GBS vaginorectal colonization in pregnant women at between 35 and 37 weeks of gestation
Keywords:
STREPTOCOCCAL INFECTIONS, INFECTIOUS COMPLICATIONS OF PREGNANCY, VERTICAL TRANSMISSION OF DISEASES
Abstract
Background: Group B streptococcus (GBS/EGB) is a cause of serious infections in neonates; intrapartum transmission in carrier women is vertical. Uruguayan data lack on information about GBS carriers. GBS detection carriage screen in all pregnant women at between 35 and 37 weeks of gestation allows intrapartum chemoprophylaxis, diminishing early neonatal infection by 60-80%.
Objective: To determine GBS colonization as well as vaginal and rectal cultures by direct inoculation onto Granada agar (GA) in a cohort of pregnant women attending a Health Centre in Montevideo.
Results: Out of 242 cases, 25.2% were positive. Rectal swabbing was the bacteriological sample of highest performance (86.8% of positives) but 13.1% of positives were negative at anorectal area and positive at vaginal area.
Conclusions: The studied cohort showed that 25% of pregnant women are GBS carriers at between 35 and 37 weeks of gestation. No differences were seen considering ages. Anorectal swabbing was the best bacteriological sample, but vaginal swabbing should not be avoided. GA culture has shown an excellent performance. Data confirmed the need to establish national recommendations for prevention, diagnose and treatment for GBS neonatal infection.
References
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29) Sociedad Española de Obstetricia y Ginecología, Sociedad Española de Neonatología. Recomendaciones para la prevención de la infección perinatal por estreptococo del grupo B. Prog Obstet Ginecol 1998; 41: 431-5.
30) National Institute for Clinical Exellence (NICE), National Collaborating Centre for Women’s and Childrens Health. New guideline for the NHS in England and Wales antenatal care for the pregnant women, 2003. Obtenido de: www.nice.org.uk/pdf/CG6_ANC_NICEguideline.pdf. (visto setiembre de 2005).
31) República Argentina. Ministerio de Salud de la Nación. Propuesta Normativa Perinatal. Atención de las patologías prevalentes perinatales. Buenos Aires: Ministerio de Salud, 1996. Obtenido de: http://www.msal.gov.ar/htm/Site/promin/ UCMISALUD/ publicaciones/publicaciones.htm (visto setiembre de 2005).
32) Comité Nacional de Infectología Pediátrica, Comité Nacional de Estudios Fetoneonatales (CEFEN). Consenso de infecciones perinatales. Arch Argent Pediatr 1999; 97(3) Obtenido de: http://www.sap.org.ar/index.php?option=com_ content &task=view&id=223& Itemid=257 (visto setiembre de 2005).
33) Dirección Nacional de Salud Materno Infantil. Recomendaciones para la prevención, diagnóstico y tratamiento de la infección neonatal precoz por Estreptococo ß Hemolítico del Grupo B (EGB).Buenos Aires, 2004. Obtenido de: http://www.msal.gov.ar/htm/Site/promin/UCMISALUD/publicaciones/ publicaciones.htm (visto setiembre de 2005).
2) Baker C, Edwards M. Group B streptococcal infections. In: Remignton J, Klein J, eds. Infectious diseases of the fetus and newborn infant. 4 ed. Philadelphia: WB Saunders, 1995; 980-1054.
3) Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B Streptococcal Disease: Revised guidelines from CDC. MMWR Recomm Rep 2002; 51(RR-11): 1-18.
4) Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep 1996; 45(RR-7): 1-24.
5) Boye KM, Gotoff SP. Prevention of early onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N Engl J Med 1986; 314(26): 1665-9.
6) Mohle-Boetani JC, Schuchat A, Plikaytis BD, Smith JD, Broome CV. Comparison of prevention strategies for neonatal group B streptococcal infection. A population-based economic analysis. JAMA 1993; 270(12): 1442-8.
7) Díaz de R. T, Nieves B, Vegas L. Colonización vaginorrectal por streptococcus del grupo B en mujeres embarazadas con complicaciones ginecoobstétricas. Rev Soc Ven Microbiol 2002; 22(1): 12-7.
8) Baker CJ, Goroff DK, Alpert S, Crockett VA, Zinner SH, Evrard JR, et al. Vaginal colonization with group B streptococcus: a study of college women. J Infect Dis 1977; 135(3): 392-7.
9) Bello O, Perotti E. Enfermedad invasiva por estreptococo del grupo B. Arch Pediatr Urug 2004; 75(3): 229-34.
10) de Cueto M, Sánchez MJ, Sampedro A, Miranda JA, Herruzo AJ, Rosa-Fraile M. Timing of intrapartum ampicillin and prevention of vertical transmission of group B streptococcus. Obstet Gynecol 1998; 91(1): 112-4.
11) de Cueto M, Sánchez MJ, Molto L, Miranda JA, Herruzo AJ, Ruiz-Bravo A. Efficacy of a universal screening program for the prevention of neonatal group B streptococcal disease. Eur J Clin Microbiol Infect Dis 1995; 14(9): 810-2.
12) WHO. Antenatal care randomized trial: manual for the implementation of de new model. Ginebra: WHO, 2001. (WHO/RHR/01.30)
13) Barillaro S, Monzo C, Negrin G, Brazeiro D. Prevalencia del estreptococo beta agalactiae en la población de embarazadas que consultan en la D.N.S.FF.AA. Salud Militar 2003; 25(1): 48-57.
