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1.
Arch. pediatr. Urug ; 92(2): e209, dic. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1278302

ABSTRACT

Introducción: el estreptococo del grupo B (EGB) es una causa frecuente de sepsis neonatal. La enfermedad precoz disminuyó su incidencia por la profilaxis antibiótica, a diferencia de la sepsis tardía, que aumentó su incidencia en los últimos años. Objetivo: conocer la incidencia de la sepsis tardía en el período 2016-2017 en el Centro Hospitalario Pereira Rossell (CHPR). El secundario, describir las características epidemiológicas y clínicas de sepsis tardía por EGB en niños ingresados a la Unidad de Cuidados Intensivos de Niños (UCIN) del CHPR en el período 2007-2017. Resultados: la incidencia calculada de sepsis tardía por EGB fue de 0,53 casos/1000 recién nacidos (RN) vivos. Entre los años 2007 y 2017 ingresaron cinco niños por sepsis tardía por EGB a la UCIN del CHPR. La presentación clínica más frecuentes fue fiebre sin foco y meningitis. Se obtuvieron tres aislamientos en sangre de EBG y tres en líquido cefalorraquídeo (dos en cultivo y otro por detección de ADN). Ninguno falleció. Los casos con meningitis presentaron alteraciones en la tomografía de cráneo. Un niño fue pretérmino. Conclusiones: la sepsis tardía se vincula a importante morbimortalidad en pediatría. No se ha establecido cuáles son los principales factores de riesgo asociados a una enfermedad grave ni las políticas para disminuir su incidencia.


Background: group B streptococcus (GBS) is a common cause of neonatal sepsis. Early disease decreased its incidence due to antibiotic prophylaxis. Late sepsis increased its incidence in recent years. Objectives: to know the incidence of late onset EGB sepsis in the period 2016-2017 at the Pereira Rossell Hospital Center (CHPR), and secondly, to describe the epidemiological characteristics and the clinical presentation of late onset sepsis due to GBS in children admitted to the Children's Intensive Care Unit (UCIN) of the CHPR in the period 2007-2017. Results: the calculated incidence of late sepsis due to GBS was 0.53 cases/1000 live newborns. Between 2007-2017, 5 children were admitted due to GBS late sepsis at the UCIN. The most frequent clinical presentation was fever without focus and meningitis. 3 isolates were obtained in EBG blood cultures and 3 in cerebrospinal fluid (2 in culture and another by DNA detection). None of them died. Cases with meningitis showed abnormalities in the brain tomography. 1 of the 5 was preterm. Conclusions: late sepsis is associated with significant morbidity and mortality in pediatric patients. The main risk factors associated with serious disease and the policies needed to reduce its incidence have not been established.


Introdução: o estreptococo do grupo B (SGB) é uma causa frequente de sepse neonatal. A doença precoce diminuiu sua incidência devido à profilaxia antibiótica, ao contrário da sepse tardia, que aumentou sua incidência nos últimos anos. Objetivo: conhecer a incidência de sepse tardia no período 2016-2017 no Centro Hospitalar Pereira Rossell (CHPR) e descrever as características epidemiológicas e clínicas da sepse tardia por SGB em crianças internadas na Unidade de Terapia Intensiva Infantil (UTIN) do CHPR no período de 2007-2017. Resultados: a incidência calculada de sepse tardia por SGB foi de 0,53 casos/1000 recém-nascidos vivos (RNs). Entre 2007-2017, 5 crianças foram internadas na UTIN do CHPR por sepse tardia devido a GBS. A apresentação clínica mais frequente foi febre sem causa e meningite. 3 isolados de EBG foram obtidos no sangue e 3 no líquido cefalorraquidiano (2 em cultura e outro por detecção de DNA). Nenhum dos pacientes morreu. Os casos com meningite apresentaram alterações na tomografia de crânio. Uma criança era pré-termo. Conclusões: a sepse tardia está associada a significativa morbimortalidade em pediatria. Os principais fatores de risco associados a uma doença grave e as políticas para reduzir sua incidência ainda não foram estabelecidas.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Streptococcal Infections/epidemiology , Neonatal Sepsis/etiology , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Uruguay/epidemiology , Catastrophic Illness , Epidemiology, Descriptive , Incidence , Retrospective Studies
2.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(4): 1165-1172, Oct-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1155297

ABSTRACT

Abstract Objectives: to estimate the prevalence and the factors associated with the colonization by group B streptococcus (GBS) in pregnant women from the urban area attended at health units in a municipality in northeastern Brazil. Methods: it is a cross-sectional study conducted from January 2017 to March 2018. Vagino-rectal swabs were collected from 210 pregnant women between 32 and 40 weeks of gestation. The swabs were seeded on 5% sheep blood agar and on chromogenic agar. For confirmatory identification of GBS, the CAMP test and latex agglutination were used. Descriptive analysis and univariate and multivariate association analysis were performed using a multinomial logistic model. Results: the prevalence of GBS colonization among pregnant women was 18.1% (n = 38), and a statistically significant association (p<0.05) was found for income and parity variables in the group of older women in the univariate analysis, and for skin color, age and parity in the final multivariate analysis. Conclusions: the prevalence of maternal colonization by GBS was similar to that described in other studies. Although some risk factors, such as skin color, age and parity, were associated with colonization, other studies are essential to establish more information on pregnant women more likely to be colonized by GBS.


