The diagnostic value of serum levels of pro calcitonin, β2 defensins, C-reactive protein and the positive rate of group B streptococci in preterm premature rupture of membranes with amniotic infection / 中国医师杂志

Objective:To explore the diagnostic value of serum levels of pro calcitonin (PCT), β2 defensins (HBD-2), C-reactive protein (CRP) and the positive rate of group B streptococci (GBS) in preterm premature rupture of membranes (PROM) with amniotic infection.Methods:This study was a retrospective study. 156 pregnant women with preterm PROM who were diagnosed by the Obstetrics Department of the Hospital of Southern University of Science and Technology from January 2017 to January 2022 were selected as the study subjects. According to whether there was amniotic infection, they were divided into 57 infected women and 99 non infected women. The levels of serum PCT, HBD-2 and CRP before delivery were compared between the two groups, and the positive rate of GBS in vaginal discharge was detected, and the receiver operating curve (ROC) was used to analyze the value of various indicators in diagnosing amniotic cavity infection in preterm PROM mothers.Results:The serum levels of PCT, HBD-2, CRP, and GBS positivity in the infected group were significantly higher than those in the non infected group, with statistically significant differences (all P<0.01); The area under the curve (AUC) value, sensitivity, and specificity of serum PCT for diagnosing preterm PROM with amniotic cavity infection were 0.894, 82.56%, and 80.74%, respectively; The AUC value of HBD-2 for diagnosing preterm PROM with amniotic cavity infection was 0.792, the sensitivity was 70.78%, and the specificity was 77.59%; The AUC value, sensitivity, and specificity of CRP in diagnosing preterm PROM with amniotic cavity infection were 0.756, 68.94%, and 72.78%, respectively; The positive rate of GBS in vaginal discharge was 0.733, the sensitivity was 64.91%, and the specificity was 81.82%. Conclusions:The serum levels of PCT, HBD-2, CRP and the positive rate of GBS in vaginal discharge of pregnant women with preterm PROM complicated with amniotic infection will increase significantly. All indicators have high practical value for the diagnosis of preterm PROM complicated with amniotic infection.

Interaction of B-group streptococcal infection and chorioamnionitis in low birth weight infants during late pregnancy / 中国医师杂志

Objective:To investigate the interaction of B-group streptococcal infection and chorioamnionitis (CAM) with late pregnancy and low birth weight infant (LBWI).Methods:A retrospective study was conducted on 524 postpartum women who underwent regular prenatal examinations and completed delivery at the Taizhou Second People′s Hospital from October 2019 to April 2022. According to their newborn birth weight, they were divided into normal group (466 cases) and LBWI group (58 cases). The age, pregnancy times, birth times, pregnancy body mass index (BMI), cesarean section history, abortion history, anemia during pregnancy, hypertensive disorder during pregnancy, diabetes during pregnancy, vaginitis, B-group streptococcal infection, CAM, premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal preterm delivery, neonatal asphyxia, neonatal infection, fetal distress were compared between the two groups. The influencing factors of LBWI were analyzed using logistic regression. The correlation and interaction between B-group streptococcal infection and CAM on LBWI were analyzed.Results:There was a statistically significant difference in age, history of miscarriage, gestational hypertension, vaginitis, B-group streptococcal infection, CAM, premature rupture of membranes, neonatal preterm birth, neonatal infection and fetal distress between the two groups (all P<0.05). The results of logistic regression analysis showed that gestational hypertension, B-group streptococcal infection, CAM, premature rupture of membranes, preterm birth, neonatal infection, and fetal distress were risk factors for LBWI (all P<0.05). B-group streptococcal infection, CAM, and LBWI were positively correlated ( r=0.587, 0.604, all P<0.001). The interaction analysis results showed a positive correlation between B-group streptococcal infection, CAM, and LBWI (all P<0.001). Conclusions:B-group streptococcal infection in late pregnancy, CAM, and LBWI are positively correlated, and their coexistence can increase the risk of LBWI.

