Prevalence of early neonatal sepsis and positive maternal culture for group B beta-hemolytic Streptococcus

SUMMARY OBJECTIVE: The aim of this study was to evaluate the prevalence of early neonatal sepsis in pregnant women with a positive culture for group B beta-hemolytic Streptococcus in a middle-income city in Southeastern Brazil. METHODS: A retrospective cohort study was conducted, involving singleton low- and high-risk pregnancies in whom group B beta-hemolytic Streptococcus cultures were evaluated between 35 and 37 weeks of gestation using vaginal and anal swabs. A specific medium (Todd-Hewitt) was used for culturing. The pregnant women were divided into two groups based on positive (n==201) and negative (n==420) cultures for group B beta-hemolytic Streptococcus. RESULTS: The maternal colonization rate by group B beta-hemolytic Streptococcus was 32.3%. The prevalence of early neonatal sepsis was 1.0% (2/201) among patients with a positive group B beta-hemolytic Streptococcus culture and 1.9% (8/420) among patients with a negative culture. Among the patients who underwent adequate prophylaxis, crystalline penicillin G was used in 51.9% (54/104), followed by cefazolin in 43.3% (45/104), ampicillin in 3.8% (4/104), and clindamycin in 1.0% (1/104). A model that included prematurity (p==0.001) proved to be an independent risk predictor of early neonatal sepsis [χ2 (1)==15.0, odds ratio: 16.9, 95% confidence interval: 4.7-61.6, p<0.001, Nagelkerke R2==0.157]. CONCLUSION: The prevalence of a positive culture for group B beta-hemolytic Streptococcus was high. However, the prevalence of early neonatal sepsis was low in pregnant women with both positive and negative group B beta-hemolytic Streptococcus cultures and in pregnant women with a positive culture who underwent both adequate and inadequate antibiotic prophylaxis. Prematurity proved to be an independent predictor of early neonatal sepsis, considering the entire study population.

Infectious endarteritis in aortic coarctation: two spectra of an infrequent disease / Endarterite infecciosa na coarctação da aorta: dois espectros de uma doença pouco frequente

ABSTRACT Objective: To describe two different degrees of clinical commitment and results in the evolution of infectious endarteritis in patients without a previous diagnosis of aortic coarctation. Case description: Two male patients aged 13 and 9 years old were admitted. The first due to a fever for 2 months, which started after dental cleaning, and the second due to high blood pressure, both patients with asthenia and weight loss. In the first case, the transthoracic echocardiogram showed aortic coarctation, and the transesophageal echocardiogram showed the presence of vegetations in the post-coarctation area, without pseudoaneurysms, with blood culture positive for Streptococcus mitis. This patient was treated for six weeks with crystalline penicillin, resolving the infection without complications. The second case was assessed for high blood pressure with a history of fever, and was treated with antibiotics. When performing a transthoracic echocardiogram, aortic coarctation was observed with a saccular image classified as a pseudoaneurysm by angiography and tomography. Blood culture was negative, and the patient developed an episode of hematemesis whose initial etiology could not be determined. Before surgical repair, he had a second episode of copious hematemesis with hypovolemic shock and death. Comments: We need to have a high index of clinical suspicion to establish the diagnosis of aortic coarctation complicated by endarteritis and start the appropriate antibiotic treatment, always maintaining surveillance for the early detection of pseudoaneurysms.

RESUMO Objetivo: Descrever dois diferentes graus de comprometimento clínico e resultados na evolução de endarterite infecciosa em pacientes sem diagnóstico prévio de coarctação da aorta. Descrição do caso: Dois pacientes do sexo masculino com idades entre 13 e nove anos foram internados. O primeiro por febre durante dois meses, iniciada após limpeza dentária. O segundo por hipertensão arterial. Ambos com astenia e perda de peso. No primeiro caso, o ecocardiograma transtorácico mostrou coarctação da aorta e o ecocardiograma transesofágico revelou vegetações na área pós-coarctação, sem pseudoaneurismas. A hemocultura foi positiva para de Streptococcus mitis. Este paciente foi tratado por seis semanas com penicilina cristalina, resolvendo a infecção sem complicações. O segundo caso foi avaliado pela presença de hipertensão arterial, com história de febre tratada com antibióticos. Ao realizar o ecocardiograma transtorácico, observou-se coarctação da aorta com imagem sacular classificada como pseudoaneurisma pela angiografia e tomografia. A hemocultura foi negativa. O paciente desenvolveu um episódio de hematêmese, cuja etiologia inicial não pôde ser determinada. Antes da correção cirúrgica, apresentou um segundo episódio de hematêmese profusa, com choque hipovolêmico e óbito. Comentários: Devemos ter um alto índice de suspeição clínica para poder estabelecer o diagnóstico de coarctação da aorta complicada com endarterite e iniciar o tratamento antibiótico adequado. É preciso manter a vigilância para a detecção precoce de pseudoaneurismas.

Análise mecânica comparativa do destorque de parafusos de minipilar com um novo componente protético, juntamente com avaliação microbiológica do vedamento para implantes de plataforma Cone Morse / Comparative mechanical analysis of the untorsion of miniabutment screws with a new prosthetic component, together with microbiological evaluation of the seal for Cone Morse platform implants