Resumo Objetivos: estimar a prevalência e apontar fatores associados à colonização por estreptococos do grupo B (EGB) em gestantes da zona urbana atendidas em unidades de saúde de um município do nordeste do Brasil. Métodos: trata-se de um estudo transversal realizado entre janeiro de 2017 a março de 2018. Foram coletados swabs vaginorretais de 210 gestantes entre a 32 e 40 semanas de gestação. As amostras foram semeadas em ágar sangue de carneiro 5% e ágar cromogênico. Para identificação confirmatoria de EGB foram utilizados o teste de CAMP e aglutinação em látex. Foram realizadas análise descritiva, de associação univariada e multivariada utilizando modelo logístico multinomial. Resultados: a prevalência de colonização por EGB entre as gestantes foi de 18,1% (n=38), e as variáveis renda e paridade no grupo de mulheres mais velhas na análise univariada além de cor da pele, idade e paridade na análise multivariada final estiveram estatisticamente associadas ao desfecho (p<0,05). Conclusões: a prevalência da colonização materna pelo EGB mostrou-se semelhante às descritas em outros estudos. Apesar de alguns fatores de risco como cor da pele, idade e paridade estarem associados à colonização, outros estudos são fundamentais para se estabelecer maiores informações sobre as gestantes mais passíveis de colonização pelo EGB.


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis , Streptococcus agalactiae , Prevalence , Risk Factors , Infectious Disease Transmission, Vertical/prevention & control , Urban Area , Primary Health Care , Socioeconomic Factors , Streptococcal Infections/epidemiology , Brazil/epidemiology , Infectious Disease Transmission, Vertical/statistics & numerical data
3.
Rev Bras Ginecol Obstet ; 42(8): 454-459, 2020. tab
Article in English | LILACS | ID: biblio-1137861

ABSTRACT

Abstract Objective Streptococcus agalactiae is an important pathogen in neonates and pregnant women. Neonatal invasive infections due to S. agalactiae are life-threatening and preventive strategies for this challenge of human have become a concern. The aim of the present study was to determine the prevalence of rectovaginal colonization, related risk factors and antibiotic resistance pattern of S. agalactiae among pregnant women in Iran. Methods The present study was performed on 240 pregnant women. Vaginal and rectal swabs were obtained from all of the women and then were transferred to the laboratory. The isolation and identification of S. agalactiae was performed by standard microbiological tests and polymerase chain reaction (PCR) assay. The antimicrobial susceptibility patterns of the isolates were determined by the Kirby-Bauer disk diffusion. Polymerase chain reaction was used to detect ermB and mefA genes in erythromycin-nonsusceptible isolates. Results Out of 240 pregnant women, 16 cases (6.7%) were colonized by S. agalactiae. There is no significant association between demographic-obstetric factors and maternal S. agalactiae colonization in the pregnant women. Linezolid, vancomycin and ampicillin were the most effective antibiotics against S. agalactiae. The ermB gene was present in 6 (35.29%) S. agalactiae isolates. However, the mefA gene was not detected in any of the isolates. Conclusion Given the relatively significant prevalence of S. agalactiae colonization in the pregnant women in the present study and the risk of serious neonatal infections, the screening of pregnant mothers for the bacteria seems necessary. Our findings highlight the importance of appropriate antibiotic prophylaxis during pregnancy for the prevention of early onset S. agalactiae-neonatal infection and comorbidity.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Rectum/microbiology , Streptococcal Infections/microbiology , Streptococcal Infections/epidemiology , Streptococcus agalactiae/drug effects , Vagina/microbiology , Streptococcus agalactiae/genetics , Carrier State/microbiology , Carrier State/epidemiology , Microbial Sensitivity Tests , Prevalence , Cross-Sectional Studies , Drug Resistance, Bacterial/genetics , Iran , Middle Aged , Anti-Bacterial Agents/pharmacology
4.
Einstein (Säo Paulo) ; 18: eAO4920, 2020. tab
Article in English | LILACS | ID: biblio-1056062

ABSTRACT

ABSTRACT Objective To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. Methods This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, minimal and maximal values. Parity and socioeconomic status were described by absolute frequency and percentages. We used logistic regression models in the software (SPSS) to analyze correlations of variables according to vaginal-rectal culture, considering a 95%CI and p-values. Variables were age, number of pregnancies, weight gain in pregnancy and gestational age at delivery. Results A total of 347 medical records were included, and after applying the exclusion criteria, 287 medical records composed the final sample. Patients' age ranged between 17 and 44 years. Mean age was 30.6 years, 67 patients had positive result for group B Streptococcus (prevalence of 23.3%; 95%CI: 18.7-28.5). Conclusion Considering the high prevalence of group B Streptococcus in our service, the antibiotic prophylaxis strategy based on rectovaginal culture screening approach seems to be cost-effective.


