Survival and biofilm formation of Listeria monocytogenes in simulated vaginal fluid: influence of pH and strain origin

Listeria monocytogenes, the agent responsible for listeriosis, can be transmitted from mother to fetus/neonates by vertical transmission, transplacentally or during passage through the birth canal. The purpose of this study was to investigate the survival and biofilm formation of L. monocytogenes (isolated from clinical cases or from food) in simulated vaginal fluid at different pH values (4.2, 5.5 and 6.5). The results demonstrated that this pathogen is inhibited by the normal vaginal pH, but may proliferate when it increases. Clinical strains were significantly more resistant to pH 4.2 than food isolates. Listeria monocytogenes survived and even grew at the higher pHs investigated, suggesting that fetus/neonates from women having increased vaginal pH values during pregnancy may be at a higher risk of listeriosis. All isolates tested were producers of biofilm at different pH values; however, L. monocytogenes produced higher quantities of biofilm in a nutrient-rich medium. No significant differences in biofilm production were detected between food and clinical isolates. As L. monocytogenes are biofilm producers, this increases the probability of occurrence of neonatal infection.     

Evaluation of characteristics of Pediococcus spp. to be used as a vaginal probiotic

Aims

The aim of our research was to select, identify and characterize an isolate of lactic acid bacteria to be considered as a vaginal probiotic.

Methods and Results

Thirty‐five isolates of Pediococcus spp. showed bacteriocinogenic activity against Listeria monocytogenes and the ability to survive in simulated vaginal fluid (SVF) at pH 4·2. One isolate of Pediococcus spp. was selected and characterized to evaluate its safety before the use as vaginal probiotic. Pediococcus pentosaceus SB83 did not show the presence of virulence factors such as the production of gelatinase, lipase and DNase, haemolytic activity, nor the presence of virulence genes (genes esp, agg, gelE, efaAfm, efaAfs, cylA, cylB and cylM). Pediococcus pentosaceus SB83 was considered sensitive to chloramphenicol, gentamicin, streptomycin, kanamycin, erythromycin and ampicillin. This strain was considered resistant to tetracycline and vancomycin. Pediococcus pentosaceus SB83 was a biofilm producer at different pH values (4·2, 5·5 and 6·5) in SVF and in de Man, Rogosa and Sharpe medium.

Conclusions

The in vitro results provide a basis for the use of P. pentosaceus SB83 as a vaginal probiotic, to prevent colonization by L. monocytogenes in pregnant women.

Significance and Impact of Study

The application of vaginal probiotics could have the potential for preventing vaginal infections and consequently reduce abortion and neonatal infections.     

Acidic pH Strongly Enhances In Vitro Biofilm Formation by a Subset of Hypervirulent ST-17 Streptococcus agalactiae Strains

Streptococcus agalactiae, also known as group B Streptococcus (GBS), is a primary colonizer of the anogenital mucosa of up to 40% of healthy women and an important cause of invasive neonatal infections worldwide. Among the 10 known capsular serotypes, GBS type III accounts for 30 to 76% of the cases of neonatal meningitis. In recent years, the ability of GBS to form biofilm attracted attention for its possible role in fitness and virulence. Here, a new in vitro biofilm formation protocol was developed to guarantee more stringent conditions, to better discriminate between strong-, low-, and non-biofilm-forming strains, and to facilitate interpretation of data. This protocol was used to screen the biofilm-forming abilities of 366 GBS clinical isolates from pregnant women and from neonatal infections of different serotypes in relation to medium composition and pH. The results identified a subset of isolates of serotypes III and V that formed strong biofilms under acidic conditions. Importantly, the best biofilm formers belonged to serotype III hypervirulent clone ST-17. Moreover, the abilities of proteinase K to strongly inhibit biofilm formation and to disaggregate mature biofilms suggested that proteins play an essential role in promoting GBS biofilm initiation and contribute to biofilm structural stability.     

