Pediatrics, Botswana-UPenn Partnership and Global Health Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;
  • | 6 Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana;
  • | 7 Bamalete Lutheran Hospital, Ramotswa, Botswana;
  • | 8 Princess Marina Hospital, Gaborone, Botswana;
  • | 9 Division of Pediatric Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Maternal rectovaginal colonization is the major risk factor for early-onset neonatal sepsis due to Group B Streptococcus (GBS), a major cause of early life morbidity and mortality. Transmission generally occurs perinatally from colonized mothers to infants. Vaccines targeting a subset of GBS serotypes are under development, but GBS epidemiology remains poorly understood in many African nations. We performed a cross-sectional study of GBS colonization among pregnant women at two sites in Botswana, a country with minimal prior GBS carriage data. We found a rectovaginal colonization rate of 19%, comparable with studies in other regions; however, we also noted a striking predominance of serotype V (> 45% of strains). Although further studies are required to delineate the burden of invasive GBS disease in Botswana and the generalizability of type V epidemiology, these data provide a useful baseline for understanding the potential local impact of GBS prevention strategies, including vaccines.

Author Notes

Address correspondence to Adam J. Ratner, New York University School of Medicine, 430 East 29th St. (AW 505), New York, NY 10016. E-mail: adam.ratner@nyulangone.org

Disclosure: A. J. R. receives consulting fees from Pfizer.

Financial support: Funding was provided by the Neonatology Division of the Children’s Hospital of Philadelphia (to B. A.-T.) and the Melissa Ketunuti Basselier Endowment at the Children’s Hospital of Philadelphia (to B. A.-T. and A. P. S.). A. J. R. is supported by the National Institutes of Health (NIH) award R56 AI136499. The project was made possible through core services and support from the Penn Center for AIDS Research (CFAR), an NIH-funded program (P30 AI045008). The results of this study were presented in part at the 1st International Symposium on Streptococcus agalactiae Disease, Cape Town, South Africa, February 20–23, 2018.

Authors’ addresses: Brady A’Hearn-Thomas, Department of Pediatrics, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, IA, E-mail: brady-thomas@uiowa.edu. Ameneh Khatami, Tara M. Randis, Anna Chamby, Margaret Gegick, Evan Suzman, and Adam J. Ratner, Department of Pediatrics, New York University School of Medicine, New York, NY, and Department of Microbiology, New York University School of Medicine, New York, NY, E-mails: ameneh.khatami@gmail.com, tara.randis@nyulangone.org, anna.chamby@nyulangone.org, margaret.gegick@tufts.edu, esuzman@gmail.com, and adam.ratner@nyulangone.org. Moses Vurayai and Margaret Mokomane, Department of Microbiology, National Health Laboratory, Gaborone, Botswana, E-mails: mvurayai@gmail.com and bafanamargaret@gmail.com. Tonya Arscott-Mills, Children’s Hospital of Philadelphia, Botswana-UPenn Partnership and Global Health Center, Philadelphia, PA, and Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana, E-mail: tonyaarscottmillsbup@gmail.com. Francis M. Banda and Tiny Mazhani, Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana, E-mail: fmbanda@yahoo.co.uk and tinym106@yahoo.com. Thabo Lepere, Bamalete Lutheran Hospital, Ramotswa, Botswana, E-mail: thabolepere@yahoo.com. Ponatshego Gaolebale and Seeletso Nchingane, Princess Marina Hospital, Gaborone, Botswana, E-mails: ancorabw@gmail.com and son2018@yahoo.com. Andrew P. Steenhoff, Children’s Hospital of Philadelphia, Botswana-UPenn Partnership and Global Health Center, Philadelphia, PA, and Division of Pediatric Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, PA, E-mail: steenhoff@email.chop.edu.

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