A interface implante pilar (IAI) por se constituir de duas peças inevitavelmente apresentam micro lacuna (GAP), na qual pode ocorrer infiltração bacteriana, permitindo a penetração de microorganismos que colonizam na parte interna do implante levando ao acúmulo de biofilme e, podendo levar ao desenvolvimento da periimplantite. O desgaste da conexão interna do implante é algo que ocorre com frequência, muitas vezes pela fratura do parafuso e/ou, pela perda da rosca interna do implante. A ausência de informações prévias também pode gerar a necessidade da remoção do implante, devido a estas intercorrências, surge a possibilidade da criação de um novo componente para implantes para possibilitar a reabilitação protética, sem ter que passar por uma nova cirurgia de remoção e instalação do implante. O objetivo do trabalho foi mensurar o nível de afrouxamento do parafuso do pilar protético e do minipilar comparando com novo componente protéticos, na tentativa de simular o comportamento do conjunto implante/pilar/prótese. Foram utilizados vinte implantes de plataforma cone morse (CM) da DSP® com seus respectivos mini pilares, na qual foram distribuídos em 2 grupos(n=10): Grupo 1 - implante CM + mini pilar FlexCone® DSP + coroa simplificada pirâmide invertida carga aplicada 3 mm do centro da coroa. E Grupo 2 - implante CM + mini pilar novo + coroa simplificada pirâmide invertida carga aplicada 3 mm do centro da coroa. Foram realizados ciclagem mecânica com carga 133 N, durante 2x106 ciclos, com frequência 2 Hz e temperatura de 37ºC em ambos grupos. Um torquímetro digital foi usado para medir os valores de torque reverso do parafuso protético da coroa e também do pilar protético, antes e após o carregamento. Os resultados do modelo de regressão demonstraram diferenças estatisticamente significativas em função do envelhecimento comparando os grupos da coroa sobre o pilar protético (p = 0.020) e entre os grupos do pilar sobre o implante (p = 0.048), indicando que após o envelhecimento de 2.000.000 de ciclos ao longo do tempo está associado de maneira significativa a essas variáveis no contexto deste estudo. O segundo objetivo deste estudo foi avaliar in vitro a taxa de infiltração bacteriana através da IAI, entre o novo componente protético e a superfície interna do implante, juntamente foi analisado a permeabilidade do IAI para colonização bacteriana. Um total de oitenta implantes foram testados. As estruturas montadas para grupo 1 foi torqueado com 20 N/cm e do G2 foram torqueados com 45 N, ambos imersos em microtubos contendo 200 µl de saliva humana. Após 14 dias de incubação da amostra de bactéria nos implantes, foi realizada uma análise qPCR (reação da cadeia da polimerase em tempo real). O teste revelou que não houve diferenças estatisticamente significativas no crescimento bacteriana entre os grupos em qualquer um dos pontos temporais analisados. Conclui-se que o novo componente testado apresentou um destoque menor do que comparado ao mini pilar FlexCone DSP® e apresentou infiltração bacteriana no GAP da conexão implante-pilar semelhante comparado ao mini pilar original da empresa (AU)

The abutment implant interface (IAI), as it consists of two pieces, inevitably presents a micro gap (GAP), in which bacterial infiltration can occur, allowing the penetration of microorganisms that colonize in the internal part of the implant, leading to the accumulation of biofilm and, which can lead to development of peri-implantitis. Wear of the implant's internal connection is something that occurs frequently, often due to screw fracture and/or loss of the implant's internal thread. The lack of prior information can also generate the need to remove the implant, due to these complications, the possibility arises of creating a new component for implants to enable prosthetic rehabilitation, without having to undergo a new surgery to remove and install the implant. implant. The objective of the work was to measure the level of screw loosening of the prosthetic abutment and the mini-abutment compared with the new prosthetic component, in an attempt to simulate the behavior of the implant/ abutment/prosthesis set. Twenty DSP® morse cone (CM) platform implants were used with their respective mini pillars, which were distributed into 2 groups (n=10): Group 1 - CM implant + FlexCone® DSP mini pillar + simplified crown inverted pyramid load applied 3 mm from the center of the crown. And Group 2 - CM implant + new mini abutment + simplified crown inverted pyramid load applied 3 mm from the center of the crown. Mechanical cycling was carried out with a load of 133 N, for 2x106 cycles, with a frequency of 2 Hz and a temperature of 37ºC in both groups. A digital torque wrench was used to measure the reverse torque values of the prosthetic crown screw and also the prosthetic abutment, before and after loading. The results of the regression model demonstrated statistically significant differences as a function of aging comparing the crown-on-prosthetic abutment groups (p =0.020) and between the abutment-on-implant groups (p = 0.048), indicating that after aging 2,000 ,000 cycles over time is significantly associated with these variables in the context of this study. The second objective of this study was to evaluate in vitro the rate of bacterial infiltration through the IAI, between the new prosthetic component and the internal surface of the implant, together with the permeability of the IAI for bacterial colonization. A total of eighty implants were tested. The assembled structures for group 1 were torqued with 20 N/cm and G2 were torqued with 45 N, both immersed in microtubes containing 200 µl of human saliva. After 14 days of incubation of the bacteria sample in the implants, a qPCR (real-time polymerase chain reaction) analysis was performed. The test revealed that there were no statistically significant differences in bacterial growth between groups at any of the time points analyzed. It is concluded that the new component tested presented a lower impact compared to the FlexCone DSP® mini abutment and presented bacterial infiltration in the GAP of the implant-abutment connection similar to the company's original mini abutment.(AU)

Protective effect and mechanism of nanoantimicrobial peptide ND-C14 against Streptococcus pneumoniae infection / 世界急诊医学杂志（英文）

@#BACKGROUND: Streptococcus pneumoniae (S. pneumoniae) is a common pathogen that causes bacterial pneumonia. However, with increasing bacterial resistance, there is an urgent need to develop new drugs to treat S. pneumoniae infections. Nanodefensin with a 14-carbon saturated fatty acid (ND-C14) is a novel nanoantimicrobial peptide designed by modifying myristic acid at the C-terminus of human α-defensin 5 (HD5) via an amide bond. However, it is unclear whether ND-C14 is effective against lung infections caused by S. pneumoniae. METHODS: In vitro, three groups were established, including the control group, and the HD5 and ND-C14 treatment groups. A virtual colony-count assay was used to evaluate the antibacterial activity of HD5 and ND-C14 against S. pneumoniae. The morphological changes of S. pneumoniae treated with HD5 or ND-C14 were observed by scanning electron microscopy. In vivo, mice were divided into sham, vehicle, and ND-C14 treatment groups. Mice in the sham group were treated with 25 µL of phosphate-buffered saline (PBS). Mice in the vehicle and ND-C14 treatment groups were treated with intratracheal instillation of 25 µL of bacterial suspension with 2×108 CFU/mL (total bacterial count: 5×106 CFU), and then the mice were given 25 μL PBS or intratracheally injected with 25 μL of ND-C14 (including 20 µg or 50 µg), respectively. Survival rates were evaluated in the vehicle and ND-C14 treatment groups. Bacterial burden in the blood and bronchoalveolar lavage fluid were counted. The lung histology of the mice was assessed. A propidium iodide uptake assay was used to clarify the destructive effect of ND-C14 against S. pneumoniae. RESULTS: Compared with HD5, ND-C14 had a better bactericidal effect against S. pneumoniae because of its stronger ability to destroy the membrane structure of S. pneumoniae in vitro. In vivo, ND-C14 significantly delayed the death time and improved the survival rate of mice infected with S. pneumoniae. ND-C14 reduced bacterial burden and lung tissue injury. Moreover, ND-C14 had a membrane permeation effect on S. pneumoniae, and its destructive ability increased with increasing ND-C14 concentration.

