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Article in English | WPRIM | ID: wpr-928565


OBJECTIVES@#To study the effect of intrapartum antibiotic prophylaxis (IAP) of group B streptococcus (GBS) infection on the incidence and bacteriological profile of early-onset neonatal sepsis (EONS).@*METHODS@#A retrospective analysis was performed on the medical data of 494 pregnant women with positive GBS screening results and 526 neonates born by these women. According to whether the pregnant woman received IAP, the neonates were divided into two groups: IAP (n=304) and control (n=222). The two groups were compared in terms of clinical indices, incidence rate of EONS, and distribution of pathogenic bacteria in blood culture.@*RESULTS@#Compared with the control group, the IAP group had a significantly lower proportion of children with abnormal clinical manifestations (P<0.001) and a significantly lower incidence rate of EONS (P=0.022). In the IAP group, Escherichia coli (2.3%) was the most common type of pathogenic bacteria in blood culture of the neonates with EONS, while GBS (3.2%) was the most common type of pathogenic bacteria in the control group. The IAP group had a significantly higher detection rate of ampicillin-resistant Escherichia coli than the control group (P=0.029).@*CONCLUSIONS@#Although IAP can significantly reduce the incidence rate of EONS in neonates born to pregnant women with positive GBS screening results, the infection rate of ampicillin-resistant Escherichia coli may increase after IAP treatment. Therefore, it is needed to enhance the monitoring of blood culture results of neonates with EONS and timely adjust treatment plan according to drug susceptibility test results.

Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Child , Female , Humans , Incidence , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Neonatal Sepsis/prevention & control , Pregnancy , Pregnancy Complications, Infectious , Retrospective Studies , Streptococcal Infections/prevention & control , Streptococcus agalactiae
Rev. bras. anal. clin ; 53(3): 264-270, 20210930. graf
Article in Portuguese | LILACS | ID: biblio-1368624


Objetivo: O objetivo deste estudo foi avaliar a incidência de Streptococcus ß-hemolítico em gestantes e a suscetibilidade aos antimicrobianos das pacientes colonizadas. Métodos: Para isso, foram analisadas 4.380 amostras de secreções vaginais e anais de gestantes, a partir de 35 semanas de gestação, atendidas em laboratório particular na cidade de Campinas, para detecção da presença de Streptococcus ß-hemolítico. Resultados: Foi encontrada uma prevalência de colonização nas gestantes analisadas de 12% (504/4380), sendo 293 (13%) vaginais e 211 (10%) anais. Das positivas, foi realizado o perfil de resistência bacteriana em 60 amostras, sendo 20% das amostras anais resistentes à clindamicina e 22% à eritromicina e das amostras vaginais 25% resistentes à clindamicina e 33% à eritromicina, não havendo resistência à penicilina e ampicilina. Conclusão: Diante da incidência apresentada, ressalta-se a importância da realização do rastreio da colonização transitória de estreptococos ß-hemolíticos em gestantes durante o pré-natal, associado à adequada profilaxia intraparto, para minimizar os riscos de ocorrência de sepse nos neonatos.

Objective: The aim of this study was evaluate the incidence of ß-hemolytic Streptococcus in pregnant women and antimicrobial susceptibility of colonized patients. Methods: For this, a cohort of 4,380 of pregnant women, from 35 weeks of gestation, were analyzed, samples of vaginal and anal secretion were collected in a private laboratory in the city of Campinas. Result: The prevalence of colonization was of 12% (504/4380) in pregnant women was evidenced, being 293 (13%) vaginal and 211 (10%) anal. From the positives, the bacterial resistance profile was performed in 60 samples, 20% of the clinical samples resistant to Clindamycin and 22% of Erythromycin and 25% of the vaginal samples resistant to Clindamycin and 33% to Erythromycin, without resistance to Penicillin and Ampicillin. Conclusion: We conclude that the emphasize the importance of performing the screening of ß-hemolytic Streptococcus in pregnant women during the prenatal period, associated with adequate intrapartum prophylaxis is needed.