The impact of pH and nutrient stress on the growth and survival of Streptococcus agalactiae

Streptococcus agalactiae is a major neonatal pathogen that is able to colonise various host environments and is associated with both gastrointestinal and vaginal maternal carriage. Maternal vaginal carriage represents the major source for transmission of S. agalactiae to the foetus/neonate and thus is a significant risk factor for neonatal disease. In order to understand factors influencing maternal carriage we have investigated growth and long term survival of S. agalactiae under conditions of low pH and nutrient stress in vitro. Surprisingly, given that vaginal pH is normally <4.5, S. agalactiae was found to survive poorly at low pH and failed to grow at pH 4.3. However, biofilm growth, although also reduced at low pH, was shown to enhance survival of S. agalactiae. Proteomic analysis identified 26 proteins that were more abundant under nutrient stress conditions (extended stationary phase), including a RelE family protein, a universal stress protein family member and four proteins that belong to the Gls24 (PF03780) stress protein family. Cumulatively, these data indicate that novel mechanisms are likely to operate that allow S. agalactiae survival at low pH and under nutrient stress during maternal vaginal colonisation and/or that the bacteria may access a more favourable microenvironment at the vaginal mucosa. As current in vitro models for S. agalactiae growth appear unsatisfactory, novel methods need to be developed to study streptococcal colonisation under physiologically-relevant conditions.     

A streptococcal NRAMP homologue is crucial for the survival of Streptococcus agalactiae under low pH conditions

Streptococcus agalactiae or Group B Streptococcus (GBS) is a commensal bacterium of the human gastrointestinal and urogenital tracts as well as a leading cause of neonatal sepsis, pneumonia and meningitis. Maternal vaginal carriage is the main source for GBS transmission and thus the most important risk factor for neonatal disease. Several studies in eukaryotes identified a group of proteins natural resistance‐associated macrophage protein (NRAMP) that function as divalent cation transporters for Fe²⁺ and Mn²⁺ and confer on macrophages the ability to control replication of bacterial pathogens. Genome sequencing predicted potential NRAMP homologues in several prokaryotes. Here we describe for the first time, a pH‐regulated NRAMP Mn²⁺/Fe²⁺ transporter in GBS, designated MntH, which confers resistance to reactive oxygen species (ROS) and is crucial for bacterial growth and survival under low pH conditions. Our investigation implicates MntH as an important colonization determinant for GBS in the maternal vagina as it helps bacteria to adapt to the harsh acidic environment, facilitates bacterial adherence, contributes to the coexistence with the vaginal microbiota and plays a role in GBS intracellular survival inside macrophages.     

Mutagenesis of a bacteriophage lytic enzyme PlyGBS significantly increases its antibacterial activity against group B streptococci

Group B streptococci (GBS) are the leading cause of neonatal meningitis and sepsis worldwide. Intrapartum antibiotic prophylaxis (IAP) is the current prevention strategy given to pregnant women with confirmed vaginal GBS colonization. Due to antibiotic resistance identified in GBS, we previously developed another strategy using a bacteriophage lytic enzyme, PlyGBS, to reduce vaginal GBS colonization. In this study, various DNA mutagenesis methods were explored to produce PlyGBS mutants with increased lytic activity against GBS. Several hyperactive mutants were identified that contain only the endopeptidase domain found in the N-terminal region of PlyGBS and represent only about one-third of the wild-type PlyGBS in length. Significantly, these mutants not only have 18–28-fold increases in specific activities compared to PlyGBS, but they also have a similar activity spectrum against several streptococcal species. One of the hyperactive mutants, PlyGBS90-1, reduced the GBS colonization from >5 logs of growth per mouse to <50 colony-forming units (cfu) 4 h post treatment (∼4-log reduction) using a single dose in a mouse vaginal model. A reduction in GBS colonization before delivery should significantly reduce neonatal GBS infection providing a safe alternative to IAP.     