Síndrome hemolítico urémico secundario a Streptococcus pneumoniae. Reporte de un caso clínico

El síndrome hemolítico urémico secundario a Streptococcus pneumoniae (SHU-Sp) es una complicación poco frecuente de las enfermedades invasoras por S. pneumoniae. Presenta una alta morbimortalidad, con requerimiento de transfusiones de glóbulos rojos y plaquetas, terapia de sustitución de la función renal de inicio precoz y más prolongada, así como mayores complicaciones a largo plazo, comparado con las formas secundarias a infección entérica por Escherichia coli productora de toxina Shiga. Presentamos el caso clínico de una preescolar de dos años, previamente sana, vacunada con tres dosis de PCV13, que desarrolló una insuficiencia renal aguda, anemia hemolítica y plaquetopenia, en el contexto de una neumonía con empiema y bacteriemia por S. pneumoniae.

Streptococcus pneumoniae associated hemolytic uremic syndrome (Sp-HUS) is an uncommon complication of invasive pneumococcal infections. Patients with Sp-HUS have a higher mortality and long term morbidity than those due to HUS from Shiga toxin-producing Escherichia coli infections (STEC-HUS). They often require more red blood cells and platelet transfusions, and early initiation of renal substitution therapy, presenting a higher rate of arterial hypertension and chronic renal disease in the long term, compared to STEC-HUS. We report a healthy 2 year-old infant, vaccinated with three doses PCV13, that developed acute renal failure, hemolytic anemia and thrombocytopenia in the course of a complicated pneumococcal pneumonia with empyema and bacteremia.

Características microbiológicas de la enfermedad neumocócica en niños menores de 5 años de Santiago de Cuba / Microbiologic characteristics of the pneumococcus disease in children under 5 years from Santiago de Cuba i: en

Introducción: La infección por Streptococcus pneumoniae constituye una causa importante de morbimortalidad en el mundo, sobre todo en niños menores de 5 años, en los que ocasiona de 1 a 2 millones de muertes anuales. Objetivo: Determinar la presencia de S. pneumoniae en muestras clínicas obtenidas en niños. Métodos: Se realizó un estudio descriptivo y transversal en niños menores de 5 años de edad con diagnóstico clínico de enfermedad neumocócica invasiva, asistidos en dos hospitales pediátricos de Santiago de Cuba durante el periodo 2014-2018. De las 1466 muestras clínicas tomadas y procesadas, en 131 fue aislado el agente patógeno; estas correspondieron a 59 pacientes con formas clínicas de la infección y 72 portadores. Para el procesamiento estadístico de la información se utilizaron las frecuencias absoluta y relativa como medidas de resumen. Resultados: En general, la positividad por S. pneumoniae fue de 8,9 %, con mayores frecuencias de aislamiento en las muestras de líquido cefalorraquídeo (81,8 %), líquido pleural (47,1 %) y exudado ótico (21,9 %), que asimismo coincidieron con los porcentajes más elevados de neumonía (61,0), otitis media aguda (23,7) y meningitis (15,3), como formas clínicas de la enfermedad neumocócica, que aquejó principalmente a niños de 1 año de edad, seguidos de los mayores de 2 años. De igual modo, se identificaron 9 serotipos de S. pneumoniae, con predominio del 19A (39,0 %), el 14 (25,4 %) y el 6A (11,9 %). En los pacientes que portaban la bacteria en la nasofaringe se identificaron 8 tipos serológicos, predominantemente el 19A y el 14. Por último, se halló una alta resistencia microbiana a la eritromicina y a la combinación trimetoprima-sulfametoxazol. Conclusiones: Los resultados de este estudio proporcionaron un referente científico antes de la introducción de la vacuna antineumocócica cubana, lo que permitirá evaluar su impacto en la incidencia de dicha enfermedad.

Introduction: The infection due to Streptococcus pneumoniae constitutes an important cause of morbimortality in the world, mainly in children under 5 years, that causes from 1 to 2 million annual deaths. Objective: To determine the presence of S. pneumoniae in clinical samples obtained in children. Methods: A descriptive and cross-sectional study was carried out in children under 5 years with clinical diagnosis of invasive pneumococcus disease, assisted in two children hospitals from Santiago de Cuba during the period 2014-2018. Of the 1466 clinical samples taken and processed, in 131 the pathogen agent was isolated; these corresponded to 59 patients with clinical forms of the infection and 72 carriers of the disease. For the statistical processing of the information the absolute and relative frequencies were used as summary measures. Results: In general the positivity for S. pneumoniae was of 8.9 %, with more isolation frequencies in the samples of cerebrospinal fluid (81.8 %), pleural fluid (47.1 %) and otic exudate (21.9 %) that also coincided with the highest percentages of pneumonia (61.0), acute otitis media (23.7) and meningitis (15.3), as clinical forms of the neumococcus disease that mainly affected 1 year children, followed by those over 2 years. In a same way, 9 serotypes of S. pneumoniae were identified, with prevalence of the 19A (39.0 %), and 14 (25.4 %) and the 6A (11.9 %). In the nasopharyngeal carriers 8 serotypes were identified, of which the 19A and 14 prevailed. Lastly, a high microbian resistance to erythromycin and the combination trimethoprim-sulfametoxazole was found. Conclusions: The results of this study provided a scientific referent before the introduction of the Cuban antipneumococcus vaccine that will allow to evaluate its impact in the incidence of this disease.

Importancia de la escala Centor en la atención a pacientes con amigdalitis aguda durante la COVID-19: Serie de casos

Fundamento: En Cuba, durante la pandemia de COVID-19, se puso a prueba la importancia de las escalas clínicas para el tratamiento de pacientes adultos con amigdalitis aguda por no contar con pruebas de detección rápida de antígenos, sin embargo, su uso sigue siendo controversial. Objetivo: Describir los resultados de la aplicación de la escala Centor en la atención a pacientes con amigdalitis aguda durante la COVID-19. Metodología: Se realizó un estudio de serie de casos y se incluyeron los pacientes con amigdalitis aguda diagnosticados en un período de dos años en la consulta externa de Otorrinolaringología del Hospital General Provincial Camilo Cienfuegos, Sancti Spíritus, Cuba. A todos se les aplicó la escala Centor. Resultados: Se incluyeron 114 pacientes. La media de edad fue de 28.9 + 18.7 años, más de la mitad de los pacientes tenían antecedentes de amigdalitis crónica y adenoiditis crónica y eran fumadores activos. Aproximadamente 2 de cada 5 pacientes tuvieron puntuaciones <3 según la escala Centor. Conclusiones: La amigdalitis aguda fue un problema de salud durante la COVID-19 y la escala Centor fue una importante herramienta para la toma de decisiones terapéuticas en pacientes con amigdalitis aguda, aun en condiciones de ausencia de pruebas confirmatorias.