Humans , Male , Female , Pregnancy , Infant, Newborn , Streptococcus agalactiae , Neonatal Sepsis , Infections , Pregnant Women
Med. infant ; 28(1): 38-42, Marzo 2021. Tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1283476


Últimamente, se están detectando mutaciones en las proteínas ligadoras de penicilina (PBP) de los estreptococos beta-hemolíticos que corresponden a sitios que en Streptococcus pneumoniae han determinado sensibilidad disminuida a los antibióticos beta-lactámicos. Primero, se describieron cepas con sensibilidad intermedia a penicilina en Streptococcus agalactiae (estreptococos del grupo B), luego en Streptococcus dysgalactiae subsp. equisimilis (mayormente grupos C y G) y, más recientemente, cepas con sensibilidad disminuida a aminopenicilinas y cefalosporinas de tercera generación en Streptococcus pyogenes (grupo A). El costo biológico de estas modificaciones nos permite pensar que los niveles de resistencia no han de ser tan elevados como para comprometer por ahora la efectividad clínica de los beta-lactámicos (AU)

Recently, mutations in penicillin-binding proteins (PBPs) of beta-hemolytic streptococci have been detected corresponding to sites that in Streptococcus pneumoniae have been determined to have decreased sensitivity to beta-lactam antibiotics. First, strains with intermediate sensitivity to penicillin were described in Streptococcus agalactiae (group B streptococci), subsequently in Streptococcus dysgalactiae subsp. equisimilis (mainly groups C and G) and, more recently, strains with decreased sensitivity to third-generation aminopenicillins and cephalosporins were found in Streptococcus pyogenes (group A). The biological cost of these modifications suggests that, for now, resistance levels are not high enough to compromise the clinical effectiveness of beta-lactams (AU)

Streptococcus agalactiae/drug effects , Streptococcus pyogenes/drug effects , Penicillin Resistance , Microbial Sensitivity Tests , beta-Lactam Resistance , beta-Lactams/pharmacology , Anti-Bacterial Agents/pharmacology
Braz. j. infect. dis ; 25(3): 101586, 2021. tab, graf
Article in English | LILACS | ID: biblio-1339430


ABSTRACT Background: Vaccines in development against Group B Streptococcus (GBS) should contain the most prevalent capsular genotypes screened in the target population. In low- and middle-income countries epidemiological data on GBS carriage among pregnant women, a prerequisite condition for GBS neonatal sepsis, is needed to inform vaccine strategies. Objective: To investigate the prevalence of different GBS capsular genotypes that colonizes at-risk pregnant women in a private maternity hospital in São Paulo, Brazil. Methods: GBS strains isolated in routine maternity procedures from at-risk pregnant women from 2014 to 2018 were confirmed by mass spectrometry (MALDI-TOF) with subsequent DNA extraction for identification of capsular genotype through polymerase chain reaction (PCR). Demographic and gestational data were analyzed. Results: A total of 820 Todd-Hewitt broths positive for GBS were selected for streptococcal growth. Recovery and confirmation of GBS by MALDI-TOF were possible in 352. Strains were processed for determination of capsular genotype by PCR. From the total of 352 GBS isolates, 125 strains (35.5%) were genotyped as Ia; 23 (6.5%) as Ib; 41 (11.6%) as II; 36 (10.2%) as III; 4 (1.1%) as IV; 120 (34.1%) as V and 1 strain (0.3%) as VIII. Two isolates (0.7%) were not genotyped by used methodology. No statistically significant correlation between gestational risk factors, demographic data and distribution of capsular genotypes were found. Conclusions: GBS capsular genotypes Ia, Ib, II, III, and V were the most prevalent isolates colonizing at risk pregnant women in the present study. The inclusion of capsular genotypes Ia and V in the composition of future vaccines would cover 69.6% of capsular genotypes in the studied population. No statistically significant differences were observed between capsular genotype and gestational and demographic data and risk factors.

Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/epidemiology , Streptococcal Infections/epidemiology , Streptococcus , Streptococcus agalactiae/genetics , Brazil , Pregnant Women , Genotype
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58: e178109, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1347979