Infectivity and virulence of Nosema ceranae (Microsporidia) isolates obtained from various Apis mellifera morphotypes

The infection of honey bees, Apis mellifera L. (Hymenoptera: Apidae), by the microsporidian Nosema ceranae is one of the factors related to the increase in colony losses and the decrease in honey production observed in recent years. However, these effects seem to differ depending on the climate zone. The range and prevalence of N. ceranae have increased significantly in the last decades, with different consequences in northern and southern temperate areas. The existence of various isolates of N. ceranae from distant geographical areas, which probably exhibit different degrees of virulence, could explain the different responses of the bee to the infection. The aim of this work was to compare the effects of two N. ceranae isolates from different host populations from Argentina on honey bee survival at two ages post-eclosion. Using cage experiments, we compared the development of infection of worker bees through the estimation of daily bee mortality and spore counts. Host subspecies identity analysis showed a strong similarity with Apis mellifera scutellata morphotype for the northern region, with a greater hybridization between subspecies with European origin toward the central and southern regions. Genetic characterization of isolates from the three regions indicated only the presence of N. ceranae. Infected bees survived longer than control bees, and bees infected at 5 days had a lower survival than those infected at 72 h with isolates from the three regions. These differences in survival matched the development of the N. ceranae infection, with differences in spore loads for infected bees at 5 days. Our studies showed that Nosema infection and survival varied among the different ages post emergence of workers, and both increased as the honey bee aged. These differences in susceptibility to infection could be related to the immune response of bees of different ages or to changes in the composition and succession of the intestinal microbiota throughout its ontogeny.     

Prevalence and significance of vaginal group B streptococcus colonization in pregnant women from Osijek, Croatia

The aim of the study was to determine the prevalence of vaginal group B streptococcus (GBS) colonization in pregnant women from Osijek area, the possible effect of GBS colonization on pregnancy outcome and neonatal complications and the role of intrapartum prophylaxis in this context. This retrospective case-control study took place at the Department of Gynecology and Obstetrics, Osijek University Hospital Center from December 2003 to June 2006. A total of 118 pregnant women was enrolled in study and divided into two groups: 59 women in 35th-37th week of gestation, free from risk factors for infection (control group); and 59 women in 25th-41st week of gestation with risk factors for infection. Low vaginal swab for GBS isolation and identification on selective and enriched medium was obtained from each woman. GBS colonization was recorded in 29 (24.6%) women: 12 (20.3%) control and 17 (28.8%) women at risk of infection, yielding a statistically non-significant difference (Chi2 = 1.480489; p < 0.48). Early neonatal infection was observed in six (20.7%) neonates born to 29 mothers with GBS colonization, pointing to a correlation between vaginal GBS colonization and early neonatal infection (r(s) = 0.99). Early perinatal infection was found in 22 (18.6%) neonates, including 17 (28.8%) pregnancies with risk factors, pointing to a significant correlation between vaginal GBS colonization, risk factors and early perinatal infection (Chi2 = 88.68; p < 0.001); however, gestational age and pregnancy outcome were not influenced by GBS colonization. In eight (36.4%) newborns, early neonatal infection developed in spite of intrapartum administration of antibiotics; three of these children were born to GBS positive mothers, and perinatal GBS infection was demonstrated in one (0.84%) child. Study results revealed a relatively high rate of GBS colonization in the population of pregnant women in Croatia, occasionally leading to early neonatal infection. Large studies are needed to develop national strategy for the prevention of GBS infection in Croatia.     

Cystic and Non-Cystic Fibrosis <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis> Isolates are not Differentiated by the Quorum-Sensing Signaling and Biofilm Production

The capability for biofilm and quorum-sensing (QS) signaling production among Pseudomonas aeruginosa isolates were evaluated. A total of 231 isolates were recovered from sputa of cystic fibrosis (CF, n = 104) and non-CF (non-CF, n = 127) patients. One hundred ninety-seven (85.3%; 95% CI 80.1–89.3%) were biofilm producers and 157 (68%; 95% CI 61.7–73.6%) were weak QS-producing. No difference was observed between CF and non-CF isolates regarding the ability to produce biofilm and QS-signaling. Interestingly, the degree of QS production appears to be related to the degree of biofilm production. Thus, blocking QS pathways may be crucial in the prevention and treatment of biofilm-related infections.     

