Group B streptococcal infection of the genitourinary tract in pregnant and non‐pregnant patients with diabetes mellitus: An immunocompromised host or something more?

• Published in: American journal of reproductive immunology (1989) 2021-12, Vol.86 (6), p.e13501-n/a
• Main Authors: Nguyen, Lynsa M., Omage, Joel I., Noble, Kristen, McNew, Kelsey L., Moore, Daniel J., Aronoff, David M., Doster, Ryan S.
• Format: Article
• Language: English
• Subjects: Chorioamnionitis; Chronic illnesses; Diabetes; Diabetes mellitus; Epidemiology; Female; Gastrointestinal tract; Genitourinary tract; Group B Streptococcus; Humans; Hyperglycemia; Immunocompromised Host; Microbiota; neonatal sepsis; Neonates; Pregnancy; Pregnancy Complications, Infectious - immunology; Pregnancy in Diabetics - immunology; Sepsis; Streptococcal Infections - immunology; Streptococcus; Streptococcus agalactiae; Streptococcus infections; Urinary tract; Urinary tract diseases; urinary tract infection; Urinary tract infections; Urogenital system; vaginal colonization
• ISSN: 1046-7408; 1600-0897; 1600-0897
• DOI: 10.1111/aji.13501

Group B Streptococcus (GBS), also known as Streptococcus agalactiae is a Gram‐positive bacterium commonly encountered as part of the microbiota within the human gastrointestinal tract. A common cause of infections during pregnancy, GBS is responsible for invasive diseases ranging from urinary tract infections to chorioamnionitis and neonatal sepsis. Diabetes mellitus (DM) is a chronic disease resulting from impaired regulation of blood glucose levels. The incidence of DM has steadily increased worldwide to affecting over 450 million people. Poorly controlled DM is associated with multiple health comorbidities including an increased risk for infection. Epidemiologic studies have clearly demonstrated that DM correlates with an increased risk for invasive GBS infections, including skin and soft tissue infections and sepsis in non‐pregnant adults. However, the impact of DM on risk for invasive GBS urogenital infections, particularly during the already vulnerable time of pregnancy, is less clear. We review the evolving epidemiology, immunology, and pathophysiology of GBS urogenital infections including rectovaginal colonization during pregnancy, neonatal infections of infants exposed to DM in utero, and urinary tract infections in pregnant and non‐pregnant adults in the context of DM and highlight in vitro studies examining why DM might increase risk for GBS urogenital infection.