To identify factors associated with vaginal colonization and persistence by group B Streptococcus (GBS) and by the hypervirulent neonatal CC-17 clone in late pregnancy and after delivery, a multicentre prospective observational cohort with 3-month follow-up was established in two university hospitals, Paris area, France. Pregnant women were recruited when antenatal screening for GBS vaginal colonization at 34–38 weeks of gestational age was positive. Vaginal samples were analysed by conventional culture methods at antenatal screening, delivery, and 21 and 60 days following delivery. Identification of the hypervirulent neonatal GBS CC-17 was performed. Colonization was defined as persistent when all vaginal samples were positive for GBS. A total of 754 women were included. GBS vaginal colonization was persistent in 63% of the cases (95% CI 59%–67%). Persistent colonization was more likely in women born in Sub-Saharan Africa compared with women born in France (OR = 1.88, 95% CI 1.05–3.52), and GBS CC-17 was overrepresented in women born in Sub-Saharan Africa (OR = 2.09, 95% CI 1.20–3.57). Women born in Sub-Saharan Africa are at higher risk for GBS vaginal persistence than women born in France. This observation correlates with an increased prevalence of the hypervirulent GBS CC-17 in the former group, which likely reflect variations linked to ethnicity and vaginal community-state types and might account for the increased susceptibility of black neonates to GBS infections.
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All data were collected in a computerized database, and all biological samples were anonymized before their inclusion in the collection.
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We thank Florence Artiguebieille, Valerie Fauroux, Farah Ketroussi, Chahrazed Guettouche, and Alexandra Bruneau from URC-CIC Cochin-Necker, AP-HP, Paris, for the management of the clinical trial. We thank all the women who participated in the study as well as the clinical teams for their assistance in recruiting patients to the study.
The sponsors were Assistance Publique–Hôpitaux de Paris (AP-HP) (Department of Clinical Research), Institut Mérieux and IRT BioAster (Lyon bioPôle). This work was funded by grants from APHP (P111008), Institut Mérieux and IRT BioAster (ColSGB ST-17), Agence Nationale de la Recherche (ANR 13-PRTS-0006), and FRM (DBF20160635740).
The funders had no role in study design, data collection, analysis, or interpretation, in the writing of the manuscript or the decision to submit it for publication. All authors had full access to all the data, and the corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Conflict of interest
CPo has received reimbursement for attending meetings from bioMérieux, Cepheid, and Becton-Dickinson and has received research funding from Institut Mérieux. CPo was a member of the SAB of Arsanis Inc. and received honorarium from it in 2015, 2016, and 2017. CPl has received reimbursement from Cepheid for attending ECCMID meeting in 2016. Other authors report no conflicts of interest.
Ethical approval and informed consent
This study was conducted in agreement with French regulations on privacy, data collection, and treatment and was approved by the Comité consultatif sur le traitement de l’information en matière de recherche (CCTIRS, Advisory committee on information processing for research, authorization 12005 of March 1st 2012) and registered at ClinicalTrials.gov, number NCT01719510.
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All women included gave written informed consent to participate.
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All women included gave written informed consent for publication of data.
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Trial registration number NCT01719510 of November 1st 2012.
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Plainvert, C., Anselem, O., Joubrel, C. et al. Persistence of group B Streptococcus vaginal colonization and prevalence of hypervirulent CC-17 clone correlate with the country of birth: a prospective 3-month follow-up cohort study. Eur J Clin Microbiol Infect Dis 40, 133–140 (2021). https://doi.org/10.1007/s10096-020-04011-6