Prevalence of Streptococcus B in the lower genital tract in pregnant women between 35 and 37 weeks San José hospital

Prevalencia del Streptococcus B en el tracto genital inferior en embarazadas entre 35 y 37 semanas hospital San José

Introduction: worldwide, infection, usually caused by Group B Streptococcus, is the leading cause of morbidity/mortality at the neonatal intensive care units. Objectives: to describe the prevalence of colonization by this microorganism in the lower genital tract of pregnant women between weeks 37.0 and 37.a at Hospital de San José. Materials and Methods: this is a cross sectional descriptive study. Vagina and rectum specimens were cultured for all patients, independently processed and prophylactic treatment was given when culture positive. Results: 11S pregnant patients were assessed between March S008 and March S009. Prevalence of the microorganism was 17.S% (n=17) and mean age was S8 years (SD 6,2). The most frequent factors were: sexual activity in the third trimester (71.8%), primigravity (48,2%) and a history of third-trimester vaginal infection (44,6%), finding no statistically significant association with the presence of the studied germ. Conclusions: the prevalence of Croup B Streptococcus infection was similar to that reported in literature of other developed or developing countries. The impact this colonization of the lower genital tract has on maternal and neonatal outcomes is an indication to recommend this test on third-trimester pregnant patients as a screening strategy.

1. Prevention of early-onset group B streptococcal disease in newborns. Int J Gynaecol Obstet. 2003 Apr;81(1):115-22.
2. Prevention of Perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep. 1996 May 31;45(RR-7):1-24.
3. Revised guidelines for prevention of early-onset group B streptococcal (GBS) infection. AmericanAcademy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn.. Pediatrics 1997; 99(3):489-96.
4. Trends in Perinatal Group B Streptococcal Disease. United States, 2000- 2006. MMWR Morb Mortal Wkly Rep. 2009 Feb 13;58(5):109-12.
5. Decreasing incidence of perinatal group B streptococcal desease − United States, 1993-1995. MMWR Morb Mortal Wkly Rep. 1997 May 30;46(21):473-7.
6. Valdés E, Pastene C, Grau M, Catalán J, Candia P, Juarez G, Caballero R. Prevalencia de colonización por Streptococcus Agalactiae (grupo B) en el tercer trimestre del embarazo en medio de cultivo no selectivo. Rev Chil Obstet Ginecol. 2003, 68(4): 305-08.
7. Adoption of hospital pólices for prevention of perinatal group B streptococcal disease. United States, 1997. MMWR Morb Mortal Wkly Rep. 1998 Aug 21;47(32):665-70.
8. Crespo MP, Vélez JD. Importancia clínica del Streptococcus Agalactiae como causante de infección. Colomb Med. 1996; 27(2): 53-58.
9. Argentina. Ministerio de Salud y Ambiente. Dirección Nacional de Salud Materno Infantil. Recomendaciones para la prevención, diagnóstico y trata- miento de la infección precoz por estreptococo B hemolítico del grupo B (EGB). Buenos Aires : El Ministerio; 2004.
10. Main EH, Slagle T. Prevention of early-onset invasive neonatal Group streptococcal disease in private hospital setting: the superiority of culture- based protocols. Am J Obstet Gynecol 2000; 182(6): 1344-54.
11. Regan JA, Hlebanoff MA, Nugent RP et al. Colonization with group B streptococci on pregnancy an adverse outcomes. Am J Obstetric Gynecol. 1996; 174:1354-1360.
12. Cortés H. Prevención de la infección neonatal por estreptococo del grupo B, jEs necesaria en nuestro medio? Rev. Col Obs. Gin. 2005; 56:231-238.
13. Gibbs R, Sweet R. Materna land fetal infectious disorders. En: Creasy R, Resnik R. Maternal-fetal medicine. 4a. ed. Philadelphia: Saunders; 2004. p. 674-77.
14. Restrepo A, Serna L, Vanegas C, et al. Prevalencia de Streptococcus agalactiae en gestantes con factores de riesgo y sus recién nacidos. Hospital Universita- rio San Vicente de Paul, 2002. Infectio 2003 ; 7(3) : 147-52.
15. Trujillo M, Ospina B, Fama M. Reevaluación del estado de colonización por streptococcus del grupo B en madres e hijos al momento del parto. Rev Ces Medicina. 1999 ; 13 :44.
16. Manotas RJ, Baquero D. Frecuencia de aislamiento de Streptococcus agalactiae en un grupo de embarazadas y sus productos. IATREIA 1989 ; 2 :111-13.
17. González CP, González JE. Prevalencia de Estreptococo Beta hemolítico en mujeres embarazadas de alto riesgo en el Hospital Simón Bolivar de Bogotá. UCIN. 2001; 2 :7-15.
18. Picard F J, Bergeron M G. Laboratory detection of group B Streptococcus for Prevention of perinatal disease. Eur J Clin Microbiol Infect Dis. 2004; 2: 665-71.
19. Schray SJ, XywicH S, Farley MM, et al. Group B Streptococcal disease in The era of intrapartum antibiotic prophylaxis. N Engl. J Med. 2000; 342: 15- 20.
20. Duran HS, Chang, Benoit VM, et al. Group B streptococcal B-hemolysin/ cytolisin promotes invasion of human lung epithelial cells and the release of interleukin-8. J Infect Dis. 2002 Jan 15;185(2):196-203
21. Mandell GL, Benneth JE, et al. Streptococcus agalactiae (group B Streptococcus). In: Principles and practice of Infectious Diseases. 6th ed. Philadelphia : Churchill Livingstone; 2005. 199:2423-2434
22. Regan JA, Hlebanoff 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. Meyn LA, Moore DM, Hillier SL, et al. Association of sexual activity with colonization and vaginal acquisition of group B Streptococcus in non pregnant women. Am J Epidemiol. 2002; 155: 949-957.
24. Campbell JR, Hillier SL, et al. Group B Streptococcal colonization and serotype-specific immunity in pregnant women at delivery. Obstet Gynecol. 2000; 96: 498-503.
25. Baker CJ, Edwards MS. Group B streptococcal infections. In: Remington JS, Hlein JO, eds. Infectious diseases of fetal and newborn infants. 5th ed. Philadelphia: Saunders, 2000: 1091-156.
26. Farley MM. Group B streptococcal disease in non pregnant adults. Clin infect Dis. 2001; 33: 556-61.
27. Bergeron MG, Menard C, et al. Rapid detection of Group B streptococci in pregnant women at delivery. N Engl. J Med. 2000; 343: 175-79.
28. Hong F, et al. Serotype identification of Group Streptococci by PCR and sequencing. J Clin Microbiol. 2002; 40: 216-26.
29. American Academy of Pediatrics. Group B streptococcal infections. In: Pickering LH, ed. Red Book: report of the committee on Infectious Diseases. 26th ed. Washington: American Academy of Pediatrics; 2003. p. 584-91.
30. Bergeron M, Danbing H , Menard C, Picard F, Gagnon M, Bernier M, Ouellette M, Roy PH, Marcoux S, Fraser WD (2000) Rapid detection of group B streptococci in pregnant women at delivery. N Engl. J Med. 2009;343(3):175-79.
31. Colombia. Ministerio de Salud. Resolución No. 008430. Octubre 4 de 1993. Normas científicas, técnicas y administrativas para la investigación en Salud.
32. Cortés H. Prevención de la infección neonatal por estreptococo del grupo B, jEs necesaria en nuestro medio?. Rev. Col Obs. Gin. 2005; 56:231-38.