Bovine mastitis is the most important disease of dairy herds worldwide. Its main etiologic agents are bacteria, including Streptococcus agalactiae. The importance of this agent in bovine mastitis is because it is highly contagious and has a high impact on the occurrence of clinical mastitis cases and in the increase of the bulk milk somatic cell counts. The dry cow therapy and the treatment of the clinical mastitis cases stand out among the measures to control intramammary infections in cows. However, these strategies require knowledge about the antimicrobial susceptibility of the causal microorganisms. Thus, this study aimed to evaluate the antimicrobial susceptibility of 89 S. agalactiae strains isolated from bovine mastitis between the years 2004 and 2008 in dairy herds from Campo das Vertentes region, Minas Gerais State, Brazil. The disc diffusion technique was used and the antimicrobials currently used in mastitis therapy were tested. The isolates tested showed 100% susceptibility to chloramphenicol, ceftiofur, cefotaxime, enrofloxacin, and cefquinome. High frequencies of susceptibility (>95%) were also observed for the beta-lactams (penicillin G, ampicillin, and oxacillin), cephalosporins (cephalotin, ceftiofur, cefotaxime, cefoperazone, and cefquinome), florfenicol, gentamicin, lincomycin, nitrofurantoin, and sulfamethoprim. The strains showed high frequencies of resistance to neomycin (15.74%), and tetracycline (21.35%). Multidrug resistance was detected in 2.25% of the tested isolates. The results pointed to variations in the antimicrobial susceptibility profiles of the studied strains and the importance of the use of the susceptibility tests to determine the correct antimicrobial to be applied in the treatment of bovine mastitis caused by S. agalactiae. The high frequencies of resistance observed to some antimicrobials, such as neomycin and tetracycline, commonly used in the treatment of mastitis and other pathologies, highlighted the need for more judicious use of antimicrobials on dairy farms.(AU)

A mastite é a principal doença de bovinos leiteiros em todo o mundo e tem como principais agentes as bactérias, entre as quais Streptococcus agalactiae. Esse agente se destaca por ser altamente contagioso e pelos reflexos que causa na incidência de casos clínicos e no incremento da contagem de células somáticas do leite do tanque. Para o controle desta enfermidade, destacam-se a terapia de vacas secas e o tratamento de casos clínicos, medidas que requerem o conhecimento do perfil de sensibilidade dos agentes causais aos antimicrobianos. Este estudo teve como objetivo avaliar os perfis de suscetibilidade a antimicrobianos em 89 amostras de S. agalactiae isoladas de casos de mastite bovina em rebanhos da região de Campo das Vertentes, Minas Gerais, no período de 2004 a 2008. A técnica de difusão em discos foi utilizada e os antimicrobianos correntemente empregados na terapia da mastite foram testados. Os testes de suscetibilidade antimicrobiana apontaram 100% de susceptibilidade para cloranfenicol, ceftiofur, cefotaxima, enrofloxacina e cefquimona. Níveis elevados de susceptibilidade (>95%) foram observados para os betalactâmicos, florfenicol, gentamicina, lincomicina, nitrofurantoína e sulfametoprim. Altas frequências de resistência foram observadas para neomicina (15,74%) e tetraciclina (21,35%). Dois isolados multirresistentes (2,25%) foram encontrados. Os resultados apontaram variações nos perfis se suscetibilidade aos antimicrobianos na população analisada, indicando a importância do uso do antibiograma para a escolha mais criteriosa dos antibacterianos a serem utilizados para o tratamento da mastite bovina causada por S. agalactiae. As altas frequências de resistência detectadas para alguns dos antimicrobianos comumente utilizados para o tratamento de mastite e outras patologias, tais como a neomicina e a tetraciclina, salientam a necessidade de monitoramento permanente do perfil de suscetibilidade aos antimicrobianos e do uso mais criterioso dos mesmos nos rebanhos leiteiros.(AU)

Animals , Cattle , Streptococcus agalactiae/isolation & purification , Cattle/microbiology , Mastitis, Bovine , Anti-Infective Agents
Pesqui. vet. bras ; 41: e06862, 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1346693


Mastitis causes significant economic losses to the dairy cattle industry. The present study aimed to evaluate the antibacterial properties of 39 heterocyclic derivatives (1,3-thiazoles and 4-thiazolidinones) against clinical mastitis isolates from dairy cows. Milk samples were collected from cows with clinical mastitis and the bacterial species were identified by PCR. Antibacterial activity was assessed using the broth microdilution method. First, 39 heterocyclic compounds were tested against four bacterial isolates (Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis and Escherichia coli) randomly chosen from those recovered from the milk samples (Study 1). Subsequently, the compounds with the strongest antibacterial activity were tested against all the bacterial isolates recovered from the milk samples (Study 2). 1,3-thiazoles showed the strongest antibacterial activity, specially compounds 30 and 38, which also showed bactericidal properties according to their minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) values. Corynebacterium spp. and Enterobacteriaceae isolates were the most susceptible to compounds 30 and 38. Compounds 30 and 38 are promising targets for new antimicrobial agents.(AU)