Streptococcus spp. en el embarazo, patología y avances en su detección temprana / Streptococcus spp. in pregnancy, pathology and advances in early detection

El Streptococcus spp ha adquirido mucha importancia a nivel mundial debido a la gran patogenicidad de sus diferentes especies. Una de ellas es el Streptococcus del Grupo B que comúnmente se encuentra a nivel vaginal en mujeres embarazadas, lo que puede ocasionar una contaminación al recién nacido en el momento del parto. Solo un pequeño porcentaje de estos neonatos desarrollan la infección y pueden llegar a presentar sepsis, meningitis, neumonía neonatal, entre otras complicaciones, así como secuelas neurológicas permanentes, retraso en el crecimiento y muerte. Debido a esto, se han implementado estrategias preventivas, en las que se incluyen pruebas de tamizaje para su detección temprana y evitar el riesgo de infección. En las últimas décadas se ha incrementado el uso de técnicas moleculares para su diagnóstico precoz y tratamiento temprano, de manera de disminuir la morbimortalidad atribuida al Streptococcus del Grupo B.

Streptococcus spp has acquired great importance due to the high pathogenicity of its different species around the world. The Group B Streptococcus is commonly found in the vaginal area of pregnant women, which at delivery may lead to contamination of the newborn. Only some of these infants develop the infection and may present sepsis, meningitis, neonatal pneumonia, among other complications, including permanent neurological sequelae, delayed growth and death. Preventive strategies include screening and early detection to avoid the risk of infection. In recent decades the use of molecular techniques for early diagnosis and treatment has increased that would decrease morbidity and mortality attributed to Group B Streptococcus.

Prevalência da colonização por Streptococcus agalactiae em uma amostra de mulheres grávidas e não grávidas de Porto Alegre, estado do Rio Grande do Sul / Prevalence of Streptococcus agalactiae colonization in a sample of pregnant and non pregnant women from Porto Alegre, Rio Grande do Sul state, Brazil

Objetivos: Verificar a prevalência de Streptococcus agalactiae em amostras vaginais e retais de mulheres grávidas e não grávidas, analisadas em um laboratório privado de Porto Alegre, Rio Grande do Sul, no período de janeiro de 2011 a junho de 2012.Métodos: Foram incluídos no estudo todos os resultados de culturas de amostras coletadas da vagina e região ano-retal de mulheres grávidas e não grávidas, com idade acima de 18 anos, no período de janeiro de 2011 a junho de 2012, em um laboratório privado do município de Porto Alegre. As amostras foram semeadas em ágar sangue e ágar cromogênico específico para S. agalactiae, sendo realizado o teste de CAMP nas amostras com crescimento bacteriano positivo. A análise estatística foi realizada por meio do teste de qui-quadrado e valores de p menor do que 0,05 foram considerados significativos.Resultados: Foram analisadas 1146 amostras, os quais 963 do ano de 2011 e 183 do primeiro semestre de 2012, sendo que 105 eram de gestantes e 1041 eram de não gestantes. Entre as 1146 mulheres examinadas, 83 (7,2% ? intervalo de confiança 95%: 5,8%-8,8%) estavam colonizadas pelo S. agalactiae. Houve maior frequência de amostras positivas no grupo de gestantes (15,2%) do que no grupo de não gestantes (6,4%) (p igual a 0,002). Esta diferença deveu-se principalmente aos resultados do ano de 2012, quando o grupo de grávidas apresentou 23,1% de amostras positivas, enquanto o grupo de não grávidas teve 6,3% (p igual a 0,004).Conclusões: A incidência elevada de colonização por S. agalactiae entre as gestantes avaliadas enfatiza a importância de detectar essa colonização no final da gravidez, para uma prevenção eficaz da doença estreptocócica neonatal.

Aims: To determine the prevalence of Streptococcus agalactiae in vaginal and rectal samples of pregnant and non-pregnant women, analyzed in a private laboratory in Porto Alegre, Rio Grande do Sul state, Brazil, from January 2011 to June 2012.Methods: The study included all culture results of vaginal and anorectal samples collected from pregnant and non-pregnant women, aged 18 years or more, from January 2011 to June 2012, in a private laboratory in the city of Porto Alegre. The samples were plated on blood agar and chromogenic specific for S. agalactiae, being analyzed in the CAMP test for samples with positive bacterial growth. Statistical analysis was performed using the chi-square and p values less than 0.05 were considered significant.Results: We analyzed 1146 samples, being 963 of 2011 and 183 of the first half of 2012, of which 105 were from pregnant and 1041 and were from non-pregnant women. Among the 1146 women surveyed, 83 (7.2%-95% confidence interval: 5.8%-8.8%) were colonized with S. agalactiae. There was a higher frequency of positive samples in the group of pregnant women (15.2%) than in the group of non-pregnant women (6.4%) (p equals 0.002). This difference was mainly due to the results of the year 2012, when the pregnant group had 23.1% of positive samples, while the non-pregnant group had 6.3% (p equals 0.004).Conclusions: The high incidence of colonization by S. agalactiae among the pregnant women screened emphasizes the importance of detecting this colonization in late pregnancy for the effective prevention of neonatal streptococcal disease.