RESUMO Objetivo Identificar a prevalência de estreptococo do grupo B entre gestantes que frequentaram um programa de saúde corporativa, bem como as correlações com a colonização positiva. Métodos Estudo retrospectivo dos prontuários do pré-natal de um hospital privado em São Paulo, no período de 2015 a 2016. Foram excluídas as mulheres que abandonaram o programa ou apresentavam dados incompletos nos prontuários. As variáveis quantitativas foram descritas por média, desvios padrão, mediana, valores mínimos e máximos. A paridade e a condição socioeconômica foram descritos por frequência absoluta e percentagens. Utilizamos modelos de regressão logística no programa (SPSS) para analisar as correlações de variáveis de acordo com a cultura retovaginal, considerando IC95% e valores de p. As variáveis foram idade, número de gestações, peso ganho na gestação e idade gestacional no parto. Resultados Foram incluídos 347 prontuários e, após a aplicação dos critérios de exclusão, 287 prontuários compuseram a amostra final. A idade dos pacientes variou entre 17 e 44 anos. A média de idade foi de 30,6 anos, e 67 pacientes tiveram resultado positivo para o estreptococo do grupo B (prevalência de 23,3%; IC95%: 18,7-28,5). Conclusão Considerando a alta prevalência de estreptococos do grupo B em nosso serviço, existem evidências de que a estratégia de antibiótico profilaxia baseada na cultura retovaginal é custo-efetiva.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Pregnancy Complications, Infectious/microbiology , Rectum/microbiology , Streptococcal Infections/microbiology , Streptococcus agalactiae/isolation & purification , Vagina/microbiology , Parity , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Prenatal Care , Socioeconomic Factors , Streptococcal Infections/diagnosis , Streptococcal Infections/epidemiology , Brazil/epidemiology , Prevalence , Retrospective Studies , Maternal Age
5.
Rev. argent. microbiol ; 51(1): 26-31, mar. 2019. tab
Article in Spanish | LILACS | ID: biblio-1003277

ABSTRACT

Los estreptococos del grupo viridans (EGV) son agentes causales de infecciones localizadas e invasivas. Dada la gravedad de las infecciones producidas por EGV sumada a las escasas comunicaciones actuales en nuestro país, los objetivos de este trabajo fueron la identificación y el estudio de la sensibilidad a los antibióticos de aislados caracterizados como EGV, recuperados de pacientes internados, para actualizar el conocimiento sobre el perfil de resistencia y la epidemiología de las infecciones ocasionadas por EGV. Se recuperaron 132 aislados de EGV en el Hospital de Clínicas «José de San Martín¼ en el período 2011-2015. La identificación se realizó mediante pruebas convencionales y espectrometría de masas (Matrix Assisted Laser Desorption Ionization - Time of Flight Mass Spectrometry). El grupo Streptococcus anginosus fue el más frecuente (42%) seguido por el grupo Streptococcus mitis (33%). Dentro del grupo S. mitis se excluyó a Streptococcus pneumoniae. El 100% de los aislados fue sensible a ertapenem, linezolid y vancomicina; el 96,9% a cef-triaxona y cefepima. Se encontró un 25,8% de resistencia a penicilina (I+R) fundamentalmente en aislados de grupo S. mitis. La resistencia a tetraciclina fue del 27,2% y solo 2/132 aislados fueron resistentes a levofloxacina. Los valores de CIM de gentamicina oscilaron entre 0,5 y 32 -og/ml. El 17,4% de los aislados presentó resistencia a eritromicina sin diferencia significativa en la distribución de fenotipos M y MLS. Los resultados muestran la importancia de la vigilancia continua de las infecciones producidas por estos microorganismos con el fin de generar aportes para la elección de la terapia antibiótica adecuada.


Members of the viridans group streptococci (VGS) are the cause of local and invasive infections. Due to the severity of these infections and taking into account that reports regarding epidemiological aspects are scarce, the aims of this work were the identification and the study of the antibiotic susceptibility profiles of the isolates recovered from patients that were hospitalized in order to find out about the resistance level and the epidemiology of infections in which VGS are involved. A hundred and thirty two isolates identified as VGS were isolated at Hospital de Clínicas «José de San Martín¼ during the period 2011-2015. The identification was performed by biochemical test and mass spectrometry by Matrix Assisted Laser Desorption Ionization -Time of Flight Mass Spectrometry. Streptococcus anginosus group was prevalent (42%) followed by Streptococcus mitis group (33%). In the latter, isolates of Streptococcus pneumoniae were excluded. All the VGS isolates were susceptible to ertapenem, meropenem, linezolid and vancomycin; 25.8% were resistant (I+R) to penicillin, being prevalent in the S. mitis group. Regarding ceftriaxone and cefepime 96.9% of the isolates were susceptible. Only two isolates were resistant to levofloxacin, 27.2% to tetracycline and it was not found high level resistance to gentamycin (MIC range 0.5-32 µg/ml). Resistance to erythromycin was 17.4% with no significant difference between M and MLS phenotypes. The most active antibiotics were in addition to ceftriaxone and cefepime, vancomycin, ertapenem, meropenem and linezolid. These results highlight the importance of the continuous surveillance of the infections caused by VGS in order to predict a correct antibiotic therapy.