A mastite causa significativas perdas econômicas à indústria leiteira bovina. O presente estudo teve como objetivo avaliar as propriedades antibacterianas de 39 derivados heterocíclicos (1,3-tiazóis e 4-tiazolidinonas) contra isolados clínicos de mastite em vacas leiteiras. Amostras de leite foram coletadas de vacas com mastite clínica e as espécies bacterianas isoladas foram identificadas por PCR. A atividade antibacteriana foi avaliada pelo método de microdiluição em caldo. Primeiramente, os 39 compostos heterocíclicos foram testados contra quatro isolados bacterianos (Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis e Escherichia coli) escolhidos aleatoriamente dentre os recuperados das amostras de leite (Estudo 1). Posteriormente, compostos com atividade antibacteriana mais forte foram testados contra todos os isolados bacterianos recuperados das amostras de leite (Estudo 2). Os compostos 1,3-tiazóis apresentaram a maior atividade antibacteriana, principalmente os compostos 30 e 38, que também apresentaram propriedades bactericidas de acordo com seus valores de concentração inibitória mínima (CIM) e concentração bactericida mínima (CBM). Os isolados Corynebacterium spp. e Enterobacteriaceae foram os mais suscetíveis aos compostos 30 e 38. Os compostos 30 e 38 mostraram-se promissores como novos agentes antimicrobianos.(AU)

Animals , Cattle , Thiazoles/administration & dosage , Mastitis/immunology , Anti-Bacterial Agents , Staphylococcus aureus , Streptococcus agalactiae , Cattle/microbiology
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(4): 1165-1172, Oct-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1155297


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.

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
Infectio ; 24(4): 255-258, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1114878


Resumen El Streptococcus pseudoporcinus es un germen de la clasificación Beta hemolítico, con similitud a Streptococcus agalactiae, con baja incidencia en producción de infección pero principalmente aislado en tracto genitourinario de mujeres embarazadas y relacionado con complicaciones materno-fetales. Reportes en la literatura como infección fuera de este sitio son inusuales, por lo cual presentamos un caso de un hombre de 48 años con infección de tracto respiratorio bajo, compatible con colección neumónica y un derrame paraneumonico complicado, con requerimiento de manejo antibiótico y drenaje por toracostomia. Al realizar el estudio microbiológico se reportó aislamiento de un Streptococcus pseudoporcinus. No hay reportes previos en la literatura como causa de infección en este sitio anatómico.

Abstract Streptococcus pseudoporcinus in a germ of the Beta hemolytic group, similar to Streptococcus agalactiae, with low incidence in the production of infection, and isolated in most of cases from the genitourinary tract of pregnant women and related to maternal and fetal complications; the reports in the literature as infection outside this site are unusual. We describe a case of one 48-year-old man with a low respiratory tract infection with a pneumonic collection and a complicated parapneumonic effusion, requiring antibiotic management and thoracostomy drainage. Isolation of a Streptococcus pseudoporcinus. There is no report in the literatura as a cause of infection in this anatomical site.

Humans , Male , Adult , Pneumonia , Respiratory Tract Infections , Streptococcus agalactiae , Respiratory System , Streptococcus , Pregnant Women , Infections
Arch. argent. pediatr ; 118(4): e392-e395, agosto 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1118583


La artritis séptica es una patología poco frecuente, pero con una alta morbilidad, debido a las importantes secuelas que puede originar. La etiología varía según la edad, y Staphylococcus aureus es el microorganismo más frecuente en todas ellas. Streptococcus agalactiae odel grupo B es una causa infrecuente de infección fuera del período neonatal; se asocia, a partir de los 3 meses de edad, con infecciones graves en pacientes inmunocomprometidos. El tratamiento de elección es penicilina G o ampicilina.Aquí se describe el caso de un niño de cuatro meses y medio de edad que desarrolló una artritis séptica por Streptococcus agalactiae odel grupo B, con inicio insidioso de la clínica. El diagnóstico etiológico obligó a descartar meningitis y una inmunodeficiencia asociada. La frecuencia extremadamente baja de dicha artritis a esta edad y la importancia de descartar una enfermedad diseminada son importantes puntos de aprendizaje en este caso.