Background: In Cuba, during the COVID-19 pandemic, the clinical scales for adult patients treatment with acute tonsillitis were put under test for not having rapid antigen detection tests, however, its use is still controversial. Objective: To describe the Centor scale application results in the care of patients with acute tonsillitis during COVID-19. Methodology: A case series study was conducted and it included acute tonsillitis patients diagnosed over a two year period in the Otorhinolaryngology external consultation at Camilo Cienfuegos Provincial General Hospital, Sancti Spíritus, Cuba. The Centor scale was applied to all of them. Results: It included 114 patients. The average age was 28.9 + 18.7 years, more than half of the patients had previous history of chronic tonsillitis and chronic adenoiditis and they were active smokers. Approximately 2 out of 5 patients had scores <3 according to the Centor scale. Conclusions: Acute tonsillitis was a health problem during COVID-19 and the Centor scale was an important tool for therapeutic decision in acute tonsillitis patients, even in absence of confirmatory evidence.

Peritonitis primaria por neumococo en un hospital pediátrico de Argentina / Primary pneumococcal peritonitis in a pediatric hospital from Argentina

Resumen La peritonitis por neumococo comprende un pequeno subconjunto de pacientes con enfermedad invasiva (ENI). Durante 15 años (2005-2020) de vigilancia de ENI en un hospital de pediatría, se detectaron 5 casos de peritonitis primaria. Los pacientes, 3 ninas y 2ninos con una media de edad de 5 anos, experimentaron signos y síntomas peritoneales; 3 de ellos presentaban síndrome nefrótico. En coincidencia con los perfiles locales, todos los aislamientos fueron sensibles a betalactámicos, una cepa expresó resistencia a tetraciclina y cotrimoxazol y otra solo a cotrimoxazol. Los serotipos encontrados en 4/5 cepas (una resultó no viable) fueron 1, 19F, 15C y 23A. Los ninos fueron tratados con cefalosporinas de tercera generación o con ampicilina, gentamicina y metronidazol; todos evolucionaron favorablemente. Se destaca la importancia del hallazgo de Streptococcus pneumoniae en peritonitis primarias en niños. Este trabajo contribuye al conocimiento de esta enfermedad en particular y al de la epidemiología local de la ENI.

Abstract Pneumococcal peritonitis represents a small subset of patients suffering from inva-sive pneumococcal disease (IPD). We describe 5 cases of primary peritonitis documented in the pediatric hospital over 15 years (2005-2020) of IPD surveillance. The patients, 3girls and 2boys with a mean age of 5 years, experienced peritoneal signs and symptoms; 3of them suffered from nephrotic syndrome. Based on the local resistance profiles, all isolates were sensitive to beta-lactams, one strain showed resistance to cotrimoxazole and tetracycline while another strain, to cotrimoxazole only. Serotypes found in 4/5 strains (one was non-viable) were: 1, 19F, 15C and 23A. Children were treated with third-generation cephalosporins or ampicillin, gentamicin and metronidazole and all of them evolved favorably. Pneumococcal etiology should be included in the differential diagnosis of acute abdominal pain in children. Our study aims to contribute to the knowledge of this condition and to the local epidemiology of IPD.

Serotipos prevalentes de Streptococcus mutans en América Latina / Prevalent serotypes of Streptococcus mutans in Latin America

La microbiota oral está conformada por diversas especies bacterianas que en condiciones normales desempeñan una función protectora del huésped; sin embargo, cuando existe un desequilibrio en el ecosistema, estos microorganismos son capaces de producir diversas manifestaciones como lo es el caso de la caries dental, enfermedad infecciosa producida principalmente por Streptococcus mutans, patógeno capaz de desmineralizar los tejidos duros del diente mediante la fermentación de hidratos de carbono obtenidos de la dieta. Se ha identificado en la pared celular de este microorganismo ocho serotipos que intervienen en la adhesión, agregación y coagregación bacteriana. En los seres humanos S. mutans presenta los serotipos c, e y f, siendo el serotipo c el más prevalente a nivel mundial, el cual se conoce que está asociado a pacientes sanos, a diferencia del e y f que son capaces de invadir las células endoteliales de las arterias coronarias. No obstante, en los últimos años se ha logrado identificar el serotipo k que de igual manera presenta alta capacidad de invadir el endotelio humano, actuando en la patogénesis de las enfermedades cardiovasculares. El objetivo de la presente revisión bibliográfica es lograr cuantificar los serotipos prevalentes de S. mutans en América Latina (AU)

The oral microbiota is made up of various bacterial species that under normal conditions perform a protective function of the host, however, when there is an imbalance in the ecosystem, these microorganisms are capable of producing various manifestations such as caries, an infectious disease. produced mainly by Streptococcus mutans, a pathogen capable of demineralizing the hard tissues of the tooth through the fermentation of carbohydrates obtained from the diet. Eight serotypes involved in bacterial adhesion, aggregation and coaggregation have been identified in the cell wall of this microorganism. In humans, S. mutans presents serotypes c, e, and f, serotype c being the most prevalent worldwide, which is known to be associated with healthy patients, unlike e and f, which are capable of invading the endothelial cells of the coronary arteries. However, in recent years it has been possible to identify serotype k, which also has a high capacity to invade the human endothelium, acting in the pathogenesis of cardiovascular diseases. The objective of this literature review is to quantify the prevalent serotypes of S. mutans in Latin America (AU)

Colonización genitourinaria por Streptococcus agalactiae y perfil de sensibilidad en mujeres gestantes