Subject(s)
Viridans Streptococci/isolation & purification , Viridans Streptococci/drug effects , Anti-Bacterial Agents/therapeutic use , Streptococcal Infections/epidemiology , Drug Resistance, Bacterial/drug effects
6.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 19 oct. 2018. a) f:18 l:24 p. graf.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 3, 113).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1103130

ABSTRACT

Situación nacional de este tipo de infecciones, del que se observa un incremento global en las últimas décadas, en Europa y Norte América, sin que la causa haya sido determinada. En Argentina, los serotipos prevalentes, en base a datos aportados por el Laboratorio Nacional de Referencia- por él identificados en infección invasiva por Streptococcus pyogenes en población general durante el período 2000- 2016- fueron M12, M1, y M. A partir del año 2017 se observa un incremento del aislamiento de serotipo M3 principalmente en población pediátrica y no se registraron resistencias antimicrobianas específicas.Se describe la situación en la Ciudad Autónoma de Buenos Aires, la normativa a cumplir para la vigilancia de estas infecciones, y se incluyen recomendaciones para el personal de salud, la comunidad, y la comunidad educativa


Subject(s)
Streptococcal Infections/diagnosis , Streptococcal Infections/pathology , Streptococcal Infections/prevention & control , Streptococcal Infections/epidemiology , Streptococcus pyogenes/pathogenicity , Streptococcus pyogenes/virology , Infection Control/methods , Disease Notification/standards , Epidemiological Monitoring
7.
Braz. j. microbiol ; 48(3): 551-559, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-889129

ABSTRACT

Abstract Streptococcus agalactiae is one of the most common pathogens leading to mastitis in dairy herds worldwide; consequently, the pathogen causes major economic losses for affected farmers. In this study, multilocus sequence typing (MLST), genotypic capsular typing by multiplex polymerase chain reaction (PCR), and virulence gene detection were performed to address the molecular epidemiology of 59 bovine (mastitis) S. agalactiae isolates from 36 dairy farms located in the largest milk-producing mesoregions in Brazil (Minas Gerais, São Paulo, Paraná, and Pernambuco). We screened for the virulence genes bac, bca, bibA, cfb, hylB, fbsA, fbsB, PI-1, PI-2a, and PI-2b, which are associated with adhesion, invasion, tissue damage, and/or immune evasion. Furthermore, five capsular types were identified (Ia, Ib, II, III, and IV), and a few isolates were classified as non-typeable (NT). MLST revealed the following eight sequence types (STs): ST-61, ST-67, ST-103, ST-146, ST-226, ST-314, and ST-570, which were clustered in five clonal complexes (CC64, CC67, CC103, CC17, and CC314), and one singleton, ST-91. Among the virulence genes screened in this study, PI-2b, fbsB, cfb, and hylB appear to be the most important during mastitis development in cattle. Collectively, these results establish the molecular epidemiology of S. agalactiae isolated from cows in Brazilian herds. We believe that the data presented here provide a foundation for future research aimed at developing and implementing new preventative and treatment options for mastitis caused by S. agalactiae.


Subject(s)
Animals , Female , Cattle , Streptococcal Infections/veterinary , Streptococcus agalactiae/isolation & purification , Mastitis, Bovine/microbiology , Streptococcal Infections/microbiology , Streptococcal Infections/epidemiology , Streptococcus agalactiae/classification , Streptococcus agalactiae/genetics , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Brazil/epidemiology , Molecular Epidemiology , Virulence Factors/genetics , Virulence Factors/metabolism , Multilocus Sequence Typing , Genotype , Mastitis, Bovine/epidemiology
9.
Rev. Soc. Bras. Med. Trop ; 50(2): 179-183, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-842837

ABSTRACT

Abstract INTRODUCTION: Group B Streptococcus (GBS), a source of neonatal infection, colonizes the gastrointestinal and genitourinary tracts of pregnant women. Routine screening for maternal GBS in late pregnancy and consequent intrapartum antibiotic prophylaxis have reduced the incidence of early-onset GBS neonatal infection. The aim of this study was to evaluate the performance of PCR, compared to culture (gold standard), in GBS colonization screening of pregnant women, and to establish the prevalence of GBS colonization among this population. METHODS: Vaginal introitus and perianal samples were collected from 204 pregnant women, between the 35th and 37th weeks of pregnancy, at the Obstetrics and Gynecology Unit of the University of Caxias do Sul General Hospital between June 2008 and September 2009. All samples were cultured after enrichment in a selective medium and then assayed by culture and PCR methods. RESULTS: The culture and PCR methods yielded detection rates of vaginal/perianal GBS colonization of 22.5% and 26%, respectively (sensitivity 100%; specificity 95.6%; positive and negative predictive values 86.8% and 100%, respectively). A higher prevalence of GBS colonization was detected in the combined vaginal and perianal samples by both culture and PCR assay analyses. CONCLUSIONS: PCR is a faster and more efficient method for GBS screening, allowing for optimal identification of women who should receive intrapartum antibiotic prophylaxis to prevent newborn infection.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Anal Canal/microbiology , Pregnancy Complications, Infectious/epidemiology , Streptococcal Infections/epidemiology , Vagina/microbiology , Pregnancy Complications, Infectious , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/microbiology , Socioeconomic Factors , Streptococcal Infections/diagnosis , Streptococcus agalactiae/isolation & purification , Streptococcus agalactiae/genetics , Brazil/epidemiology , Carrier State/microbiology , Carrier State/epidemiology , Polymerase Chain Reaction , Prevalence , Predictive Value of Tests , Sensitivity and Specificity
10.
Braz. j. infect. dis ; 21(1): 92-97, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-1039184

ABSTRACT

Abstract Objectives: To describe early-onset neonatal sepsis (EOS) epidemiology in a public maternity hospital in Brasilia, Brazil. Methods: We defined EOS as a positive blood culture result obtained from infants aged ≤72 hours of life plus treatment with antibiotic therapy for ≥5 days. Incidence was calculated based on the number of cases and total live births (LB). This is a descriptive study comparing the period of 2012-2013 with the period of 2014-September 2015, before and after implementation of antibiotic prophylaxis during labor for group B streptococcus (GBS) prevention, respectively. Results: Overall, 36 infants developed EOS among 21,219 LB (1.7 cases per 1000 LB) and 16 died (case fatality rate of 44%). From 2014, 305 vaginal-rectal swabs were collected from high-risk women and 74 (24%) turned out positive for GBS. After implementation of GBS prevention guidelines, no new cases of GBS were detected, and the EOS incidence was reduced from 1.9 (95% CI 1.3-2.8) to 1.3 (95% CI 0.7-2.3) cases per 1000 LB from 2012-2013 to 2014-September 2015 (p = 0.32). Conclusions: Although the reduction of EOS incidence was not significant, GBS colonization among pregnant women was high, no cases of neonatal GBS have occurred after implementation of prevention guidelines.


