Streptococcus agalactiae en embarazadas: Prevalencia en el Hospital Nacional Alejandro Posadas  <span class="so-article-trans-title" dir="auto"> Translated title: Streptococcus agalactiae in pregnant women: Prevalence at the Posadas Hospital </span>

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Abstract

Streptococcus agalactiae (estreptococo grupo B de Lancefield) es el microorganismo más frecuentemente involucrado en infección neonatal por transmisión vertical madre-feto. También es responsable de infecciones en mujeres embarazadas y adultos con enfermedades de base. El objetivo de este trabajo fue conocer la prevalencia de portación de S. agalactiae en mujeres embarazadas que concurrieron al Hospital Posadas y determinar la sensibilidad a penicilina, eritromicina y clindamicina de los aislamientos. De las 1203 gestantes estudiadas, se aisló S. agalactiae en 113 muestras, con una prevalencia de 9,39%. Se realizaron las pruebas de sensibilidad a 87 de los 113 aislamientos. Todos ellos resultaron sensibles a penicilina y únicamente 2 cepas fueron resistentes a eritromicina y clindamicina (mecanismo MLS constitutivo). Resaltamos la importancia de conocer la resistencia a estos dos últimos agentes, en el caso de mujeres alérgicas a los antibióticos beta-lactámicos.

Translated abstract

Streptococcus agalactiae (Lancefield group B Streptococcus), is the most frequently microorganism involved in neonatal infections through the mother-fetus vertical transmission. It is also responsible for infections in pregnant women, and adults with underlying diseases. The objective of this work was to know the S. agalactiae carrier prevalence in pregnant women who attended to Posadas Hospital, and to study the susceptibility pattern of the isolates to penicillin, erythromycin and clindamycin. From 1203 pregnant women studied, S. agalactiae was recovered in 113, which means a prevalence of 9.39%. Antimicrobial susceptibility was tested to 87 isolates. All of them were susceptible to penicillin, and only 2 isolates were resistant to erythromycin and clindamycin (constitutive MLS mechanism). We emphasize the importance of knowing these last resistance, in the case of beta-lactam antibiotics allergic women.

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Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC.

Stephanie J. Schrag, Rachel Gorwitz, Kristi Fultz-Butts … (2002)

Group B streptococcus (GBS) remains a leading cause of serious neonatal infection despite great progress in perinatal GBS disease prevention in the 1990s. In 1996, CDC, in collaboration with other agencies, published guidelines for the prevention of perinatal group B streptococcal disease (CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45[RR-7]:1-24). Data collected after the issuance of the 1996 guidelines prompted reevaluation of prevention strategies at a meeting of clinical and public health representatives in November 2001. This report replaces CDC's 1996 guidelines. The recommendations are based on available evidence and expert opinion where sufficient evidence was lacking. Although many of the recommendations in the 2002 guidelines are the same as those in 1996, they include some key changes: * Recommendation of universal prenatal screening for vaginal and rectal GBS colonization of all pregnant women at 35-37 weeks' gestation, based on recent documentation in a large retrospective cohort study of a strong protective effect of this culture-based screening strategy relative to the risk-based strategy * Updated prophylaxis regimens for women with penicillin allergy * Detailed instruction on prenatal specimen collection and expanded methods of GBS culture processing, including instructions on antimicrobial susceptibility testing * Recommendation against routine intrapartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries who have not begun labor or had rupture of membranes * A suggested algorithm for management of patients with threatened preterm delivery * An updated algorithm for management of newborns exposed to intrapartum antibiotic prophylaxis Although universal screening for GBS colonization is anticipated to result in further reductions in the burden of GBS disease, the need to monitor for potential adverse consequences of intrapartum antibiotic use, such as emergence of bacterial antimicrobial resistance or increased incidence or severity of non-GBS neonatal pathogens, continues, and intrapartum antibiotics are still viewed as an interim strategy until GBS vaccines achieve licensure.

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Escherichia coli O157:H7: clinical, diagnostic, and epidemiological aspects of human infection.