Freeze tolerance of soil chytrids from temperate climates in Australia

Very little is known about the capacity of soil chytrids to withstand freezing in the field. Tolerance to freezing was tested in 21 chytrids isolated from cropping and undisturbed soils in temperate Australia. Samples of thalli grown on peptone–yeast–glucose (PYG) agar were incubated for seven days at −15 °C. Recovery of growth after thawing and transferring to fresh medium at 20 °C indicated survival. All isolates in the Blastocladiales and Spizellomycetales survived freezing in all tests. All isolates in the Chytridiales also survived freezing in some tests. None of the isolates in the Rhizophydiales survived freezing in any of the tests. However, some isolates in the Rhizophydiales recovered growth after freezing if they were grown on PYG agar supplemented with either 1 % sodium chloride or 1 % glycerol prior to freezing. After freezing, the morphology of the thalli of all isolates was observed under LM. In those isolates that recovered growth after transfer to fresh media, mature zoosporangia were observed in the monocentric isolates and resistant sporangia or resting spores in the polycentric isolates. Encysted zoospores in some monocentric isolates also survived freezing. In some of the experiments the freezing and thawing process caused visible structural damage to the thalli. The production of zoospores after freezing and thawing was also used as an indicator of freeze tolerance. The chytrids in this study responded differently to freezing. These data add significantly to our limited knowledge of freeze tolerance in chytrids but leave many questions unanswered.     

Vaginal microbiota in healthy pregnant women and prenatal screening of group B streptococci (GBS)

The microbiota of the lower female genital tract was evaluated from vaginal swabs obtained from 623 healthy pregnant women at gestation periods of 35–40 weeks. Isolated and identified microorganisms were expressed as percentages of total samples. As expected, lactobacilli made up the dominant vaginal microbiota (70%). Enterobacteriaceae, mainly Escherichia coli, Klebsiella spp. and Proteus, were present in 38% of the samples, which might reflect the possible contamination of vaginal tract with rectal microorganisms. Candida albicans was present in 10% of healthy pregnant woman assayed. Streptoccocci (Streptococcus sp. and Enterococcus faecalis with 3% and 4%, respectively) and other gram-positive cocci (Staphylococcus sp., 5%), along with other microorgansisms such as Gardnerella vaginalis (5%) and Pseudomonas aeruginosa (2%) may represent a potential infection risk. Streptococcus agalactiae (group B streptococci β-hemolytic, GBS) was detected in 7% of the samples. GBS infection is a leading cause of neonatal morbidity and mortality in the developed world. Furthermore, GBS was often co-isolated with C. albicans (54.5%) in the samples. A complete and detailed evaluation of the vaginal biota swab, with particular attention to the presence of potential pathogens such as GBS, is a preventive strategy that can provide useful information to obstetricians and gynecologist in managing the last days of pregnancy and delivery. Electronic Publication     

Production of a potentially novel antimicrobial compound by a biofilm-forming marine Streptomyces sp. in a niche-mimic rotating disk bioreactor

After initial small-scale experiments, a 25.0 l rotating disk bioreactor (RDBR) was investigated for the cultivation of a biofilm-forming salt-tolerant Streptomyces sp. MS1/7, producing an antimicrobial compound. Peak activity attainment rate, PAAR (ratio of the peak antimicrobial activity, PAMA and the time taken to attain PAMA) was determined. Of the three pH values examined (8.0, 9.0 and 10.0) maximum PAAR (1.82 mm/h) was attained at pH 9.0. Three aeration rates (9.0, 6.0 and 3.0 l/min) were considered at three levels (25, 50 and 75%) of disk submergence. At the highest aeration rate and 50% submergence level, PAMA (41 mm), PAAR (1.86 mm/h) and biofilm density (BD, 0.91 g/ml) attained their highest values. At any given aeration rate, PAMA was always higher at 50% submergence level. This supports our earlier premise that ideal intertidal conditions, 12 h periods of immersion and emersion, promote maximum BD and antimicrobial production in the niche-mimic RDBR.     