Subject(s)
Humans , Male , Female , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Streptococcal Infections/prevention & control , Streptococcal Infections/epidemiology , Antibiotic Prophylaxis/methods , Neonatal Sepsis/prevention & control , Neonatal Sepsis/epidemiology , Pregnancy Complications, Infectious/microbiology , Streptococcus/drug effects , Vaginal Smears , Brazil/epidemiology , Incidence , Reproducibility of Results , Risk Factors , Treatment Outcome , Escherichia coli/isolation & purification , Escherichia coli/drug effects , Escherichia coli Infections/prevention & control , Escherichia coli Infections/epidemiology , Neonatal Sepsis/microbiology , Hospitals, Maternity
11.
Córdoba; s.n; 2017. 150 p. ilus.
Thesis in Spanish | LILACS | ID: biblio-983085

ABSTRACT

Marco Teórico: Entre las principales causas que explican la mortalidad en el recién nacido está las infecciones invasivas por Streptococcus agalactiae (Sag). En la patogénesis de la infección neonatal por Sag interviene la colonización asintomática del tracto genito-rectal de su madre así como los factores de virulencia bacterianos. Entre estos se destacan los antígenos polisacáridos (PLS) capsulares, que además permiten clasificar a Sag en serotipos (la Ib, II,III,IV,V,VI,VII,VIII, y IX). Diferentes estrategias de prevención se han implementado desde los '90. En nuestro país en el año 2008, la Ley Nacional 26.369 incorporó la modalidad de búsqueda universal en mujeres embarazadas y la administración de profilaxis intraparto (PIP) en casos positivos. Modalidad que tiene sus limitaciones, ya que solamente controla las infecciones de aparición temprana


Summary: Background: Invasive infections caused by Streptococcus agalactiae (Sag) constitute on of the main causes of mortality in newborn babies. Asymptomatic colonization of maternal genital and rectal tracts, as well as bacterial virulence factors, participates in the pathogenesis of neonatal infections by Sag. Among these it is important to highlight the presence of capsule polysaccharide (CPS) antigens, which in addition, allow classification of Sag into different serotypes (la Ib, II,II,IV,V,VI,VII,VIII and IX). Various prevention strategies have been implemented since the '90's. In Argentina, National Law 26369/2008 incorporated universal prenatal screening as well as the administration of intrapartum antibiotic prophylaxis (IAP) in positive cases. However, this procedure has some limitations since it only alloes to control early-onset Sag infections


Subject(s)
Female , Humans , Pregnancy , Gram-Positive Bacterial Infections , Infant Mortality , Infant, Newborn , Microbiology , Streptococcal Infections/epidemiology , Streptococcus agalactiae , Argentina/epidemiology
13.
Arch. argent. pediatr ; 114(3): 199-207, jun. 2016. graf, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-838204

ABSTRACT

Introducción. Las infecciones invasivas por Streptococcus pyogenes (IISP) presentan elevada morbimortalidad aún en la actualidad; no obstante, a nivel regional, existen escasas publicaciones en pediatría. Objetivo. Describir la prevalencia, los factores predisponentes y las características clínicas de niños internados por IISP, analizar los factores de riesgo asociados a bacteriemia y letalidad. Material y métodos. Estudio retrospectivo, descriptivo de IISP en niños ≤ 18 años, internados en Pediatría de 20 centros asistenciales del país, entre 2010 y 2012. Variables evaluadas: edad, sexo, focos clínicos iniciales y tardíos, patología crónica previa, factores predisponentes, tratamiento y evolución. Resultados. Se analizaron 143 pacientes. Incidencia de 4,97 casos/10 000 egresos. Mediana de edad 54 meses; tenían patología crónica previa 11,2%. Tuvieron factores predisponentes 67,1%. Las formas de presentación más frecuentes fueron la piel y las partes blandas en 77, sepsis en 30, osteoarticulares en 19, fascitis necrotizante en 13, síndrome de shock tóxico en 11. Se aisló Streptococcus pyogenes en 56,6% de los hemocultivos; la presencia de más de un foco clínico y la ausencia de cirugía se asociaron a bacteriemia (OR 4,8; p= 0,003 y OR 3,1; p= 0,0012, respectivamente). El promedio de internación fue 13,4 días. La tasa de letalidad fue 7,6% asociada a síndrome de shock tóxico (OR 10; p= 0,005), fascitis necrotizante (OR 104; p < 0,0001) e ingreso a la Unidad de Cuidados Intensivos Pediátricos (OR 26; p < 0,001). Conclusiones. La mayoría de las IISP se presentaron en pacientes sin patología crónica previa. Los focos de presentación, frecuentemente con bacteriemia, fueron la piel y las partes blandas. Hubo asociación estadísticamente significativa entre bacteriemia y ≥ 2 focos iniciales y ausencia de cirugía. La letalidad, asociada a SSTS y fascitis necrotizante, fue similar a otras publicaciones.


