Sulung @ Ab Hadi, Faridah
(2021)
Determination of Group B Streptococcus (GBS) Serotypes, Its Virulenece Genes And Patient’s Clinical Presentation Among Non-Pregnant Adults in Kelantan.
Masters thesis, Universiti Sains Malaysia.
Abstract
Serotype and virulence genes of Group B Streptococcus (GBS) isolated among
non-pregnant adults in East Coast Malaysia and its association with patient’s
clinical diagnosis.
Background: GBS infection among non-pregnant adults is emerging nowadays. The
severity of the disease caused by GBS depends on the serotype and presence of
virulence genes in the particular strains. This study aimed to determine the distribution
of GBS serotypes and virulence genes and to know the association of GBS serotype
with the clinical disease.
Methods: A cross-sectional study involving retrospective record review was done
involving a total of 75 GBS isolates collected from October 2018 till October 2019 in
two major hospitals in Kelantan (East coast of peninsula Malaysia). Those isolates
were from various clinical samples of non-pregnant adults > 18 years old (excluding
vaginal swab). Identification of all isolates serotype (serotype Ia, Ib, II until IX) and
their virulence genes (scpB, lmb, bca, bac, rib, cylE, and hylE) were done using
conventional PCR. The antibiotic susceptibility testing was traced from The BIOMIC
V3, Microbiology System. Clinical information of patient was assessed from medical records and were analysed and presented as tables and figures.
Results: GBS was commonly isolated among adults aged between 41-60 (66.7%,
n=50). Of all the isolates tested, serotype III (21.3%, n=16) was the most common
followed by serotype Ia (18.7%, n=14), II (12%, n=12), and IV (13.3%, n=10).
Virulence gene PCR showed cylE, scpB, lmb, hylE, and bca were discovered in most
isolates while rib and bac were detected in 10.7% (n=8) and 2.7% (n=2) of the isolates.
The most common clinical diagnosis was skin and soft tissue infection (66.7%, n=50);
it was mainly associated with serotype Ia (22%, n=11). Diabetes mellitus (DM) was
the leading risk factor for GBS disease (76%, n=57). The majority of the isolates
(98.7%, n=74) were penicillin-sensitive. One of the serotype IV isolates had reduced
susceptibility to penicillin. The resistance rate to clindamycin and erythromycin were
9.3% (n=7) and 6.7% (n=5), respectively. The mortality rate was 2.7% (n=2). There
was no association between the most common GBS serotypes, and clinical diagnosis.
Conclusion: Serotype III was the most common serotype detected among nonpregnant
adults infected with GBS. GBS generally infected adults with underlying DM
who had skin and soft tissue infections.
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