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Maternal and neonatal colonization in Bangladesh: prevalences, etiologies and risk factors

Journal of Perinatology volume 33, pages 971–976 (2013)Cite this article

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Abstract

Objective:

To estimate the prevalence of maternal colonizers in South Asia and their potential to colonize the umbilicus, an important precondition causing neonatal sepsis.

Study design:

We conducted a cross-sectional study at a maternity center in Dhaka with 1219 pregnant women and a subset of 152 newborns from 15 January to 31 October 2011. During labor, study paramedics collected vaginal swabs for bacterial culture and rectal swabs for Group B Streptococcus (GBS) testing. Community health workers collected neonatal umbilical swabs. Log-binomial regression models were used to estimate risk ratios.

Result:

In all, 454 women (37.2%, 95% confidence interval (CI) 34.5 to 40.0%) were colonized. The most common organisms isolated were Staphylococcus aureus, Non-GBS and GBS. A total of 94 women (7.7%, 95% CI 6.2 to 9.2%) were colonized with GBS. The risk of GBS umbilical colonization was higher (RR=12.98, 95% CI 3.97 to 42.64) among newborns of mothers with GBS colonization.

Conclusion:

Newborns of mothers colonized with GBS are at higher risk of developing umbilical colonization.

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Acknowledgements

We thank our colleagues at the International Centre for Diarrheal Disease Research, Bangladesh Shams El Arifeen, Marzia Zaman, Taufiqur Rahman, Qazi Sadequr Rahman and Abu Salaheen for their field and data management support. We are grateful to Kazi Moksedur Rahman and the paramedics and community health workers from Shimantik who worked tirelessly for collecting data. We acknowledge Maksuda Islam, Anik Sarkar and Iftekhar Quasem from the Child Health Research Foundation, Bangladesh for laboratory work contributions. Thank you to Aletta Nonyane at Johns Hopkins Bloomberg School of Public Health and Daniel Roth from the University of Toronto for their technical expertise. Finally, we thank the mothers and newborns who generously gave their time to participate in this study. This research was supported by the Thrasher Research Fund Early Career Award and grant# 5KL2RR025006 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research.

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Authors and Affiliations

  1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    G J Chan, A H Baqui & R E Black

  2. Department of Microbiology, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka, Bangladesh

    J K Modak & S K Saha

  3. Centre for Child and Adolescent Health, International Center for Diarrheal Disease Research Bangladesh, Dhaka, Bangladesh

    A A Mahmud

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  1. G J Chan
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  4. A H Baqui
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Correspondence to G J Chan.

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Chan, G., Modak, J., Mahmud, A. et al. Maternal and neonatal colonization in Bangladesh: prevalences, etiologies and risk factors. J Perinatol 33, 971–976 (2013). https://doi.org/10.1038/jp.2013.99

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