Introduction. Invasive Streptococcus pyogenes infections (ISpIs) cause a high morbidity and mortality, even at present; however, at a regional level there are few publications on this subject in the field of pediatrics. Objective. To describe the prevalence, predisposing factors and clinical characteristics of children hospitalized for ISpI, and analyze risk factors associated with bacteremia and lethality. Material and methods. Retrospective, descriptive study on ISpIs in children <18 years old hospitalized in the Pediatric Ward of 20 healthcare facilities across Argentina between 2010 and 2012. Assessed outcome measures: age, gender, early and late clinical sources of infection, prior chronic condition, predisposing factors, treatment and evolution. Results. One hundred and forty-three patients were analyzed. The incidence of ISpI was 4.97 cases/10 000 hospital discharges. Patients' median age was 54 months old, and 11.2% had a prior chronic condition. Also, 67.1% had predisposing factors. The most common clinical manifestations were in the skin and soft tissue in 77 patients, sepsis in 30, bone and joint involvement in 19, necrotizing fasciitis in 13, and toxic shock syndrome in 11. Streptococcus pyogenes was isolated in the blood cultures of 56.6%. More than one clinical source of infection and no surgery were associated with bacteremia (odds ratio [OR]: 4.8, p= 0.003 and OR: 3.1, p= 0.0012, respectively). The average length of stay in the hospital was 13.4 days. Fatality rate was 7.6% in association with toxic shock syndrome (OR: 10, p= 0.005), necrotizing fasciitis (OR: 104, p < 0.0001) and admission to the Pediatric Intensive Care Unit (OR: 26, p < 0.001). Conclusions. Most ISpIs were observed in patients without a prior chronic condition. The most common manifestation was, frequently with bacteremia, in the skin and soft tissue. A statistically significant association was observed between bacteremia and ≥2 early sources of infection and no surgery. Fatality rate, in association with streptococcal toxic shock syndrome and necrotizing fasciitis, was similar to that observed in other publications.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Streptococcal Infections/microbiology , Streptococcal Infections/epidemiology , Streptococcus pyogenes , Risk Factors , Bacteremia/etiology , Cross-Sectional Studies , Retrospective Studies
14.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2016; 26 (1): 27-30
in English | IMEMR | ID: emr-175799

ABSTRACT

Objective: To determine the frequency and risk factors of Group B Streptococci [GBS] in pregnant patients in third trimester in a tertiary care hospital in Lahore


Study Design: Cross-sectional, prospective study


Place and Duration of Study: Lady Willingdon Hospital, Lahore, from October 2014 to March 2015


Methodology: Sterile lower vaginal swabs were taken from 200 women aged 20 years and over, in third trimester, with no history of vaginal bleeding, ruptured membrane, recent intake of antibiotics or chronic illness. These swabs were cultured for detection of GBS. The risk factors of GBS and its frequency were noted in the pregnant population. Quantitative and qualitative data was analyzed by SPSS version 20. Chi-square test was applied to see association between diagnosis of GBS and other categorical variables. P-value

Results: In this study, the mean age of all the females was 26.36 +/- 4.32 years and mean duration of pregnancy was 35.54 +/- 2.65 weeks. Frequency of GBS in pregnant women was found as 14%. We observed significant association of GBS with parity and previous history of miscarriage [p-value = 0.033 and 0.010 respectively]. Moreover, significant association between vaginal discharge and GBS was also found [p = 0.027]


Conclusion: GBS is present in a small but significant number of pregnant women in our setting and it has association with multiparity, vaginal discharge during pregnancy, and previous history of miscarriage


Subject(s)
Humans , Female , Adolescent , Adult , Streptococcal Infections/epidemiology , Pregnant Women , Tertiary Care Centers , Risk Factors , Pregnancy Trimester, Third , Cross-Sectional Studies , Prospective Studies , Vaginal Discharge
15.
Rev. chil. infectol ; 31(6): 729-734, dic. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-734767

ABSTRACT

Introduction: Streptococcus pyogenes infection causes a wide spectrum of clinical manifestations. Invasive disease (ID) is defined by the isolation of the microorganism from sterile sites. Objective: To analyze the clinical, epidemiological and molecular characteristics of ID by S.pyogenes in children hospitalized at Pediatric Hospital Pereira Rossell, from January 2005 to January 2013. Materials and Methods: A descriptive retrospective study was done in cases with isolation of S.pyogenes from sterile sites. Epidemiological variables, disease characteristics, laboratory parameters, treatment regimen received, hospitalization days and clinical outcome were analyzed. The presence of 4 genes encoding for virulence factors and chromosome profile studied by pulsed-field electrophoresis were done in the isolated strains. Results: A total of 42 cases (rate: 4.6 out of 10,000 admissions) were detected, from which 32 were analyzed. Average age was 44.7 months (14/32 < 2 years of age). In 5 cases, the portal of entry was identified. Clinical presentations were: osteoarticular infections (n = 15), shock (n = 6), skin and soft-tissue infections (n = 5), pneumonia (n = 3) and bacteremias (n = 3). Twenty cases required surgical procedures and 13 required intensive care admission. Average hospital stay was 17 days and one patient died. Molecular studies were performed in five strains; 4 different toxin profiles and pulsotypes were identified. Discussion: The incidence of ID at our hospital is similar to other series in the region. A better knowledge of clinical presentation and its relation with molecular characteristics represents a challenge.


