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Identifier

000438380

Title

Αποικισμός εγκύων και νεογνών από Streptococcus ομάδας Β : επίπτωση και παράγοντες κινδύνου

Alternative Title

Group B Streptococcus colonization in pregnant women and neonates

Author

Βαρδάκη, Καλλιόπη

Thesis advisor

Χατζηδάκη, Ελευθερία

Reviewer

Γαλανάκης, Εμμανουήλ
Γκέντζη, Δέσποινα

Abstract

Background: Group B streptococcus (GBS) is an opportunistic commensal, part of the intestinal and vaginal physiologic flora, that converts to a major bacterial pathogen causing invasive infections. Since 1970s GBS has been a leading cause of serious neonatal infections, while maternal colonization seems to be the main risk factor for early GBS neonatal disease. The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36+0 and 37+6 weeks of gestation. All women whose vaginal–rectal cultures are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis, unless a prelabor cesarean birth is performed in the setting of intact membranes. Antibiotic prophylaxis should receive, as well, those with GBS bacteriuria, gestational age less than 37 weeks, prolonged rupture of membranes or a previous newborn affected by GBS early disease. GBS rates and prevention strategies vary considerably worldwide and data in Greece are scarce. The aim of this study was to determine GBS colonization rate and estimate the effectiveness of prevention strategies in our region. Methods: All pregnant women and newborns in Crete’s two major hospitals from 1/1/2015 to 31/12/2019 were retrospectively included in the study. GBS colonization by vaginal cultures was evaluated and potential risk factors (age, nationality, residence area, multiparity, comorbidities, visits, gestational age when culture performed, mode of delivery) were recorded. The rates of antibiotic prophylaxis and neonatal disease were, also, assessed. Results: A total of 7,362 pregnant women was reviewed, 4,984 (67.7%) underwent screening and 83 (1.7%) were colonized by GBS. Most of GBS(+) women (34.9%) were 31-35 years old, 45.8% were examined early in gestation (<35th week) and only 9.6% appeared to have comorbidities (diabetes, hypertension). Multiparity (³2) was associated with colonization in 66.3%, whereas other factors were not determinant. All GBS(+) women were given peripartum prophylaxis and none of their newborns developed disease. Nevertheless, from the rest of hospitalized neonatal population, 3 developed early and 1 late-onset disease. Conclusions: GBS colonization in our area is among the lowest reported. Peripartum antibiotic prophylaxis seems to sufficiently prevent transmission, but there is still morbidity. Thus, not only better compliance to recommendations, but also more effective prevention strategies, including maternal vaccination, are needed.

Language

Greek

Subject

GBS neonatal disease

GBS αποικισμός

GBS νεογνική νόσος

Intrapartum prophylaxis

Issue date

2021-03-29

Collection

School/Department--School of Medicine--Department of Medicine--Post-graduate theses

Type of Work--Post-graduate theses