OJOG  Vol.5 No.14 , December 2015
Ritual Immersion in a Mikveh Is Associated with Increased Risk of Group B Streptococcal Carrier State in Israeli Parturient Women
ABSTRACT
Purpose: Group B Streptococcus (GBS) infection is a major cause of neonatal sepsis. The objective of this study was to estimate the prevalence and risk factors for GBS carriership among parturient women in Jerusalem. Methods: A cross-sectional study of 436 parturient Jewish women at Hadassah-Hebrew University Medical Center, Mount Scopus. The study included patient interview and vagino-rectal swab for culture. Main outcome measures were the prevalence of GBS carriership among study population. Results: Of the 436 participants, 77 had a positive culture for GBS, giving a carrier rate of 17.7%. No differences were found between carriers and non-carriers in age, BMI or parity. Orthodox Jewish women had a significantly higher carrier rate compared with secular Jewish women (20.6% vs. 12.8% respectively), yielding an age, education and BMI adjusted odds ratio (OR) of 1.9 (95% confidence interval (CI): 1.06 - 3.40). Similarly, ritual immersion was associated with increased risk of carrier state with an adjusted OR of 2.01 (95% CI: 1.03 - 3.92, P = 0.039). Conclusions: Our study suggests an association between ritual immersion in the Mikveh and GBS carriership.

Cite this paper
Drai-Hasid, R. , Calderon-Margalit, R. , Lev-Sagie, A. , Avital, G. , Block, C. , Moses, A. and Hochner-Celnikier, D. (2015) Ritual Immersion in a Mikveh Is Associated with Increased Risk of Group B Streptococcal Carrier State in Israeli Parturient Women. Open Journal of Obstetrics and Gynecology, 5, 769-774. doi: 10.4236/ojog.2015.514108.
References
[1]   Centers for Disease Control and Prevention (1996) Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective. MMWR Recommendations and Reports, 45, 1-24.

[2]   Verani, J.R., Mccee, L. and Schrag, S.J. (2010) Prevention of Perinatal Group B Streptococcal Disease—Revised Guidelines from CDC. MMWR Recommendations and Reports, 59, 1-32.

[3]   From the Centers for Disease Control (2002) Revision of Guidelines for the Prevention of Perinatal Group B Streptococcal Disease. JAMA, 287, 1106-1107.
http://dx.doi.org/10.1001/jama.287.9.1106-JWR0306-2-1

[4]   Eidelman, A.I., Rudensky, B., Ferne, M., Weintraub, G. and Isacshon, M. (1983) Epidemiology of Group B Streptococci in an Israeli Hospital. Israel Journal of Medical Sciences, 19, 903-905.

[5]   Eidelman, A.I., Rudensky, B., Turgeman, D., Nubani, N., Schimmel, M.S. and Isacsohn, M. (1990) Epidemiology of Group B Streptococci Colonization and Disease in Mothers and Infants: Update of Ongoing 10-Year Jerusalem Study. Israel Journal of Medical Sciences, 26, 71-73.

[6]   Eisenberg, V.H., Raveh, D., Meislish, Y., Rudensky, B., Ezra, Y., Samueloff, A., et al. (2006) Prevention of Early-Onset Neonatal Group B Streptococcal Infection: Is Universal Screening by Culture Universally Applicable? The Israel Medical Association Journal, 8, 698-702.

[7]   German, L., Solt, I., Bornstein, J., Ben-Harush, S., Ben-Elishai, M. and Weintraub, Z. (2006) Is There an Increase in the Incidence of GBS Carrier Rates among Pregnant Women in Northern Israel? Harefuah, 145, 866-869, 944.

[8]   Schimmel, M.S., Eidelman, A.I., Rudensky, B., et al. (1994) Epidemiology of Group B Streptococcal Colonization and Infection in Jerusalem, 1989-91. Israel Journal of Medical Sciences, 30, 349-351.

[9]   Adler, A., Block, C., Engelstein, D., Hochner-Celnikier, D., Drai-Hassid, R. and Moses, A.E. (2008) Culture-Based Methods for Detection and Identification of Streptococcus agalactiae in Pregnant Women—What Are We Missing? European Journal of Clinical Microbiology & Infectious Diseases, 27, 241-243.
http://dx.doi.org/10.1007/s10096-007-0421-2

[10]   Centers for Disease Control and Prevention (2002) Prevention of Perinatal Group B Streptococcal Disease. Revised Guidelines from CDC. MMWR Recommendations and Reports, 51, 1-22.

[11]   Barcaite, E., Bartusevicius, A., Tameliene, R., Kliucinskas, M., Maleckiene, L. and Nadisauskiene, R. (2008) Prevalence of Maternal Group B Streptococcal Colonisation in European Countries. Acta Obstetricia et Gynecologica Scandinavica, 87, 260-271.
http://dx.doi.org/10.1080/00016340801908759

[12]   Le Doare, K. and Heath, P.T. (2013) An Overview of Global GBS Epidemiology. Vaccine, 31, D7-D12.
http://dx.doi.org/10.1016/j.vaccine.2013.01.009

[13]   Meyn, L.A., Moore, D.M., Hillier, S.L. and Krohn, M.A. (2002) Association of Sexual Activity with Colonization and Vaginal Acquisition of Group B Streptococcus in Nonpregnant Women. American Journal of Epidemiology, 155, 949-957.
http://dx.doi.org/10.1093/aje/155.10.949

[14]   Zanetti-Dallenbach, R., Lapaire, O., Maertens, A., Frei, R., Holzgreve, W. and Hosli, I. (2006) Water Birth: Is the Water an Additional Reservoir for Group B Streptococcus? Archives of Gynecology and Obstetrics, 273, 236-238.
http://dx.doi.org/10.1007/s00404-005-0067-1

[15]   Hoogkamp-Korstanje, J.A., Gerards, L.J. and Cats, B.P. (1982) Maternal Carriage and Neonatal Acquisition of Group B Streptococci. The Journal of Infectious Diseases, 145, 800-803.
http://dx.doi.org/10.1093/infdis/145.6.800

 
 
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