Introducción: Streptococcus agalactiae, también conocido como estreptococo beta-hemolítico del grupo B de Lancefield, adquiere relevancia durante el embarazo debido a la posibilidad de transmisión al recién nacido. Las normas internacionales sugieren realizar tamizaje vagino-anal entre las 35 y 37 semanas de gestación. Objetivo: Determinar prevalencia de colonización por Streptococcus agalactiae en muestras cérvico-vaginales de embarazadas entre 35 y 37 semanas, y en urocultivos de gestantes de cualquier edad gestacional ingresadas en el hospital ginecobstetrico provincial, así como su perfil de sensibilidad. Materiales y métodos: Se realizó un estudio observacional, descriptivo y exploratorio, de corte transversal, entre enero y agosto de 2021, en el Hospital Provincial Docente Ginecobstétrico José Ramón López Tabrane, de la ciudad de Matanzas. El universo estuvo conformado por todas las gestantes de cualquier trimestre a las que se les realizó urocultivo, y estudio microbiológico cérvico-vaginal entre las 35 y 37 semanas de gestación, cumplidos previamente criterios de inclusión. Resultados: El 18,61 % presentó cultivos positivos para Streptococcus agalactiae. Predominó la presencia de positividad en gestantes no diabéticas; se encontró un 18,75 % de urocultivos positivos. Predominaron los aislamientos sensibles a eritromicina y clindamicina, con un 63 %, seguidos de la resistencia inducible a clindamicina (MLSBi), con un 19 %. Conclusiones: El diagnóstico microbiológico de Streptococcus agalactiae en gestantes, es de vital importancia para la prevención de sepsis puerperal y neonatal. A pesar de que los resultados de este estudio muestran perfiles de sensibilidad adecuados, su monitorización permanente garantizaría el diagnóstico precoz de cepas resistentes, dado el ligero incremento del fenotipo (MLSBi) identificado.

Introduction: Streptococcus agalactiae, also known as Lancefield's group B beta-hemolytic streptococcus, acquires relevance during pregnancy due to the possibility of transmission to the newborn. International standards suggest performing vaginal-anal screening between 35 and 37 weeks of gestation. Objective: to determine the prevalence of colonization by Streptococcus agalactiae, in cervical-vaginal samples of pregnant women between 35 and 37 weeks, and in urine cultures of pregnant women of any gestational age admitted to the provincial gyneco-obstetric hospital, as well as their sensitivity profile. Materials and methods: an observational, descriptive and exploratory cross-sectional study was performed, between January and August 2021, at the Provincial Teaching Gyneco-obstetric Hospital Jose Ramon Lopez Tabrane of Matanzas. The universe was made up by all pregnant women of any trimester who underwent a urine culture, and a cervical-vaginal microbiologic study between 35 and 37 gestation weeks, previously meeting inclusion criteria. Results: 18.61% presented positive cultures for Streptococcus agalactiae. The presence of positivity predominated in non-diabetic women. 18.75 % of positive urine cultures were found. Erythromycin and clindamycin-sensitive isolates predominated (MLSBi), with 63%, followed by inducible resistance to clindamycin, with 19%. Conclusions: the microbiological diagnosis of Streptococcus agalactiae in pregnant women is of vital importance to prevent puerperal and neonatal sepsis. Although the results of this study show adequate sensitivity profiles, its permanent monitoring would warrantee the early diagnosis of resistant strains, given the slight increase of the phenotype (MLSBi) identified.

Neumonía bacteriana en niños en Ecuador: una mirada al impacto de las vacunas

Introducción: La neumonía adquirida en la comunidad es una de las enfermedades con mayor prevalencia en la comunidad pediátrica en nuestro país. De las diferentes etiologías que pueden causarlas, la neumonía ocasionada por Streptococcus pneumoniae puede ser prevenida con el uso de inmunización. Actualmente se disponen de tres tipos de vacunas antineumocócicas conjugadas autorizadas de uso pediátrico de forma sistemática. Objetivo: Identificar la prevalencia de neumonía bacteriana en niños bajo 5 años de edad, que requirieron hospitalización comparando la vacuna neumocócica recibida: 10 valente (PCV10) versus 13 valente (PCV13). Pacientes y Métodos: Estudio de descriptivo, retrospectivo. Se incluyeron pacientes hospitalizados bajo 5 años de edad, con diagnóstico de neumonía bacteriana mediante codificación CIE10 en un hospital de tercer nivel de la ciudad de Quito-Ecuador, durante el año 2019. Resultados: Se estudiaron 175 pacientes de los cuales 74 cumplieron con criterios clínicos de neumonía, de estos 46 recibieron PCV10 y 28 recibieron vacuna PCV13. Discusión y Conclusiones: La prevalencia de neumonía bacteriana fue mayor en los pacientes inmunizados con PCV10 lo que sugiere una relación de menor probabilidad de neumonía con el uso de la vacuna PCV13.

Background: Community-acquired pneumonia is one of the most prevalent diseases in the pediatric community in our country, of the different etiologies that can cause them, pneumonia caused by Streptococcus pneumoniae can be prevented with the use of immunization. Currently there are three types of authorized pneumococcal conjugate vaccines for pediatric use in a systematic way. Aim: To identify the prevalence of bacterial pneumonia in children under 5 years of age who required hospitalization by comparing the pneumococcal vaccine received: 10 valent (PCV10) versus 13 valent (PCV13). Methods: Descriptive, retrospective study. Hospitalized patients under 5 years of age with a diagnosis of bacterial pneumonia by ICD10 coding in a third level hospital in the city of Quito - Ecuador during 2019 were included. Results: 175 patients were studied, of which 74 patients met clinical criteria for pneumonia, of these 46 received PCV10 and 28 received PCV13 vaccine. Discussion and Conclusions: The prevalence of bacterial pneumonia was higher in patients immunized with PCV10, suggesting a relationship of lower probability of pneumonia with the use of the PCV13 vaccine.

Prevalencia de colonización rectovaginal por Streptococcus agalactiae en mujeres gestantes atendidas en un hospital de segundo nivel en Honduras

Introducción. Streptococcus agalactiae, conocido actualmente como estreptococo del grupo B (EGB), es el principal microorganismo que coloniza el tracto genitourinario en pacientes gestantes, llegando a causar consecuencias graves en el neonato, como sepsis neonatal, neumonía y meningitis. Objetivo. Determinar la prevalencia de EGB en mujeres gestantes del Hospital Nacional Dr. Mario Catarino Rivas, en Honduras. Materiales y métodos. Estudio descriptivo, prospectivo, transversal. Se utilizó un muestreo por conveniencia, se enroló un total de 143 gestantes entre las 34 y 40 semanas de gestación atendidas en el servicio de ginecología y obstetricia del Hospital Nacional Dr. Mario Catarino Rivas, durante enero de 2020 a junio del 2021. Los cultivos se prepararon de acuerdo con la metodología recomendada por los Centers for Disease Control and Prevention, agregándose el agar chromID Strepto B. Se empleó estadística descriptiva para el análisis. Resultados. La edad promedio de las gestantes fue 26 ± 7,4 años. La prevalencia de EGB en la población fue del 3,5%, encontrando 5 casos positivos. Conclusión. La prevalencia de colonización por EGB en mujeres embarazadas es variable y puede no estar asociada a factores de riesgo para ser colonizada, resultando en complicaciones sanitarias neonatales y maternas. Ello pone de manifiesto la necesidad de búsqueda activa de estreptococos del grupo B en las gestantes.