Septic arthritis is not a very frequent disease, but with a high morbidity due to the important sequelae that it can cause. The etiology is age-specific, with Staphylococcus aureus being the most frequent microorganism in all ages. Streptococcus agalactiae or group B Streptococcus is an uncommon cause of infection outside the neonatal period. Beyond 3 months of age, infections by this pathogen are associated with serious infections in immunocompromised patients. The treatment of choice is penicillin G or ampicillin. A 4.5-month-old child who developed a group B Streptococcus septic arthritis is reported. The onset was insidious, and the etiological diagnosis prompted us to rule out meningitis and associated immunodeficiency. The extremely low frequency of group B Streptococcus septic arthritis at this age and the importance of ruling out a disseminated disease are crucial learning points in this case

Humans , Male , Infant , Streptococcus agalactiae , Arthritis, Infectious/diagnostic imaging , Arthritis, Infectious/therapy , Hip Injuries/diagnostic imaging
Rev Bras Ginecol Obstet ; 42(8): 454-459, 2020. tab
Article in English | LILACS | ID: biblio-1137861


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.

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
Einstein (Säo Paulo) ; 18: eAO4920, 2020. tab
Article in English | LILACS | ID: biblio-1056062


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.

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
Mem. Inst. Oswaldo Cruz ; 115: e190398, 2020. graf
Article in English | LILACS | ID: biblio-1091238


BACKGROUND Streptococcus agalactiae capsular type III strains are a leading cause of invasive neonatal infections. Many pathogens have developed mechanisms to escape from host defense response using the host membrane microdomain machinery. Lipid rafts play an important role in a variety of cellular functions and the benefit provided by interaction with lipid rafts can vary from one pathogen to another. OBJECTIVES This study aims to evaluate the involvement of membrane microdomains during infection of human endothelial cell by S. agalactiae. METHODS The effects of cholesterol depletion and PI3K/AKT signaling pathway activation during S. agalactiae-human umbilical vein endothelial cells (HUVEC) interaction were analysed by pre-treatment with methyl-β-cyclodextrin (MβCD) or LY294002 inhibitors, immunofluorescence and immunoblot analysis. The involvement of lipid rafts was analysed by colocalisation of bacteria with flotillin-1 and caveolin-1 using fluorescence confocal microscopy. FINDINGS In this work, we demonstrated the importance of the integrity of lipid rafts microdomains and activation of PI3K/Akt pathway during invasion of S. agalactiae strain to HUVEC cells. Our results suggest the involvement of flotillin-1 and caveolin-1 during the invasion of S. agalactiae strain in HUVEC cells. CONCLUSIONS The collection of our results suggests that lipid microdomain affects the interaction of S. agalactiae type III belonging to the hypervirulent ST-17 with HUVEC cells through PI3K/Akt signaling pathway.

Humans , Infant, Newborn , Streptococcus agalactiae/pathogenicity , Virulence , Membrane Microdomains/virology , Endothelial Cells/virology , Membrane Lipids , Streptococcus agalactiae/genetics
Article in Chinese | WPRIM | ID: wpr-828489


OBJECTIVE@#To investigate the relationship of group B (GBS) colonization in late pregnancy with perinatal outcome.@*METHODS@#Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics.@*RESULTS@#A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( < 0.05 or < 0.01).@*CONCLUSIONS@#The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.

Anti-Bacterial Agents , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious , Pregnancy Outcome , Streptococcal Infections , Streptococcus agalactiae , Vagina
Article in Chinese | WPRIM | ID: wpr-880804


OBJECTIVE@#To explore the effects of intervention with oral probiotic @*METHODS@#This study were conducted among 155 women in the third trimester of pregnancy with positive results of GBS culture in the Outpatient Department of Zhujiang Hospital from March to November, 2019. After excluding 32 patients who received lactobacillus intervention for less than 2 weeks or underwent postpartum GBS retesting, the women were divided into oral probiotics intervention group (60 cases) and non-intervention group (63 cases). According to the results of GBS retesting, the 60 women in the intervention group were divided into GBS-negative group (18 cases) and persistent GBS-positive group (42 cases). At the end of the intervention, the rates of negative GBS culture result were calculated and the pregnancy outcomes were compared. From 5 women randomly selected from the intervention group, samples of vaginal secretions were collected before and after the intervention for amplicon sequencing and bioinformatics analysis.@*RESULTS@#At the end of the intervention, the GBS-negative rate in the intervention group was 30% (18/60), as compared with 23% (3/13) in the non-intervention group. Probiotic intervention significantly reduced the incidence of premature rupture of membranes (@*CONCLUSIONS@#Intervention with oral probiotics can reduce vaginal GBS colonization in late pregnancy and improve the pregnancy outcome.

