Prevalence Of Maternal Cononization With Group B Streptoccus In China: A Systematic Review And Meta-analysis

Background and objective:Group B Streptococcus(GBS)is one of the main causes of neonatal disease and death.Maternal group B streptococcus rectovaginal colonization at delivery is the most critical risk factor of early-onset invasive group B streptococcal disease.To clarify the distribution,regularity and mechanism of group B streptococcus colonization,it is helpful to develop the prevention and treatment methods of group B streptococci.The purpose of this study is to calculate the colonization rate of group B streptococcus in various regions of China,analyze the condition;understand the distribution of serotypes and the sensitivity of antibiotics,and determine the influencing factors of group B streptococcus colonization to further study the nature of group B streptococcus colonization.Provide a scientific basis for developing effective new prevention and treatment methods.Methods:A systematic review of maternal GBS colonization in China was performed by searching studies that reported the prevalence of group B streptococcus colonization of Chinese pregnant women published in PubMed,Embase,Web of science,CNKI and Wanfang databases between2000.01.01-2018.09.01.The studies in which swabs were collected according to US Centers for Disease Control and Prevention(CDC).GBS infection was detected by the methods of selective culture and PCR were included in this analysis.The mean prevalence of maternal GBS colonization in China and in the west,east as well as central China was calculated across studies.I~2 statistic test and Cochran Q test was used for assessing heterogeneity.Results:In total,252207 cases included in 57 articles about prevalence were analyzed.The average colonization prevalence of group B streptococcus rectovaginal was 8.1%(95%CI,6.2-10.0)in China and was highest in central China 9.3%(95%CI 6.6-12.0),and east 8.3%(95%CI5.5-11.0)followed by west China 6.8%(95%CI 5.4-8.3).Nevertheless,the low incidence was detected in west China,while this result may be contributed by insufficient sample size.The difference in sampling time,detection method,sample size,time and so on could not explain the heterogeneity.Serotype III GBS was the highest in pregnant women(42.5%,95%CI 37.5-47.4),and Ia,Ib,was the highest in pregnant women(42.5%,95%CI 37.5-47.4).The positive rate of III and V genotype was91.3%(95%CI 89.3-93.4).The sensitivity of GBS to erythromycin,azithromycin and clindamycin is less than 50%,although it is still highly sensitive to?-amides antibiotics,but it has been shown to be resistant to erythromycin,azithromycin and clindamycin.Conclusion:The results showed that the GBS colonization rate of pregnant women in China was lower than the global level,the distribution characteristics were the highest in the central part,followed by the eastern and western regions.Ia,Ib,III and V serotype were the main infectious subtypes.The sensitivity of?-amide antibiotics is high,but the resistance to erythromycin and azithromycin is serious.The characteristics of GBS colonization are related to the difference of population(molecular level).