Introduction: Streptococcus agalactiae, currently known as group B streptococcus (GBS) is the main microorganism that colonizes the genitourinary tract in pregnant women, causing serious consequences in the neonate, such as neonatal sepsis, pneumonia, and meningitis. Objective: To determine the prevalence of GBS in pregnant women at the Dr. Mario Catarino Rivas National Hospital in Honduras. Materials and methods: Descriptive, prospective, cross-sectional study. A total of 143 pregnant women between 34-40 weeks of gestation attended at the gynecology and obstetrics service of the Dr. Mario Catarino Rivas National Hospital in Honduras from January 2020 to June 2021 were enrolled. Cultures were developed following the methodology recommended by the Centers for Disease Control and Prevention and Strepto B chromID agar was added. Descriptive statistics were used for analysis. Results: The mean age of the pregnant women was 26 ± 7.4 years. The prevalence of GBS in the study population was 3.5%, with 5 positive cases. Conclusion: The prevalence of GBS colonization in pregnant women is variable and may not be associated with risk factors for colonization, resulting in neonatal and maternal health complications. This highlights the need for active search for group B Streptococcus in pregnant women.

Epidemiología de la faringitis estreptocócica. Período enero de 2018 - diciembre de 2021 / Epidemiology of streptococcal pharyngitis. January 2018 - December 21

La faringoamigdalitis es uno de los motivos más frecuentes de consulta en pediatría. Aproximadamente un 70-80% de las faringoamigdalitis son de etiología viral. El 20-30% restante son de origen bacteriano. El agente causal más frecuente es Streptococcus pyogenes (estreptococo ß-hemolítico del grupo A). El rol de Streptococcus dysgalactiae subsp. equisimilis, (estreptococos ß-hemolíticos grupos C y G) fue claramente establecido como agente etiológico en la faringitis bacteriana, tanto en niños como en adultos. Se realizó un análisis descriptivo y retrospectivo entre enero 2018 y diciembre de 2021. Se evaluó la prevalencia de faringitis estreptocócica, la edad, el período estacional, los agentes etiológicos y la resistencia a macrólidos durante los períodos pre-COVID-19 (2018-2019) y COVID-19 (2020-2021). Se analizaron 11 396 muestras de exudados de fauces de pacientes con sospecha de faringitis bacteriana; las mismas se procesaron mediante el uso de técnicas microbiológicas convencionales. En el período estudiado el porcentaje de positividad de los cultivos de exudados de fauces se mantuvo constante. Al comparar los períodos pre-COVID-19 (2018-2019) y COVID-19 (2020-2021) se observó una disminución en el número de aislados de S. pyogenes con un aumento de S. dysgalactiae subsp. equisimilis, mientras que la resistencia a macrólidos encontrada fue superior en S. pyogenes y para S. dysgalactiae subsp. equisimilis se mantuvo constante. Es importante realizar el cultivo para la identificación del agente etiológico y determinar la sensibilidad antibióticapara continuar con la vigilancia epidemiológica de la resistencia a los macrólidos, porque representan una opción en pacientes alérgicos a ß-lactámicos (AU)

Pharyngotonsillitis is one of the most frequent reasons for consultation in children. Approximately 70-80% of pharyngotonsillitis are of viral etiology. The remaining 20-30% are bacterial in origin. The most frequent causative agent is Streptococcus pyogenes (group A ß-hemolytic streptococcus). Streptococcus dysgalactiae subsp. equisimilis (ß-hemolytic streptococcus groups C and G) was clearly established as an etiologic agent in bacterial pharyngitis in both children and adults. A descriptive and retrospective analysis was conducted between January 2018 and December 2021. The prevalence of streptococcal pharyngitis, age, seasonal period, etiologic agents, and macrolide resistance during the pre-COVID-19 (2018-2019) and COVID-19 (2020-2021) periods were evaluated. We analyzed 11 396 specimens of swabs from patients with suspected bacterial pharyngitis. Conventional microbiological techniques were used. In the study period, the percentage of positivity of swab cultures remained constant. When comparing the preCOVID-19 (2018-2019) and COVID-19 (2020-2021) periods, a decrease in the number of S. pyogenes isolates was observed with an increase in S. dysgalactiae subsp. equisimilis, while the resistance to macrolides found was higher for S. pyogenes and remained constant for S. dysgalactiae subsp. equisimilis. The identification of the etiologic agent and determination of antibiotic sensitivity are important for epidemiological surveillance of macrolide resistance, as they are a treatment option in patients who are allergic to ß-lactams (AU)

Comparative Evaluation of the Effects of Black Tea Extract Mouthrinse and Chlorhexidine Mouthwash on Salivary Streptococcus Mutans Load

Background- Dental caries is one of the most frequent oral health problems. The present study shows the antibacterial effect of black tea extract on salivary Sterptococcus Mutans load. Materials & Methods- The study was conducted on 125 individuals. The differences in the Colony Forming Units and count-scores of S.mutans were analyzed in salivary samples collected from individuals before and after administration of 2% black tea extract mouth-rinse and chlorhexidine mouthwash(CM). Results- There was a statistical difference in mean salivary S. mutans colony count and mean count- score before and after administration of black tea extract mouth-rinse (p = 0.0003) and chlorhexidine mouthwash (p = 0.0002) respectively. Hence, it was found that there is no statistically significant difference in the fall of S.mutans load due to black tea mouth-rinse and chlorhexidine mouthwash. Conclusions- A 2% black tea extract mouth-rinse significantly reduces salivary S.mutans load, irrespective of age and gender. Also, it is an effective natural anti-cariogenic agent with no known implicated side effects.

