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      Colonización vaginoanorrectal por Streptococcus del grupo B en mujeres embarazadas con complicaciones ginecoobstétricas. Translated title: Rectovaginal colonization by group B Streptococcus in pregnant women with gyno-obstetrics complications.


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          En el presente trabajo nos propusimos determinar los factores clínicos epidemiológicos y la frecuencia de colonización vaginoanorrectal por Streptococcus del grupo B (SGB) en mujeres embarazadas con complicaciones ginecoobstétricas que asistieron al Servicio de Emergencia Obstétrica del Instituto Autónomo Hospital Universitario de los Andes (IAHULA) durante el período abril-octubre de 2000. Se estudió a 60 mujeres embarazadas con complicaciones ginecoobstétricas, a quienes se les colectó muestra a partir de hisopados vaginoanorrectales y endocervicales, las cuales se cultivaron en agar sangre Columbia con ácido nalidíxico (15µg/ml) y gentamicina (8µg/ml). La identificación presuntiva se realizó mediante pruebas convencionales, y la identificación definitiva mediante la detección del antígeno especifico de pared celular de SGB (Slidex Strep B- Biomerieux). SGB se aisló en alta frecuencia (36,7%) del cultivo vaginoanorrectal proveniente de mujeres embarazadas con complicaciones ginecoobstétricas No se encontró asociación significativa entre la colonización por SGB y las características clínicas y epidemiológicas de las mujeres estudiadas. No obstante, dicho microorganismo se recuperó con mayor frecuencia de mujeres embarazadas con una edad promedio de 25,5 años, con bajo nivel educativo, que vivían con su pareja, no fumadoras y edad gestacional entre 35-36 semanas.

          Translated abstract

          The present work is an attempt to determine the clinical and epidemiological factors and the frequency of colonization by group B Streptococci (GBS) in pregnant women with gynecological and obstetric complications attended by the Emergency Obstetrics Service of the Instituto Autónomo Hospital Universitario de Los Andes (IAHULA) from April to October 2000. 60 women with gynecological and obstetric problems were included in the study and rectovaginal and endocervical swabs taken, were incubated in Columbia blood agar with nalidixic acid (15µg/ml) and gentamicin (8µg/ml). Standard tests gave an approximate identification, while definitive identification was based on the presence of GBS cell wall antigen (Slidex- Strepto B-BioMérieux). In the study period, GBS was isolated with a high degree of frequency (36.7%) in rectovaginal cultures from pregnant women with gynecological and obstetric complications. Nor was there any significant correlation between GBS colonization and the clinical and epidemiological features of the women in the study, although GBS was recovered with greater frequency from pregnant women with an average age of 25.5, low level of education, living with a partner, non-smoker and in the 35 - 36 week of pregnancy.

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          Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis.

          Group B streptococcal infections are a leading cause of neonatal mortality, and they also affect pregnant women and the elderly. Many cases of the disease in newborns can be prevented by the administration of prophylactic intrapartum antibiotics. In the 1990s, prevention efforts increased. In 1996, consensus guidelines recommended use of either a risk-based or a screening-based approach to identify candidates for intrapartum antibiotics. To assess the effects of the preventive efforts, we analyzed trends in the incidence of group B streptococcal disease from 1993 to 1998. Active, population-based surveillance was conducted in selected counties of eight states. A case was defined by the isolation of group B streptococci from a normally sterile site. Census and live-birth data were used to calculate the race-specific incidence of disease; national projections were adjusted for race. Disease in infants less than seven days old accounted for 20 percent of all 7867 group B streptococcal infections. The incidence of early-onset neonatal infections decreased by 65 percent, from 1.7 per 1000 live births in 1993 to 0.6 per 1000 in 1998. The excess incidence of early-onset disease in black infants, as compared with white infants, decreased by 75 percent. Projecting our findings to the entire United States, we estimate that 3900 early-onset infections and 200 neonatal deaths were prevented in 1998 by the use of intrapartum antibiotics. Among pregnant girls and women, the incidence of invasive group B streptococcal disease declined by 21 percent. The incidence among nonpregnant adults did not decline. Over a six-year period, there has been a substantial decline in the incidence of group B streptococcal disease in newborns, including a major reduction in the excess incidence of these infections in black infants. These improvements coincide with the efforts to prevent perinatal disease by the wider use of prophylactic intrapartum antibiotics.
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            Prevention of perinatal group B streptococcal disease. A public health perspective

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              Peripartum infection associated with vaginal group B streptococcal colonization.

              To determine the frequency of peripartum infection in parturients colonized with group B streptococci. We screened 915 obstetric patients for group B streptococcal colonization using selective broth media; 823 had vaginal cultures performed within 2 weeks preceding delivery and received complete follow-up. Vaginal group B streptococcal colonization and other risk factors for peripartum maternal infection were assessed using univariate and multivariate logistic modeling. Two hundred sixteen women (26%, 95% confidence interval [CI] 23-29) were colonized with group B streptococci. Chorioamnionitis or endometritis occurred in 45 of 216 colonized women (21%, 95% CI 15.6-26.4) and 72 of 607 women who were not colonized (12%, 95% CI 9-15; P < .01). When confounding variables were controlled in a multivariate analysis, the association between group B streptococcal colonization and chorioamnionitis, but not endometritis, was confirmed (odds ratio 3.6, 95% CI 2.1-6.2). The risk of chorioamnionitis increased in a stepwise fashion with light (odds ratio 1.9, 95% CI 1.0-3.7), moderate (odds ratio 2.6, 95% CI 1.3-5.2), and heavy (odds ratio 3.2, 95% CI 1.5-6.6) colonization. Intrapartum vaginal colonization with group B streptococci is an important independent risk factor for chorioamnionitis.

                Author and article information

                Revista de la Sociedad Venezolana de Microbiología
                Rev. Soc. Ven. Microbiol.
                Organo Oficial de la Sociedad Venezolana de Microbiología. (Caracas, DF, Venezuela )
                January 2002
                : 22
                : 1
                : 12-17
                [01] Mérida orgnameUniversidad de Los Andes orgdiv1Laboratorio de Bacteriologia Dr. Roberto Gabaldon orgdiv2Facultad de Farmacia Venezuela
                [02] Mérida orgnameInstituto Autonomo Hospital Universitario de Los Andes orgdiv1Departamento de Obstetricia y Ginecologia Venezuela
                S1315-25562002000100004 S1315-2556(02)02200104


                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 6

                SciELO Venezuela

                Investigaciones Originales y Otras Modalidades de Publicación

                colonización,embarazadas,complicaciones ginecoobstétricas,Streptococcus grupo B


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