Cieľ štúdie: Vyhodnotiť efektivitu skríningu a profylaxie streptokokov skupiny B (GBS). Typ štúdie: Retrospektívna štúdia. Názov a sídlo pracoviska: Gynekologicko-pôrodnícka klinika, Jesseniova lekárska fakulta, Univerzita Komenského, Martin, Slovenská republika. Metodika: Skupiny rodičiek: A – GBS negatívne (n=601), B – GBS pozitívne (n=166) a C – neznámy GBS status (n=238). Výsledky: Vyhodnotili sme 1005 pôrodov, antenatálny skríning bol vykonaný u 767 rodičiek (166 GBS pozitívnych). Intrapartálna antibiotická profylaxia (IAP) bola najčastejšie podaná v skupine B (75,3 %), (A – 10,0 %, C – 15,0 %). Najčastejšie podávané antibiotiká: ampicilín a cefalosporíny 1. a 2. generácie. Časový interval od odtoku plodovej vody po podanie prvej dávky IAP bol signifikantne najkratší v skupine B. Najdlhší interval od odtoku plodovej vody po pôrod bol v skupine A (490 min.). Záver: Štúdia poukazuje na možnosti zlepšenia prevencie GBS sepsy, najmä u rodičiek s nejasným GBS statusom a pri predčasnom pôrode.
Objective: Assessment of screening and prophylaxis of streptococci group B (GBS). Design: Retrospective study. Setting: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. Methods: Groups of patients: A–GBS negative (n=601), B–GBS positive (n=166), and C–unknown GBS status (n=238). Results: We assessed 1005 deliveries; antenatal screening was done in 767 patients (166 GBS positive). Intrapartal antibiotic prophylaxis (IAP) was the most frequent in group B (75.3%), (A–10.0%, C–15.0%). The most common antibiotics: ampicillin, and cephalosporins of the 1st and 2nd generation. The interval from rupture of membranes (ROM) to the first IAP dose was significantly the shortest in group B. The longest interval from ROM to delivery was in group A (490 min.). Conclusion: This study shows the possibilities for improvement in GBS prophylaxis, in unknown GBS status, and preterm delivery, particularly.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- infekční komplikace v těhotenství diagnóza farmakoterapie MeSH
- lidé MeSH
- novorozenec MeSH
- Streptococcus agalactiae MeSH
- streptokokové infekce diagnóza farmakoterapie přenos MeSH
- těhotenství MeSH
- vertikální přenos infekce prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
BACKGROUND: Early-onset group B Streptococcal disease (EOGBSD) is a serious but preventable neonatal infection. Maternal intrapartum antibiotic prophylaxis (IAP) does not prevent all cases of the disease. Management of asymptomatic neonates of GBS colonized mothers is problematic. AIMS: The objective of this prospective study was to determine whether administration of intramuscular penicillin at birth to a strictly defined group of term newborns of GBS colonized mothers is an effective and safe method to prevent EOGBSD. METHODS: A protocol for management of full-term infants born to GBS colonized mothers was created. Either an abnormality of blood count or presence of more than one obstetric risk factor were chosen as the indication criteria for administering postnatal antibiotic prophylaxis (PAP). RESULTS: The study sample consists of 250 newborns (11.5% of all term infants). PAP was administered in 39 cases. Indication criteria included leucocytosis in 37 cases, leucopenia in 1 case and obstetric risk factors in 1 case. There was no case of clinically manifest infection, and no case of sepsis either suspect or proven. CONCLUSIONS: The authors suggest that the strategy of selective PAP using penicillin, may be an effective and safe method in order to reduce morbidity and mortality from streptococcal infections. They recommend a combination of IAP and selective PAP.