Epithelial responses and Candida albicans pathogenicity are enhanced in the presence of oral streptococci

Abstract Experimental models that consider host-pathogen interactions are relevant for improving knowledge about oral candidiasis. The aim of this study was to assess the epithelial immune responses, Candida penetration of cell monolayers, and virulence during mixed species culture infections. Single species cultures of Candida albicans and mixed cultures (C. albicans, Streptococcus mutans, and Streptococcus sanguinis) were used to infect monolayers of HaCaT and FaDu ATCC HTB-43 cells for 12 h. After infection, IL-18 and IL-34 gene expression was measured to assess epithelial cell immune responses, and lactate dehydrogenase (LDH) activity was measured as an indicator of cell damage. Microscopy determined C. albicans morphology and penetration of fungal cells through the keratinocyte monolayer. Monolayers devoid of infection served as controls. Data were analyzed by an ANOVA one-way test followed by Tukey's post-hoc test (α = 0.05). The results found that IL-18 and IL-34 gene expression and LDH activity were significantly (p < 0.05) upregulated for both cell lines exposed to mixed species cultures compared with C. albicans alone. Candida albicans yeast and hyphae were evident in C. albicans only infections. In contrast, monolayers infected by C. albicans, S. mutans, and S. sanguinis exhibited higher microbial invasion with several hyphal aggregates detected. The presence of streptococci in C. albicans infection enhances the virulence and pathogenicity of the fungus with associated increased immune responses and tissue damage. Extrapolation of these findings to oral infection would indicate the added potential benefit of managing bacterial components of biofilms during treatment.

Resumo O objetivo deste estudo foi avaliar a resposta epithelial imune, a colonização da Candida albicans em monocamadas celulares e sua virulência em resposta a infecções de culturas de biofilme multiespécie. Culturas de biofilme monoespécie de C. albicans e culturas mistas (C. albicans, Streptococcus mutans e Streptococcus sanguinis) foram utilizadas para infectar monocamadas de células HaCaT e FaDu por 12 h. Após a infecção, a expressão dos genes IL-18 e IL-34 foi medida para avaliar as respostas imunes das células epiteliais. A atividade da lactato desidrogenase (LDH) foi medida como um indicador de dano celular. A microscopia determinou a morfologia de C. albicans e a penetração das células fúngicas através da monocamada de queratinócitos. Monocamadas em que não houve infecção serviram como controles. Os dados foram analisados por um teste ANOVA one-way seguido pelo teste post-hoc de Tukey (α = 0,05). Os resultados demonstraram que a expressão gênica de IL-18 e IL-34 e a atividade de LDH foram (p < 0,05) reguladas positivamente para ambas as linhagens de células expostas a culturas de espécies mistas em comparação com C. albicans isoladamente. Leveduras de C.albicans e hifas foram evidentes em infecções apenas por C. albicans. Entretanto, monocamadas infectadas por C. albicans, S. mutans e S. sanguinis exibiram maior invasão microbiana com vários agregados de hifas detectados. Dessa maneira, a presença de estreptococos na infecção por C. albicans aumentou a virulência e a patogenicidade do fungo com respostas imunes aumentadas associadas a danos nos tecidos. A extrapolação desses achados para a infecção oral indicaria o potencial benéfico do controle dos componentes bacterianos em biofilmes durante a terapia da candidíase

Impact of PCV10 on pediatric pneumococcal disease burden in Brazil: time for new recommendations?

Abstract Objective: To describe the impact of the 10-valent pneumococcal conjugate vaccine on the pediatric burden of pneumococcal infections, carriage, serotype replacement, and antimicrobial resistance in Brazil since its introduction in 2010. Data source: A narrative review of English, Spanish, and Portuguese articles published in online databases and in Brazilian epidemiological surveillance databases was performed. The following keywords were used: Streptococcus pneumoniae, pneumococcal disease, conjugate vaccine, PCV10, antimicrobial resistance, and meningitis. Summary of the findings: Declines in hospitalization rates of all-cause pneumonia occurred in the target age groups and some age groups not targeted by vaccination early after the use of PCV10. Large descriptive studies of laboratory-confirmed pneumococcal meningitis and hospital-based historical series of hospitalized children with IPD have evidenced a significant impact on disease burden, in-hospital fatality rates, and admission to the intensive care unit before and after the inclusion of the vaccine. Impact data on otitis media is limited and inconsistent; the main benefit remains the prevention of complicated diseases. During the late post-vaccine years, a significant and progressive increase in high-level penicillin non-susceptibility pneumococci has been described. Since 2014 serotype 19A has been the leading serotype in all ages and was responsible for 28.2%-44.6% of all IPD in children under 5 yrs. Conclusions: PCV10 has performed a significant impact on IPD in Brazil since 2010, however, progress has been continuously hampered by replacement. Broader spectrum PCVs could provide expanded direct and indirect protection against ST19A and other additional serotypes of increasing importance if administered to children in the Brazilian National Immunization Program.

Efecto antibacteriano del extracto hidroalcohólico de Solanum sessiliflorum Dunal (cocona) sobre Streptococcus mutans

Introducción: La búsqueda de nuevos extractos de origen vegetal con propiedades antibacterianas para mantener la salud bucal, es fundamental para el óptimo desempeño del personal militar. Objetivos: Evaluar el efecto antibacteriano del extracto hidroalcohólico de Solanum sessiliflorum Dunal (cocona) sobre Streptococcus mutans. Métodos: Estudio experimental in vitro y comparativo. Se realizó un ensayo fitoquímico preliminar del extracto hidroalcohólico de Solanum sessiliflorum Dunal. Se emplearon 48 placas de agar Müller-Hinton (Merck®), distribuidas en 6 grupos (n= 8): grupo I (agua destilada), grupo II (etanol al 70 %), grupo III (clorhexidina al 0,12 %), grupo IV (Solanum sessiliflorum Dunal al 25 %), grupo V (Solanum sessiliflorum Dunal al 50 %) y grupo VI (Solanum sessiliflorum Dunal al 75 %). Se utilizó la técnica de difusión con discos descrita por Bauer y Kirby; la cepa empleada fue Streptococcus mutans ATCC 25175 y las mediciones de los halos de inhibición se realizaron a las 24 horas, para determinar la actividad antibacteriana. Resultados: En el ensayo fitoquímico se detectaron compuestos fenólicos, antocianinas, quinonas y glicósidos cardiotónicos. Se comprobó el efecto antibacteriano del grupo VI (Solanum sessiliflorum Dunal al 75 %) con 19,831 ± 0,0553 mm (99,37 %), comparable con el de clorhexidina al 0,12 % (grupo III) 19,956 ± 0,0431 mm (100 %) sobre Streptococcus mutans ATCC 25175. Conclusiones: El extracto hidroalcohólico de Solanum sessiliflorum Dunal al 75 % presenta efecto antibacteriano in vitro sobre cepas de Streptococcus mutans ATCC 25175 con valores similares a clorhexidina al 0,12 % .