Female , Humans , Lactobacillus reuteri , Lactobacillus rhamnosus , Microbiota , Pregnancy , Probiotics/therapeutic use , Streptococcus agalactiae , Vagina
An. bras. dermatol ; 94(3): 363-364, May-June 2019. graf
Article in English | LILACS | ID: biblio-1011113


Abstract: The authors report the case of a 62-year-old man with a history of total left hip arthroplasty nine years previously presenting with a large infiltrated plaque on the posterior area of the left thigh with three months of evolution without systemic symptoms or elevated inflammatory markers. Computed tomography of the left lower limb revealed a 12-centimeter linear extension of the lesion to the posterior part of the left proximal femur. Prosthesis joint infection, although rare, is a surgical complication to be taken into account, even if the surgery was performed many years before.

Humans , Male , Middle Aged , Suppuration/diagnosis , Arthroplasty, Replacement, Hip/adverse effects , Hip Prosthesis/adverse effects , Streptococcus agalactiae/isolation & purification , Suppuration/microbiology , Thigh , Biopsy , Tomography, X-Ray Computed , Femur
Pesqui. vet. bras ; 39(5): 308-316, May 2019. tab
Article in English | LILACS, VETINDEX | ID: biblio-1012746


Bovine mastitis is the most frequent disease worldwide in dairy herds, causing high economic losses to producers and industry, as well as having implications for public health due to the zoonotic potential of some agents involved in its etiology and the increased risk of antimicrobial residues in milk and its derivatives. Considering the multifactorial aspect of this disease, knowledge of the agents involved in its etiology and their antimicrobial susceptibility profiles is very important. This study was conducted with 306 dairy herds from the Campo das Vertentes region, located in the south of Minas Gerais state, whose owners were milk suppliers to a dairy in the same region. The study involved approximately 34,000 dairy cows and covered an area of approximately 12,564 km2. In these herds, prevalence rates of Staphylococcus aureus and Streptococcus agalactiae and their relationship with bulk milk somatic cell counts (BMSCC), total bacterial counts (TBC), and daily production were evaluated. In addition, analyses of resistance of these pathogens to the antimicrobials most commonly used in the treatment of mastitis in dairy herds were performed. Microbiological analyses of milk samples from collect from bulk milk tanks were performed aiming to evaluate the prevalence of S. aureus and S. agalactiae. For these proposes, the modified Baird-Parker Agar medium was used for detection of S. aureus and the modified Edwards Agar medium, enriched with 5% defibrinated sheep blood, was used for detection of S. agalactiae. The disc diffusion technique was applied to evaluate antimicrobial resistance. Results show high prevalence rates of S. aureus (70.3%) and S. agalactiae (67.0%) in the dairy farms studied, with 47.71% of the herds showing both pathogens. Associations between BMSCC and the presence of pathogens S. aureus and S. agalactiae and between TBC and the presence of S. agalactiae were observed, demonstrating the influence of these pathogens in milk quality. No variation was observed in the distribution of S. aureus and S. agalactiae in the different strata of daily production. High levels of resistance and multi-resistance were observed among the pathogens S. aureus and S. agalactiae. The results indicate the need for more effective control measures for mastitis caused by S. aureus and S. agalactiae in the dairy herds of the region studied and more judicious use of antimicrobials in order to reduce the problem of resistance to them.(AU)