Tubo ovarian abscess caused by streptococcus group B: A case report and literature review.

A 34 year-old Thai female woman who had a previous history of recurrent pelvic inflammatory disease or recurrent pelvic inflammatory disease (PID), presented with recurrent pelvic pain and high grade fever. She was admitted and a diagnosis of tubo ovarian abscess was made. Physical examination and ultrasonographic examination demonstrated high grade fever, adnexal tenderness and a right mixed solid cystic mass compatible with tubo ovarian abscess. Despite prescription of combined parenteral antibiotic, her symptoms did not improve. An exploratory laparotomy showed a left ovarian abscess with a kinked fallopian tube behind the uterus. A left salpingectomy with partial oophorectomy was performed. Cultured pus was identified as group B streptococci. Antibiotics therapy was continued until clinical improvment and she was discharged on the seventh post operative day. Tubo ovarian abscess or tubo ovarian abscess (TOA) is a serious consequence of PID. The streptococcus group B infection is a rare cause of TOA. There is a discussion about diagnosis, medical treatment and surgical treatment. Although medical treatment with broad-spectrum antibiotics has allowed patients to avoid operations, some of them who failed medical treatment required surgical treatment. Especially in women who need childbearing potential in future, conservative surgery has become the initial approach as well as this case report.

A Study of Group B Streptococcal Infection in Pregnant Women, by LIM Broth Media / 소아과

PURPOSE: To evaluate the degree of Group B streptococcal colonization in Korean pregnant women of gestational age 35-37 weeks. METHODS: From May 1, 2002 to April 30, 2003, the medical records of 53 pregnant(gestational age from 35 to 37 weeks) women who visited the department of Ob & Gyn, Pusan National Hospital for antenatal care, were reviewed. By use of CDC recommendations, specimens were obtained from lower vagina, cervix and rectum, and inoculated on Lim Broth(selective media, Becton Dikinson Co., Cokeysville, MD, USA) to isolate group B streptococci. RESULTS: The prevalence of group B streptococci in pregnant women was 3.44%(2/58). Two specimens were obtained from cervicovagina; there were no GBS infection signs in their neonate. CONCLUSION: This study reported a 3.44% prevalence rate. GBS colonization in pregnant women (gestational age 35-37weeks) was lower than other countries. By use of CDC recommendation, we reported that our results were meaning. To resolve the reason for low the GBS infection of Korean pregnant women, further studies will be needed.

Frecuencia de aislamiento de streptococcus agalactiae en un grupo de embarazadas y sus productos / Frequency of isolation of streptococus agalactiae in pregnant women and their offspring

Se estudiaron 86 madres y 61 de sus recien nacidos con el fin de determinar la frecuencia de aislamiento de Streptococcus agalactiae (esptreptococo beta hemolitico del grupo B); no se aislo el germen de ninguno de los cultivos tomados de las secreciones del cuello uterino pero si a partir de las muestras faringeas, en tres de las madres (3.4%) y en dos de sus hijos. El tercer nino no se estudio porque su nacimiento ocurrio por cesarea. Las cifras encontradas en el presente trabajo estan de acuerdo con lo que relata la literatura, pero el bajo numero de casos estudiado no permite hacer consideraciones epidemiologicas mas profundas

A group of 88 pregnant women and 61 of their newborn Infants was studied In order to determine the frequency of isolation of Streptococcus agalactiae; all genital maternal cultures were negative but 3 mothers and 2 Infants had positive pharyngeal secretions; no evidence of streptococcal disease was found in the colonized Infants. The frequency of colonization found in this study agrees with that reported by other authors but the reduced number of cases does not allow In depth epidemiological considerations.