Effect of relative humidity and origin of isolates of Neozygites tanajoae (Zygomycetes: Entomophthorales) on production of conidia from cassava green mite, Mononychellus tanajoa (Acari: Tetranychidae), cadavers

Neozygites tanajoae is a very specialized fungus pathogenic to the cassava green mite (CGM), Mononychellus tanajoa, an important cassava pest introduced to Africa from the Neotropics. Conidial discharge from cadavers of CGM that died from infections with 14 isolates of N. tanajoae collected from diverse climates of Brazil was quantified to help select potential candidate strains for introduction to Africa. Studies aimed to identify isolates with lower requirements for relative humidity for sporulation and isolates that discharged more conidia during short periods of moisture. At 96 ± 0.5% RH, production of conidia was variable and even isolates from the Brazilian semi-arid region, e.g., Petrolina and Itaberaba, produced few conidia. Significant differences in the numbers of conidia produced by diverse Brazilian isolates were observed after 6, 9 and 12 h at 100% RH. At 100% RH, production of primary conidia increased considerably from an average of 57 ± 4 conidia at 6 h to 509 ± 37 conidia at 12 h. The isolate sporulating least (BIN21) discharged only 45.7% of the number of conidia produced by isolate BIN1, one of the isolates producing the most spores. Results from this study demonstrate that differences in production of conidia among isolates should be considered when selecting Neozygites isolates for new biological control introductions.     

Investigating the effect of patulin,penicillic acid and EDTA on biofilm formation of isolates from dental unit water lines

This study investigated the effect of patulin and penicillic acid, two known quorum-sensing inhibitors, and the common biocide ethylenediaminetetraacetic acid (EDTA) on the biofilm formation and auto-inducer (AI)-2 production of three isolates from dental unit water lines, Klebsiella sp., Bacillus subtilis and Bacillus cereus. Penicillic acid on its own had no effect on the biofilm formation of all isolates, whereas in combination with EDTA, it enhanced biofilm formation significantly in Klebsiella sp. and B. cereus. EDTA at concentrations greater than 10 μM promoted biofilm formation in B. cereus and B. subtilis. Patulin was found to promote biofilm formation in B. cereus up to 25 μM. A significant increase in biofilm formation was observed in B. cereus and B. subtilis at concentrations greater than 10 μM of patulin when combined with EDTA. The Vibrio harveyi BB170 AI-2 bioassay showed a positive response for Klebsiella sp. AI-2 production with a maximum fold induction at the late exponential growth phase. Addition of glucose prolonged the AI-2 production phase considerably. No significant effect of patulin, penicillic acid alone as well as in combination with EDTA was observed on AI-2 production by Klebsiella sp. The findings have important implications for the design of biofilm prevention and eradication strategies. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Synergistic Effect Between Two Bacteriocin-like Inhibitory Substances Produced by Lactobacilli Strains with Inhibitory Activity for <Emphasis Type="Italic">Streptococcus agalactiae</Emphasis>