P Tarr (1994)

E. coli O157:H7 is one of many E. coli organisms that contain genes encoding one or more toxins similar in structure and function to Shiga toxin. E. coli O157:H7 is the most frequently isolated diarrheagenic type of E. coli isolated in North America today; this pathogen can cause serious, even fatal disease. Syndromes caused by E. coli O157:H7 include diarrhea, hemorrhagic colitis, and HUS. Poorly cooked ground beef has been the most frequently implicated vehicle of transmission, but additional vehicles are being identified. Treatment consists of rehydration during hemorrhagic colitis and support of the patient during the multiple systemic complications of HUS. A policy of routine screening for E. coli O157:H7 in clinical microbiology laboratories, without reliance on the physician to request that this organism be sought or the technician to notice blood in the stool, is the most effective way to find cases. Timely and accurate diagnosis can prevent secondary transmission, avert unnecessary and possibly dangerous procedures and/or therapies, and detect continuing outbreaks. SLTEC strains other than E. coli O157:H7 may cause diseases similar to or less severe than those caused by E. coli O157:H7. At present, however, screening for such pathogens in clinical laboratories is too labor-intensive to be practical. Education and legislation should promote safe food-preparation and food-handling practices. Research should be directed at reducing the carriage of E. coli O157:H7 at its bovine source, minimizing the microbial content of food and water, and averting systemic microangiopathic hemolytic anemia after infection with this pathogen.

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Group B streptococcal disease in nonpregnant adults.

Monica Farley (2001)

Group B streptococcal (GBS) disease in nonpregnant adults is increasing, particularly in elderly persons and those with significant underlying diseases. Diabetes, neurological impairment, and cirrhosis increase risk for invasive GBS disease. Skin, soft-tissue, and osteoarticular infections, pneumonia, and urosepsis are common presentations. Meningitis and endocarditis are less common but associated with serious morbidity and mortality. Disease is frequently nosocomial and may be related to the placement of an iv catheter. Recurrent infection occurs in 4.3% of survivors. Capsular serotypes Ia, III, and V account for the majority of disease in nonpregnant adults. Although group B streptococci are susceptible to penicillin, minimum inhibitory concentrations are 4-fold to 8-fold higher than for group A streptococci. Resistance to erythromycin and clindamycin is increasing. The role of antibodies in protection against GBS disease in nonpregnant adults is unresolved. However, the immunogenicity of GBS vaccines being developed for prevention of neonatal disease should be assessed for adults who are at risk.

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Author and article information

Journal

Journal ID (publisher-id): ram

Title: Revista argentina de microbiología

Abbreviated Title: Rev. argent. microbiol.

Publisher: Asociación Argentina de Microbiología (Ciudad Autónoma de Buenos Aires, , Argentina )

ISSN (Print): 0325-7541

ISSN (Electronic): 1851-7617

Publication date (Print and electronic): September 2005

Volume: 37

Issue: 3

Pages: 142-144

Affiliations

[01] orgnameServicio de Bioquímica orgdiv1Sección Bioquímica Microbiológica

[02] El Palomar Pcia. de Buenos Aires orgnameHospital Nacional Profesor A. Posadas orgdiv1Servicio de Neonatología Argentina sudiba@ 123456ciudad.com.ar

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Publisher ID: S0325-75412005000300007 Publisher ID: S0325-7541(05)03700300007

SO-VID: 5e45fdb1-ec44-49c2-a629-e9509b711e48

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

History

Date received : 25 October 2004

Date accepted : 12 September 2005

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Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 3

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Streptococcus agalactiae en embarazadas: Prevalencia en el Hospital Nacional Alejandro Posadas Translated title: Streptococcus agalactiae in pregnant women: Prevalence at the Posadas Hospital

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SciELO Argentina

Most cited references 24

Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC.

Escherichia coli O157:H7: clinical, diagnostic, and epidemiological aspects of human infection.

Group B streptococcal disease in nonpregnant adults.

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