title: Maternal β-hemolytic streptococcal pharyngeal exposure and colonization in pregnancy.
abstract: OBJECTIVE
  To report the pharyngeal colonization rate of β-hemolytic streptococci and changes in the value of antistreptolysin O (ASO) and anti-DNase B serology titers during pregnancy.
  
  
  METHODS
  Healthy pregnant women were recruited and blood was drawn in each trimester. The upper limit of normal (ULN) values for ASO and anti-DNase B was calculated for each trimester. Throat swabs were collected for culture and positive cultures were further assessed for the identification of serogroup of the isolated β-hemolytic streptococcus.
  
  
  RESULTS
  Out of a total of 126 pregnant women, 34.1% had positive throat cultures. Group C and group G strains were isolated in 18.2% of throat cultures while group F was detected in 13.5% of cases. The rate of colonization with GAS was 1.6%. There was an overall drop in ASO titer during pregnancy while anti-DNase B titers remained relatively unchanged. ULN values of 164(IU), 157(IU), and 156(IU) were calculated for ASO at the first, second, and third trimesters, respectively. Based on the ULN values, 28.6% of patients had recent streptococcal exposure.
  
  
  CONCLUSIONS
  These results show that pregnant women act as a reservoir for spreading potentially immunogenic (groups C and G) and disease producing (group F) virulent strains of streptococci.
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Giv
authors.identifier: 0000-0001-5631-0399
authors.initials: G
authors.lastname: Heidari-Bateni
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Anoop K
authors.initials: AK
authors.lastname: Brar
authors.affiliation: Children's Hospital Association, 6803 West 64th Street, Overland Park, KS 66202, USA.
authors.forename: Matthew
authors.identifier: 0000-0001-7778-5887
authors.initials: M
authors.lastname: Hall
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Trupti
authors.initials: T
authors.lastname: Hathcock
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Deirdre
authors.identifier: 0000-0001-9132-4278
authors.initials: D
authors.lastname: Epstein
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Lisa S
authors.identifier: 0000-0003-2170-2338
authors.initials: LS
authors.lastname: Goessling
authors.affiliation: Department of Microbiology and Immunology, The University of Oklahoma Health Sciences Center, 940 Stanton L. Young Boulevard, BMSB 1053, Oklahoma City, OK 73104, USA.
authors.forename: Madeleine W
authors.initials: MW
authors.lastname: Cunningham
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Pirooz
authors.initials: P
authors.lastname: Eghtesady
mesh_terms: D000328:Adult; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D010612:Pharyngitis / Q000453:epidemiology / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000382:microbiology*; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D014481:United States / Q000453:epidemiology; D055815:Young Adult