A mastite bovina é a doença de maior frequência em rebanhos leiteiros em nível mundial, acarretando grandes prejuízos econômicos aos produtores e à indústria. Além disso, esta enfermidade tem implicações na saúde pública, devido ao potencial zoonótico de alguns agentes envolvidos em sua etiologia e por aumentar os riscos de resíduos de antimicrobianos no leite e derivados. Considerando o aspecto multifatorial da mastite bovina, o conhecimento dos agentes envolvidos em sua etiologia e os perfis de suscetibilidade aos antibióticos é de suma importância. O estudo envolveu 306 fazendas de leite da região de Campo das Vertentes, localizada no sul de Minas Gerais, cujos proprietários eram fornecedores de leite para um laticínio da região, totalizando aproximadamente 34.000 animais e abrangendo uma área aproximada 12.564 km2. Nestes rebanhos, avaliaram-se a prevalência de Staphylococcus aureus e Streptococcus agalactiae e a relação destes agentes com os índices de contagem de células somáticas do leite do tanque de expansão (CCSt), contagem bacteriana total (CBT) e produção diária. Analisou-se também a resistência destes patógenos aos antimicrobianos mais comumente utilizados no tratamento da mastite em rebanhos leiteiros. Análises microbiológicas de amostras de leite dos tanques de expansão foram realizadas para se determinar as prevalências dos patógenos S. aureus e S. agalactiae. Para a detecção de S. aureus, utilizou-se o meio seletivo Ágar Baird-Parker modificado e para a detecção de S. agalactiae, o meio seletivo Ágar Edwards modificado, enriquecido com 5% de sangue ovino desfibrinado. Foi utilizada a técnica de difusão em discos para a avaliação de resistência aos antimicrobianos. Os resultados apontaram altas prevalências de S. aureus (70,3%) e de S. agalactiae (67,0%), com 47,71% dos rebanhos examinados apresentando ambos os agentes. Verificaram-se associações entre a CCSt e a presença dos patógenos S. aureus e S. agalactiae, e também entre a CBT e a presença de S. agalactiae, demonstrando a interferência negativa destes patógenos nestes quesitos de qualidade. Não se observaram variações nas distribuições dos patógenos S. aureus e nem S. agalactiae em função da produção diária das propriedades estudadas. Níveis elevados de resistência e de multirresistência foram observados para ambos os agentes. Os resultados apontam a necessidade de medidas mais efetivas de controle para S. aureus e S. agalactiae nos rebanhos da região estudada e do uso mais criterioso dos antimicrobianos, visando minimizar o problema da resistência aos mesmos.(AU)

Animals , Female , Cattle , Staphylococcus aureus , Streptococcus agalactiae , Milk/microbiology , Anti-Infective Agents/analysis
Biosci. j. (Online) ; 35(2): 629-639, mar./apr. 2019. tab, ilus
Article in English | LILACS | ID: biblio-1048616


Neonatal sepsis is a clinical syndrome defined by systemic signs of infection in newborns accompanied by bacteremia. Can be responsible for serious consequences for the newborn child,characterized at the birth as early sepsis or late onset sepsis, with high rate of neonatal morbidity and mortality. Pathological agents such as Escherichia coli (E. coli), Streptococcus agalactiae (S. agalactiae), Ureaplasma urealyticum and Mycoplasma hominis are most often responsible for intrauterine infections. The objective of this study is to evaluate the factors of neonatal sepsis predisposition in pregnant women through histopathological examination and the apoptotic index of placental tissues and detect DNA of E. coli and S. agalactiae using the Polymerase Chain Reaction (PCR). Histopathological analyses were made and the apoptotic index was determined to verify the levels of possible inflammatory infiltrates and cell death. Placenta samples were collected from November 2013 to May 2014. After DNA extraction, a PCR was performed amplifying the target fragment from the conserved regions of the rpoB (beta-RNA polymerase) polymorphism of E. coli and the factor 1 of S. agalactiae. The apoptosis index was tested with Acridine Orange and the histological procedure with Hematoxylin-Eosin staining. Among 100 samples of placental tissues analyzed by PCR, 48 represented the control group and did not present a risk factor associated with neonatal sepsis, and 52 samples representing the study group had at least one risk factor. Among these 52 samples, 7 (13.4%) had a PCR positive for E. coli. No placenta samples showed a positive PCR for S. agalactiae. The quantification of the apoptotic index did not show statistical significances between the groups and no inflammatory infiltrates were observed. However, histological sections showed fibrinoid necrosis, infarct areas and areas of calcification in all samples. Therefore, the results allow to conclude that the seven patients of experimental group with positive PCR for E. coli had eminent risk factors of neonatal sepsis, and the infection of the urinary tract (UTI) is the main aggravating circumstance. The histopathological examination demonstrated that the risk factors caused significant alterations, producing fibrinoid necrosis and infarcted areas in the placenta, contrary to apoptotic index that didn't differ from the group with unprecedented risk