14) De La Rosa M, Villareal R, Vega D, Miranda C, Martinezbrocal A. Granada medium for detection and identification of group B steptococci. J Clin Microbiol 1983; 18(4): 779-85.
15) Overman SB, Eley DD, Jacobs BE, Ribes JA. Evaluation of methods to increase the sensitivity and timeliness of detection of Streptococcus agalactiae in pregnant women.J Clin Microbiol 2002; 40(11): 4329-31.
16) De La Rosa M, Pérez M, Carazo C, Pareja L, Peis JI, Hernández F. New Granada Medium for detection and identification of group B streptococci. J Clin Microbiol 1992; 30(4): 1019-21.
17) Gil EG, Rodríguez MC, Bartolomé R, Berjano B, Cabero L, Andreu A. Evaluation of the Granada agar plate for detection of vaginal and rectal group B streptococci in pregnant women. J Clin Microbiol 1999; 37(8): 2648-51.
18) Rosa-Fraile M, Rodríguez-Granger J, Cueto-López M, Sampedro A, Gaye EB, Haro JM, et al. Use of Granada medium to detect group B streptococcal colonization in pregnant women. J Clin Microbiol 1999; 37(8): 2674-7.
19) Rolland C, Bailleux B, Biausque S, Fortín L. Evaluation of the Granada medium used for the determination of Streptococcus agalactiae at the eight month of pregnancy. Ann Biol Clin (Paris) 2003; 61(6): 705-8.
20) Kelly VN, Garland SM. Evaluation of new Granada medium (modified) for the antenatal screening of group B Streptococcus. Pathology 1994; 26(4): 487-9.
21) 21 Schuchat A, Wenger JD. Epidemiology of group B streptococcal disease. Risk factors, prevention strategies, and vaccine development. Epidemiol Rev 1994; 16(2): 374-402.
22) Regan JA, Klebanoff MA, Nugent RP. The epidemiology of group B streptococcal colonization in pregnancy. Vaginal Infections and Prematurity Study Group. Obstet Gynecol 1991; 77(4): 604-10.
23) Hager WD, Schuchat A, Gibbs R, Sweet R, Mead P, Larsen JW. Prevention of perinatal group B streptococcal infection: current controversies. Obstet Gynecol 2000; 96(1): 141-5.
24) Jaime WE, Edwards RK, Duff P. Vaginal-perianal compared with vaginal-rectal cultures for identification of group B streptococci. Obstet Gynecol 2004; 104(5): 1058-61.
25) Juncosa Morros T, Munoz Almagro C, Gene Giralt A, Fortea Busquests J, Latorre Otin C. Infecciones neonatales por Streptococcus agalactiae. An Esp Pediatr 1996; 45(2): 153-6.
26) Centers for Disease Control and Prevention (CDC). Decreasing incidence of perinatal Group B streptococcal disease-United States, 1993-1995. MMWR Morb Mortal Wkly Rep 1997; 46(21): 473-7.
27) Centers for Disease Control and Prevention (CDC). Adoption of hospital policies for prevention of perinatal group B streptococcal disease-United States, 1997. MMWR Morb Mortal Wkly Rep 1998; 47(32): 665-70.
28) Rosenstein NE, Schuchat A. Opportunities for prevention of perinatal group B streptococcal disease: a multistate surveillance analysis. The Neonatal Group B Streptococcal Disease Study Group. Obstet Gynecol 1997; 90(6): 901-6.
29) Sociedad Española de Obstetricia y Ginecología, Sociedad Española de Neonatología. Recomendaciones para la prevención de la infección perinatal por estreptococo del grupo B. Prog Obstet Ginecol 1998; 41: 431-5.
30) National Institute for Clinical Exellence (NICE), National Collaborating Centre for Women’s and Childrens Health. New guideline for the NHS in England and Wales antenatal care for the pregnant women, 2003. Obtenido de: www.nice.org.uk/pdf/CG6_ANC_NICEguideline.pdf. (visto setiembre de 2005).
31) República Argentina. Ministerio de Salud de la Nación. Propuesta Normativa Perinatal. Atención de las patologías prevalentes perinatales. Buenos Aires: Ministerio de Salud, 1996. Obtenido de: http://www.msal.gov.ar/htm/Site/promin/ UCMISALUD/ publicaciones/publicaciones.htm (visto setiembre de 2005).
32) Comité Nacional de Infectología Pediátrica, Comité Nacional de Estudios Fetoneonatales (CEFEN). Consenso de infecciones perinatales. Arch Argent Pediatr 1999; 97(3) Obtenido de: http://www.sap.org.ar/index.php?option=com_ content &task=view&id=223& Itemid=257 (visto setiembre de 2005).
33) Dirección Nacional de Salud Materno Infantil. Recomendaciones para la prevención, diagnóstico y tratamiento de la infección neonatal precoz por Estreptococo ß Hemolítico del Grupo B (EGB).Buenos Aires, 2004. Obtenido de: http://www.msal.gov.ar/htm/Site/promin/UCMISALUD/publicaciones/ publicaciones.htm (visto setiembre de 2005).
Published
2006-09-30
How to Cite
1.
Rivas C, Tallac I, Etchenique A. GBS vaginorectal colonization in pregnant women at between 35 and 37 weeks of gestation. Rev. Méd. Urug. [Internet]. 2006Sep.30 [cited 2024May17];22(3):191-6. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/692
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