Group B streptococci (GBS) are bacterial species that colonize the vagina in pregnant women and as such may cause serious infections in neonates that passed through the birth channel. The objective of this work was to study the inhibitory activities produced by each bacteriocin-like inhibitory substance (BLIS) of Lactobacillus rhamnosus L60 and Lactobacillus fermentum L23, and the effects of the combined BLIS-es of these lactobacilli on GBS. The interactions between the BLIS-es were assessed by qualitative and quantitative methods on agar plates. The minimum inhibitory concentrations (MICs) and fractional inhibitory concentrations (FICs) were determined by a modification of the broth microdilution and checkerboard methods, respectively. Antibiotic susceptibilities of all S. agalactiae strains were assayed and the results of these tests were evaluated for statistical significance. A 7.5% of GBS isolates were recovered from 760 pregnant women and 91% of those strains were susceptible to each BLIS produced by L. fermentum, L. rhamnosus, and also to a mixture of them. The comparisons among the BLIS-es showed statistically significant differences, with a combination of the BLIS-es from the two Lactobacillus species being better than the BLIS of each one alone (P < 0.05) as GBS growth inhibitors. Synergistic activities between the BLIS-es were found on 100% of susceptible GBS strains, MICs ranges of BLIS of L23 and L60 were 80–160 and 160–320 UA ml⁻¹, respectively. By the checkerboard method, the BLIS-es combination showed synergistic effect on all sensitive strains tested, with values of FICs ranging from 0.131 to 0.218. The BLIS-es produced by these lactobacilli of vaginal origin were able to inhibit S. agalactiae isolates. The results indicate that these strains may have probiotic potential for the control of GBS in women and may consequently prevent GBS infections in newborns.     

妊娠妇女阴道微生态和B族链球菌与胎膜早破及母婴结局的相关性

探讨妊娠妇女阴道微生态状况和B族链球菌（GBS）感染与妊娠晚期胎膜早破及母婴结局的相关性。

回顾性收集2021年1月至2022年12月我院114例临床确诊足月胎膜早破妊娠妇女为研究对象（胎膜早破组）,随机选取同期分娩的129例健康妊娠妇女为对照组。收集两组对象临床资料,比较两组对象阴道微生态变化、GBS感染及不良母婴结局发生情况。

两组妊娠妇女阴道假丝酵母菌菌体及孢子检出情况比较差异均无统计学意义（均P＞0.05）。胎膜早破组患者阴道pH≥4.5、细菌性阴道病、需氧菌性阴道炎的发生率及微生态失衡率高于对照组（均P＜0.05）。胎膜早破组妊娠妇女绒毛膜羊膜炎、产褥感染、胎儿窘迫及新生儿肺炎等不良母婴结局发生率高于对照组（均P＜0.05）。单因素分析结果显示,阴道pH≥4.5、有GBS感染、阴道微生态失调与不良母婴结局有关（均P＜0.05）。

妊娠晚期阴道微生态失衡、GBS感染与妊娠晚期胎膜早破的发生相关,同时会增加不良母婴结局的发生率。加强相关危险因素的干预可降低妊娠晚期女性胎膜早破发生率,改善不良母婴结局。

     

A Novel Itraconazole Bioadhesive Film for Vaginal Delivery: Design, Optimization, and Physicodynamic Characterization

The purpose of this work was to design and optimize a novel vaginal drug delivery system for more effective treatment against vaginal candidiasis. Itraconazole was formulated in bioadhesive film formulations that could be retained in the vagina for prolonged intervals. The polymeric films were prepared by solvent evaporation and optimized for various physicodynamic and aesthetic properties. In addition, percentage drug retained on vaginal mucosa was evaluated using a simulated dynamic vaginal system as function of time. A polymeric film containing 100 mg itraconazole per unit (2.5 cm × 2.5 cm) have been developed using generally regarded as safe listed excipients. The pH of vaginal film was found to be slightly acidic (4.90 ± 0.04) in simulated vaginal fluid and alkaline (7.04 ± 0.07) in water. The little moisture content (7.66 ± 0.51% w/w) was present in the film, which helps them to remain stable and kept them from being completely dry and brittle. The mechanical properties, tensile strength, and percentage elongation at break (9.64 N/mm² and 67.56% for ITRF₆₅) reveal that the formulations were found to be soft and tough. The films (ITRF₆₅) contained solid dispersion of itraconazole (2.5)/hydroxypropyl cellulose (1)/polyethylene glycol 400 (0.5), which was found to be the optimal composition for a novel bioadhesive vaginal formulation, as they showed good peelability, relatively good swelling index, and moderate tensile strength and retained vaginal mucosa up to 8 h. Also, the film did not markedly affect normal vaginal flora (lactobacillus) and was noncytotoxic as indicated by the negligible decrease in cell viability.     

