EVALUATION OF VIRULENCE GENES (ICA AND FNB) ASSOCIATED WITH PRETERM LABOUR IN TERTIARY HOSPITALS, BAYELSA STATE, NIGERIA

Background: Preterm Labour is when the uterus starts contracting regularly and the cervix begins to thin and open before it reaches 37 weeks of gestation. Preterm labour is caused by a Gram-positive bacterium, Group B Streptococcus (GBS), also known as Streptococcus agalactiae, which is one of the main causes of newborn infections, especially sepsis and meningitis.
Aim: The study aimed at evaluating virulence genes (ica and Fnb) associated with preterm labour in Tertiary Hospitals, Yenagoa, Bayelsa State, Nigeria. A total of 168 high vaginal swabs, of which 60(35.7%) 26(15.5%) and 82(48.8) were from Family Support Program Clinics (FSP), Federal Medical Centre Yenagoa (FMCY), Diete Koki Memorial Hospital (DKMH), respectively. The samples were aseptically cultured on agar plates and incubated at 37OC for 18-24hrs, using Microbiological standard procedures for the purpose of isolating pathogenic microbes responsible for preterm labour. Virulence genes such as (fnba and biofilm gene) were detected using molecular methods. Associations were assessed using chi-square tests at p ≤ 0.05.
Results: The various bacteria isolated were Staphylococcus aureus 21(18.3%), Streptococcus sp 2(1.7%), Bacillus sp (5(4.3%), Coagulase negative staph 1(0.9%), Escherichia coli 11(9.6%), and a fungus Candida sp 75(65.2%). However, FSP recorded a total of 28(68.2%) microbial isolates, FMCY 12(60.0%) microbial isolates and D KMH 35(64.8%) microbial isolates. Participants between 15–35 years, were in early third trimester (28–33 weeks) and were of low parity. Candida spp. was the predominant isolate across all institutions, age groups, gestational ages, parity levels, and behavioral practices, followed by Staphylococcus aureus and Escherichia coli. Microbial isolation clustered mainly at 28–33 weeks gestation. Low-parity women accounted for most infections. Vaginal douching and sex toy use were associated with altered microbial patterns, particularly increased Candida colonization and selective recovery of less common opportunistic pathogens, although most associations with age were not statistically significant.
Conclusion: Pathogenic microbes, amongst participants between 15–35 years, has overpowered the genital tract of pregnant women, hereby causing an infection. Health education and the strengthening of antimicrobial stewardship, should be encouraged to reduce infection-related preterm labour and improve maternal and neonatal outcomes.