Introducción: Streptococcus pyogenes, produce diversas manifestaciones clínicas. La enfermedad invasora (EI) se define por el aislamiento del microorganismo en sitios estériles. Objetivo: Analizar características clínico-epidemiológicas y moleculares de EI por S. pyogenes en niños hospitalizados en el HP-CHPR (1/1/05-31/1/13). Materiales y Métodos: Estudio descriptivo, retrospectivo, de casos con aislamiento de S. pyogenes de sitios estériles. Se analizaron variables epidemiológicas, características de la enfermedad, laboratorio, tratamientos, días de hospitalización y evolución. Se estudió la presencia de cuatro genes que codifican factores de virulencia y perfiles cromosómicos resueltos por electroforesis en campos pulsados. Resultados: Se detectó un total de 42 casos (tasa 4,6 cada 10.000 admisiones), se analizaron todas las variables en 32. Mediana de edad 44,7 meses (14 < 2 años). En cinco se identificó puerta de entrada. Formas de presentación: infección osteo-articular (n: 15), shock (n: 6), infección de piel y tejidos blandos (n: 5), neumonía (n: 3) y bacteriemia (n: 3). Veinte requirieron procedimientos quirúrgicos y 13 de cuidado intensivo. La media de estadía hospitalaria fue de 17 días. Hubo un fallecimiento. Se realizó estudios moleculares en cinco cepas, identificándose cuatro perfiles de toxinas y pulsotipos diferentes. Discusión: La incidencia de EI en nuestra institución coincide con otras series en la región. Profundizar el conocimiento de la presentación clínica y su relación con las características moleculares es un desafío.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Streptococcal Infections/epidemiology , Hospitals, Pediatric/statistics & numerical data , Retrospective Studies , Risk Factors , Streptococcus pyogenes , Uruguay/epidemiology
16.
Mem. Inst. Oswaldo Cruz ; 109(7): 935-939, 11/2014. tab, graf
Article in English | LILACS | ID: lil-728810

ABSTRACT

Streptococcus pyogenes is responsible for a variety of infectious diseases and immunological complications. In this study, 91 isolates of S. pyogenes recovered from oropharynx secretions were submitted to antimicrobial susceptibility testing, emm typing and pulsed-field gel electrophoresis (PFGE) analysis. All isolates were susceptible to ceftriaxone, levofloxacin, penicillin G and vancomycin. Resistance to erythromycin and clindamycin was 15.4%, which is higher than previous reports from this area, while 20.9% of the isolates were not susceptible to tetracycline. The macrolide resistance phenotypes were cMLSB (10) and iMLSB (4). The ermB gene was predominant, followed by the ermA gene. Thirty-two emm types and subtypes were found, but five (emm1, emm4, emm12, emm22, emm81) were detected in 48% of the isolates. Three new emm subtypes were identified (emm1.74, emm58.14, emm76.7). There was a strong association between emm type and PFGE clustering. A variety of PFGE profiles as well as emm types were found among tetracycline and erythromycin-resistant isolates, demonstrating that antimicrobial resistant strains do not result from the expansion of one or a few clones. This study provides epidemiological data that contribute to the development of suitable strategies for the prevention and treatment of such infections in a poorly studied area.


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Genetic Variation/genetics , Penicillin Resistance/genetics , Streptococcal Infections/epidemiology , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/genetics , Vancomycin Resistance/genetics , Anti-Bacterial Agents/pharmacology , Bacterial Typing Techniques , Brazil/epidemiology , Erythromycin/pharmacology , Genotype , Macrolides/pharmacology , Oropharynx , Phenotype , Sequence Analysis, Protein/methods , Streptococcal Infections/prevention & control , Streptococcus pyogenes/classification
17.
Article in English | IMSEAR | ID: sea-163478

ABSTRACT

Group A Streptococci (GAS) are one of the common pathogens responsible for causing tonsillitis and pharyngitis in both children and young adults. The asymptomatic pharyngeal carriage of GAS in children may lead to spread of respiratory infection in the community. Children aged 5 to 15 years with no signs and symptoms of upper respiratory tract infections and no history of antibiotic therapy within last two weeks were included in study. Throat swabs collected were cultured on blood agar. GAS was identified by conventional method and serogrouped using latex agglutination assay. GAS was isolated from 7 children, out of 250 children. The carrier rate was 3.6% which correlated well with other South Asian studies. Our study showed the importance of surveillance programme to keep carriers in check.