Characterization of biofilm formed by multidrug resistant Pseudomonas aeruginosa DC-17 isolated from dental caries

The present work reports with the screening of biofilm-producing bacteria from the dental caries. The dental pathogens showed resistance against various antibiotics and biofilm forming ability at various levels. Among the bacterial strain, Pseudomonas aeruginosa DC-17 showed enhanced biofilm production. Extracellular polymeric substance (EPS) was synthesized by the selected bacterial isolate considerably and contributed as the major component of biofilm. EPS composed of eDNA, proteins and lipids. The total protein content of the EPS was found to be 1.928 mg/mL and was the major component than carbohydrate and DNA. Carbohydrate content was 162.3 mg/L and DNA content of EPS was 4.95 μg/mL. These macromolecules interacted in the matrix to develop dynamic and specific interactions to signalling biofilm to differentiating various environments. Also, the isolated bacteria showed resistant against various commercially available antibiotics. The isolates showed more resistance against penicillin (98%) and were sensitive against amoxicillin. Among the factors, temperature, pH and sugar concentration influenced biofilm formation. Biofilm forming ability of the selected bacterial stain was tested at various pH values and alkaline pH was favoured for biofilm production. Biofilm production was found to be maximum at 40 °C and 8% sucrose enhanced biofilm formation. Biofilm formed by P. aeruginosa DC-17 was resistant against various tested antimicrobials and chemicals.     

生殖道GBS感染对妊娠晚期妇女阴道微生态环境及免疫因子的影响

探讨妊娠晚期生殖道B族溶血性链球菌（GBS）感染对阴道微生态环境及免疫因子的影响。

收集2021年7月至2022年7月本院76例GBS筛查阳性妊娠晚期妊娠妇女（GBS阳性组）,另选取同期GBS筛查阴性的76例妊娠晚期妊娠妇女（对照组）,比较2组阴道微生态情况、血清免疫炎症因子（IL-1β、IL-6）水平及妊娠结局;另根据阴道微生态评价结果将GBS阳性组妊娠妇女进一步分为微生态失调组（n=56）和微生态正常组（n=20）,比较2组妊娠结局。

GBS阳性组和对照组研究对象的阴道pH值、细菌性阴道病（BV）发生率、外阴阴道假丝酵母菌病（VVC）发生率、阴道菌群密集度、阴道菌群多样性及微生态失调发生率比较差异均有统计学意义（χ²=8.550、5.842、5.156、4.682、5.339、14.341,均P＜0.05）,2组研究对象滴虫性阴道炎发生率、阴道清洁度比较差异均无统计学意义（χ²=0.541、1.685,均P＞0.05）。GBS阳性组血清IL-1β、IL-6水平显著高于对照组（t=16.711、19.388,均P＜0.05）。GBS阳性组早产、产褥感染、胎儿窘迫及病理性黄疸发生率显著高于对照组（χ²=5.365、10.059、7.938、5.787,均P＜0.05）,2组研究对象胎膜早破、产后出血、新生儿窒息及新生儿肺炎发生率比较差异均无统计学意义（χ²=1.849、0.882、2.027、2.027,均P＞0.05）。微生态失调组胎膜早破、胎儿窘迫发生率显著高于微生态正常组（χ²=4.113、4.113,均P＜0.05）,2组研究对象早产、产褥感染、产后出血、新生儿窒息、病理性黄疸和新生儿肺炎发生率比较差异均无统计学意义（χ²=2.805、1.281、0.384、0.734、0.880、0.734,均P＞0.05）。

妊娠晚期GBS感染妊娠妇女易发生阴道微生态及炎症因子失调,增加不良妊娠结局发生风险。