Virtual Poster 21st Lancefield International Symposium for Streptococci and Streptococcal Diseases 2022

Streptococcus Viridans isolated from blood cultures in Ugandan infants in 2021 : an update from the PROGRESS study (#411)

Lauren Hookham 1 , Amusa Wamawobe 2 , Hannah Davies 1 , Mary Kyohere 3 , Valerie Tusubira 3 , Musa Sekikubo 4 , Phillipa Musoke 5 , Kirsty Le Doare 1
  1. st george's university at MU-JHU, Kampala, [SELECT STATE], Uganda
  2. Clinical Microbiology Laboratory, Makere University , Kampala, Uganda
  3. MU-JHU research collaboration / MUJHU Care Ltd, Kampala, Uganda
  4. Obstetrics and Gynaecology , Makerere University, College of Health Sciences & MUJHU Care Ltd , Kampala, Uganda
  5. Paediatrics and Child Health , Makerere University, College of Health Sciences, Kampala , Uganda

Introduction: Every year roughly 2 million babies are stillborn and 2.4 million children die within the first month of life; the majority occurring in Low- and Middle-Income countries, with infection being an important driver.

Methods: Between January 1st 2021 and 31st December 2021 women enrolled in the PROGRESS study (https://www.gbsatstgeorges.co.uk) who had a stillbirth at delivery were approached by study staff and a heart blood aspirate sample for blood culture was taken. Over the same time period infants 0-90 days of life admitted with signs of sepsis had a blood culture collected. Blood cultures were incubated for five days in a BD BactecTM machine with monitoring after every 24hrs. Gram stain was undertaken on all presumptive positive cultures. Blood agar plates were read after 18-24hrs for growth with final confirmation by biochemical tests.

Results: In 2021 a total of 2135 blood cultures were taken. 86% (n=1835) were obtained with neonates with signs of sepsis and 14% (n=300) were obtained from heart blood aspirates. 30.3% (n=91) heart blood aspirates were positive, with 56% of specimens (n=50) isolating organisms considered likely to be pathogens. In 20% of cases (n=10) the organism was confirmed to be a viridans group Streptococcus. This was the second most common organism isolated after Enterococcus spp in heart blood aspirates. In the active surveillance cohort 2.8% (n=52) isolated pathogenic organisms, of which 7.7% (n=4) were viridans group Streptococci.

Conclusions: Our results indicate a potential role for Streptococcus viridans as a common causative agent in the aetiology of neonatal sepsis and of stillbirths in Ugandan infants.