Subject(s)
Carrier State/epidemiology , Carrier State/microbiology , Child , Hemolysis , Humans , Prevalence , Schools , Streptococcal Infections/epidemiology , Streptococcal Infections/microbiology , Streptococcus/classification , Streptococcus pyogenes/epidemiology , Streptococcus pyogenes/etiology , Streptococcus pyogenes/microbiology
18.
Med. infant ; 21(2): 80-84, Junio 2014. tab
Article in Spanish | LILACS | ID: biblio-911107

ABSTRACT

Streptococcus pyogenes (estreptococo beta-hemolítico del grupo A) (SGA) y Streptococcus dysgalactiae subsp. equisimilis, (estreptococos beta-hemolíticos grupos C y G) (SDSE) son capaces de provocar enfermedades graves como la fascitis necrotizante y el síndrome de shock tóxico estreptocócico (SSTE) y de causar complicaciones posinfecciosas. El objetivo de este trabajo fue presentar resultados de un estudio multicéntrico y compararlo con diferentes estudios descriptivos previos sobre infecciones invasivas por estreptococos beta-hemolíticos de los grupos A, C y G, también realizados en la Argentina. Se incluyeron 54 pacientes de 0 a 15 años con infecciones invasivas por SGA (N=50) o SDSE (N=4) en forma prospectiva entre julio de 2011 y junio de 2012 en 28 centros de 17 ciudades argentinas. Se aisló S. pyogenes en 28 pacientes que presentaron bacteriemia, 6 de ellas sin foco. Cuatro pacientes (7,4%) presentaron SSTE, en todos los casos por S. pyogenes. La mortalidad fue del 2,0% para SGA. La evolución de los pacientes fue peor en los tres estudios anteriores respecto del actual: mayor porcentaje de casos de SSTE (diferencias no significativas) y mayor mortalidad (diferencia significativa respecto de dos estudios previos). Es probable que la morbimortalidad haya decrecido en esta última década en la Argentina posiblemente debido al uso temprano de clindamicina en las infecciones invasivas por S. pyogenes y SDSE, aunque no se puede descartar la diferente circulación de cepas virulentas. Esta apreciación además está sesgada por la inclusión de pacientes de distintos centros con diferentes formas de presentación inicial (AU)


Streptococcus pyogenes (group A ß-hemolytic streptococcus (GAS)) and Streptococcus dysgalactiae subsp. equisimilis (group C and G ß-hemolytic streptococcus (GCGS)) may cause severe diseases such as necrotizing fasciitis and streptococcal toxic shock syndrome (STSS) as well as postinfectious complications. The aim of this report was to present the results of a multicenter study and compare them with the results of different previous descriptive studies on invasive infections due to beta-hemolytic streptococcus groups A, C, and G that were also conducted in Argentina. Forty-five patients between 0 and 15 years of age with invasive infections due to GAS (N=50) or GCGS (N=4) were prospectively included in the study between July 2011 and June 2012 from 28 centers in 17 Argentine cities. S. pyogenes was isolated in 28 patients who presented with bacteremia, without a focus in six. Four patients (7.4%) had STSS, due to S. pyogenes in all of them. In patients with GAS, mortality rate was 2.0%. Outcome of the patients was worse in previous studies than in the present one: Percentages of cases with STSS (no significant difference) and mortality (significant difference) were higher. It is probable that over the last decade morbidity and mortality have decreased in Argentina, possibly due to the early use of clindamycin in invasive infections due to S. pyogenes and GCGS, although a different circulation of virulent strains cannot be ruled out. Additionally, this observation is biased by the inclusion of patients from different centers with different presentations at onset (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Streptococcal Infections/microbiology , Streptococcal Infections/epidemiology , Streptococcus/isolation & purification , Streptococcus/classification , Streptococcus pyogenes/isolation & purification , Bacteremia , Argentina/epidemiology , Clindamycin/therapeutic use , Incidence , Mortality
19.
Article in English | IMSEAR | ID: sea-156426

ABSTRACT

Background. Rheumatic fever (RF)/rheumatic heart disease (RHD) continue to be a neglected public health priority. We carried out a registry-based control project, prospective surveillance and sample surveys to estimate the burden of disease. Methods. We trained healthcare providers and established a surveillance system for the 1.1 million population of Rupnagar district in Punjab. In sample surveys conducted among schools, physicians examined the sampled children. Children with a cardiac murmur were investigated by echocardiography. Throat swabs were obtained from a sub-sample, and group A streptococci (GAS) were identified and emm typed by standard laboratory methods. We estimated the morbidity rates for RF/RHD from surveillance data and school surveys using a correction factor to account for under-registration of cases in the registry. Results. A total of 813 RF/RHD cases were registered from 2002 to 2009. Of the 203 RF and 610 RHD cases, respectively, 51.2% and 36.7% were males. In the age group of 5–14 years, RF was more common (80%) than RHD (27%). The prevalence of RF/RHD in 5–14-year-old students was 1.0/ 1000 (95% CI 0.8–1.3). The school survey indicated that about two-thirds of the RF/RHD cases were enrolled in the hospital-based registries. Based on the school survey, the prevalence of RF/RHD was estimated to be 143/100 000 population. In the registry, the annual incidence of acute RF was estimated to be at least 8.7/100 000 children in the age group of 5–14 years. The prevalence of GAS was 2% (13/656) in children with sore throat and 0.5% (14/2920) among those not having sore throat. Typing of 27 GAS revealed 16 emm types. We estimate that about 1000 episodes of GAS pharyngitis lead to one episode of acute RF. Conclusion. RF/RHD continue to be a public health problem in Punjab, India.


Subject(s)
Adolescent , Child , Child, Preschool , Echocardiography , Female , Humans , Incidence , India/epidemiology , Male , Pharyngitis/epidemiology , Pharyngitis/microbiology , Population Surveillance , Prevalence , Prospective Studies , Registries , Rheumatic Fever/epidemiology , Rheumatic Fever/microbiology , Rheumatic Heart Disease/epidemiology , Rheumatic Heart Disease/microbiology , Streptococcal Infections/epidemiology , Streptococcal Infections/microbiology
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