colonización por estreptococo beta hemolítico del grupo b durante el embarazo y prevención de enfermedad neonatal group b streptococcus colonization during pregnancy and prevention of early onset of disease

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2005
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Abstract
El estreptococo beta-hemolítico del grupo B (SGB) es uno de los principales agentes causantes de sepsis neonatal precoz. La mortalidad de los afectados oscila entre el 6 y el 20%, y la tasa de secuela neurológica llega al 30%. En 1996 el Centro de Prevención y Control de Enfermedades de Atlanta, el Colegio Americano de Obstetras y Ginecólogos y la Academia Americana de Pediatría sugirieron en consenso que el personal de atención de salud materna-neonatal debía adoptar una estrategia para la prevención de la sepsis por este germen. Los objetivos del presente trabajo prospectivo fueron determinar el porcentaje de colonización por SGB en las pacientes gestantes asistidas del 1° de julio de 2001 al 31 de diciembre de 2002 e implementar un programa de prevención de sepsis neonatal precoz por SGB a través de profilaxis antibiótica intraparto basado en cultivos. Sobre 1756 pacientes, se realizaron cultivos con hisopado vaginal y anal a 1228 (69.9%). El porcentaje de colonización materna por SGB fue del 1.4% (17 pacientes). Se presentó un caso de sepsis neonatal compatible con SGB (0.6‰) en una madre con cultivo negativo. Sólo una paciente portadora de SGB presentó factores de riesgo. Los resultados nos sugieren continuar con la estrategia de prevención basada en cultivos debido a que la mayoría de las pacientes colonizadas no presentaron factores de riesgo. Son necesarios estudios de relación costo-beneficio en nuestro medio para definir si esta estrategia de prevención es aplicable a la realidad sanitaria argentina.
Group B Streptococcus (GBS) is the most frequent cause of early onset of neonatal sepsis. Case-fatality rate is 6-20% for newborns. Neurological sequel occurs in 30% of survivors. In 1996, the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommended that obstetrics providers should adopt either a culture-based or a risk-based approach for the prevention of this disease. The aim of this prospective study was to determine the colonization rate of GBS in our population of pregnant women between July 1st 2001 and December 31st 2002, and to introduce a culture-based strategy to prevent early onset neonatal GBS disease. From a population of 1756 pregnant women, 1228 were screened with rectal and vaginal swabs (69.9%). Maternal colonization rate was 1.4% (17 patients). There was one case of early-onset neonatal sepsis consistent with GBS disease (0.6‰) in a patient with negative cultures. From the colonized patients, only one presented risk factors. Because most of the colonized women did not present intrapartum risk factors, the results of this study suggest that the culture-based approach should be used for the prevention of early-onset GBS disease in our population. Cost-benefit studies are needed in our country to determine if this prevention strategy is able to be implemented in all the settings of Argentina.
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larcher2005medicinacolonizacin Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;José Sad Larcher;Florencia Capellino;Roxana De Giusto;Claudia Travella;Fabián Gómez Balangione;Gustavo Kreiker;Hernán Prats Cardona;Abel Zárate;Mario Vilaro;Daniela Hernández;Guillermo Ruiz Orrico
Journal proceedings on: 2016 ieee central america and panama student conference, conescapan 2016
Year 2005
DOI
DOI not found
URL
http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802005000300003
Keywords
group b streptococcus neonatal sepsis allergyinfectious and parasitic diseases

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