A sepse neonatal é uma síndrome clínica definida por sinais sistêmicos de infecção em recém-nascidos acompanhados de bacteremia. Pode ser responsável por sérias consequências para o recém-nascido, caracterizadas ao nascimento como sepse precoce ou sepse tardia, com alta taxa de morbidade emortalidade neonatal. Agentes patológicos como Escherichia coli (E. coli), Streptococcus agalactiae (S. agalactiae), Ureaplasma urealyticum e Mycoplasma hominis são mais frequentemente responsáveis por infecções intra-uterinas. O objetivo deste estudo é avaliar os fatores de predisposição da sepse neonatal em gestantes através do exame histopatológico e do índice apoptótico de tecidos placentários e detectar DNA de E. coli e S. agalactiae utilizando a reação em cadeia da polimerase (PCR). Análises histopatológicas foram realizadas e o índice apoptótico foi determinado para verificar os níveis de possíveis infiltrados inflamatórios e morte celular. Amostras de placenta foram coletadas de novembro de 2013 a maio de 2014. Após a extração de DNA, foi realizada uma PCR amplificando o fragmento alvo das regiões conservadas do polimorfismo rpoB (polimerase beta-RNA) de E. coli e o fator 1 de S. agalactiae. O índice de apoptose foi testado com alaranjado de acridina e o procedimento histológico com coloração de hematoxilina-eosina. Entre 100 amostras de tecidos placentários analisados por PCR, 48 representaram o grupo controle e não apresentaram fator de risco associado à sepse neonatal, e 52 amostras representativas do grupo de estudo apresentaram pelo menos um fator de risco. Entre essas 52 amostras, 7 (13,4%) apresentaram PCR positivo para E. coli. Nenhuma amostra de placenta foi positivo para S. agalactiae na PCR. A quantificação do índice apoptótico não mostrou significância estatística entre os grupos e não foram encontrados infiltrados inflamatórios. No entanto, cortes histológicos mostraram necrose fibrinóide, áreas de infarto e áreas de calcificação em todas as amostras. Portanto, os resultados permitem concluir que as sete pacientes do grupo experimental com PCR positivo para E. coliapresentavam fatores de risco eminentes de sepse neonatal, sendo a infecção do trato urinário (ITU), o principal agravante. O exame histopatológico demonstrou que os fatores de risco causaram alterações significativas, produzindo necrose fibrinóide e áreas infartadas na placenta, ao contrário o índice apoptótico que não diferiu do grupo sem precedentes de risco.

Placenta , Bacteremia , Escherichia coli , Neonatal Sepsis , Streptococcus agalactiae , Polymerase Chain Reaction
Niger. j. med. (Online) ; 28(1): 5-12, 2019. ilus
Article in English | AIM | ID: biblio-1267391


BACKGROUND: Group B streptococcus (GBS) is one of the principal agents of early onset neonatal sepsis, pneumonia and meningitis with significant morbidity for newborns and parturients.AIM: This study was done to determine the prevalence of vaginal group B streptococcus amongst parturients in FMC Owerri. It also aimed to elucidate the antibiotic sensitivity of the strains of GBS isolated while comparing the sensitivity of antigen detection tests of GBS to culture.PATIENTS AND METHODS: This cross-sectional study was done at the labour ward and lying-in units of the Federal Medical Center, Owerri,from February 2015 to October, 2015. It involved one hundred and eighty (180)womenrecruitedsystematically. Two swab samples, high vaginal and rectal were collected from the parturients intrapartum and cultured. The babies were examined and weighed immediately after delivery, seen on the second and tenth days after delivery for features of fever or any other complaints. RESULTS: The overall prevalence of GBS amongst parturients was found to be 6.1%. Prevalence of vaginal colonization was 3.3% and that of the rectum was 2.8%, (2c=0.1282, df=1,p=0.502). Neonates with colonized mothers all had complaints of fever postpartum which was statistically significant (=55.86, df=1, p<0.001). All the microbes showed 100% sensitivity to penicillin G, erythromycin, gentamycin and ceftriaxone. Antibiotic resistance was discovered in augmentin (67%), Cloxacillin (55.6%) and ofloxacin (33.3%). Antigen detection tests gave Sensitivity=100%, specificity=96.4%, positive predictive value (PPV) = 64.7%, negative predictive value (NPV) =100%. Detection in both vaginal (=60.290, p=0.000) and rectal (=50.799, p=0.000) samples were statistically significant. CONCLUSION: The prevalence of GBS in parturients in the Centre is low. Strains of GBS isolated amongst the sampled population in FMC Owerri had a high sensitivity to penicillin G, erythromycin, gentamycin and 3 generation cephalosporins. Antigen detection method for screening of GBS though very sensitive is however not specific with a significant false positive detection rate due to antigen cross reaction. It is however recommended that antigen detection be employed as intrapartum measure in high risk cases to reduce turnover time whilst supported by culture results later. There was associated significant neonatal sequaelae and further research to establish causal relationship will be advised

Nigeria , Prevalence , Streptococcus agalactiae