Introduction: The search for new extracts of plant origin with antibacterial properties to maintain oral health is essential for the optimal performance of military personnel. Objectives: To evaluate the antibacterial effect of the hydroalcoholic extract of Solanum sessiliflorum Dunal (cocona) on Streptococcus mutans. Methods: In vitro and comparative experimental study. A preliminary phytochemical assay of the hydroalcoholic extract of Solanum sessiliflorum Dunal was performed. Forty-eight Müller-Hinton agar plates (Merck®) were used, distributed in 6 groups (n= 8). Group I (distilled water), group II (70% ethanol), group III (0.12% chlorhexidine), group IV (25% Solanum sessiliflorum Dunal), group V (50% Solanum sessiliflorum Dunal) and group VI (75% Solanum sessiliflorum Dunal); the disc diffusion technique described by Bauer and Kirby was used; the strain used was Streptococcus mutans ATCC 25175 and the inhibition halos were measured at 24 hours to determine the antibacterial activity. Results: Phenolic compounds, anthocyanins, quinones and cardiotonic glycosides were detected in the phytochemical assay. The antibacterial effect of group VI (Solanum sessiliflorum Dunal 75%) was proven with 19,831 ± 0,0553 mm (99,37%), comparable to that of 0,12% chlorhexidine (group III) 19,956 ± 0,0431 mm (100%) on Streptococcus mutans ATCC 25175. Conclusions: The 75% hydroalcoholic extract of Solanum sessiliflorum Dunal shows in vitro antibacterial effect on Streptococcus mutans ATCC 25175 strains with values similar to 0,12% chlorhexidine.

Diagnóstico por imagen de abscesos hepáticos y pulmonares por estreptococos del grupo viridans. Presentación de caso / Imaging diagnosis of liver and lung abscesses due to viridans streptococci. Case presentation

Resumen El Streptococcus viridans es conocido más comúnmente como agente infeccioso en las endocarditis, sin embargo, poco se conoce sobre su potencial infeccioso en otros órganos o sistemas, donde ha demostrado una elevada mortalidad. El reconocimiento del Streptococcus viridans como agente productor de abscesos en otras localizaciones como a nivel hepático o pulmonar, permitirá un diagnóstico oportuno mediante los distintos métodos de imagen, reduciendo las graves consecuencias para el paciente y los tiempos de hospitalización. Se presenta el caso de un paciente del sexo masculino de 33 años de edad sin antecedentes crónico degenerativos, que inició con sintomatología 7 meses previos a su ingreso, con fiebre intermitente, fatiga, astenia, anorexia y pérdida de peso. A la exploración física presentó dolor a la palpación media y profunda en hipocondrio derecho, en el panel de laboratorios presentó llamativa neutrofilia, en la tomografía de tórax y abdomen se mostró lesión cavernomatosa en pulmón y quistes complicados hepáticos, a los cuales se les realizó drenaje percutáneo guiado por ultrasonido, con envío de muestras a cultivo con resultado positivo para Streptococcus viridans, lo que permitió brindar el tratamiento dirigido al paciente, y que remitiera la enfermedad.

Abstract Streptococcus viridans is more commonly known as an infectious agent in endocarditis, however, little is known about its infectious potential in other organs or systems, where it has shown high mortality. The recognition of Streptococcus viridans as an abscess-producing agent in other locations, such as the liver or lungs, will allow timely diagnosis using different imaging methods, reducing serious consequences for the patient and hospitalization times. We present the case of a 33-year-old male patient with no chronic degenerative history, who started symptoms 7 months prior to admission, with intermittent fever, fatigue, asthenia, anorexia and weight loss, on physical examination he presented pain at the medium and deep palpation in the right hypochondrium, in the laboratory panel I present striking neutrophilia, in the tomography of the thorax and abdomen a cavernous lesion in the lung and complicated hepatic cysts are shown, to which percutaneous drainage guided by ultrasound is performed, with sending of cultured samples with a positive result for Streptococcus viridans. Thus, allowing treatment to be provided to the patient, thereby achieving remission of the disease.

Effects of BlueM® against Streptococcus mutans biofilm and its virulence gene expression

Abstract This study evaluated the antimicrobial capacity of BlueM® mouthwash against the bacterium Streptococcus mutans and its influence on gbpA gene expression as well as its cytotoxic effect on fibroblast cells. BlueM® showed antimicrobial activity, with MIC and MBC values of 0.005% and 0.01%, respectively. The MBIC was 6.25% for S. mutans. CFU count and confocal microscopy revealed significant effect of BlueM® on S. mutans biofilm pre-formed on dentin surfaces. Interestingly, the analysis of gbpA gene expression indicated a decrease in gene expression after 15 min of treatment with BlueM® at a concentration of 25%. Moreover, BlueM® exhibited low levels of cytotoxicity. In conclusion, our results showed the antimicrobial effectiveness of BlueM® against S. mutans, its ability to modulate the expression of the gbpA gene and its low cytotoxicity. This study supports the therapeutic potential of BlueM® as an alternative agent for the control of oral biofilm.

Resumo Este estudo avaliou a capacidade antimicrobiana do enxaguatório BlueM® contra a bactéria Streptococcus mutans e sua influência na expressão do gene gbpA, bem como seu efeito citotóxico em células de fibroblastos. BlueM® apresentou atividade antimicrobiana, com valores de CIM e CBM de 0,005% e 0,01%, respectivamente. O MBIC foi de 6,25% para S. mutans. A contagem de UFC e a microscopia confocal revelaram efeito significativo do BlueM® no biofilme de S. mutans pré-formado nas superfícies de dentinas. Curiosamente, a análise da expressão do gene gbpA, indicou uma diminuição na expressão do gene após 15 min de tratamento com BlueM® na concentração de 25%. Além disso, BlueM® exibiu baixos níveis de citotoxicidade. Em conclusão, nossos resultados mostraram a eficácia antimicrobiana do BlueM® contra S. mutans, sua capacidade de modular a expressão do gene gbpA e sua baixa citotoxicidade. Este estudo apoia o potencial terapêutico do BlueM® como agente alternativo para o controle do biofilme oral.

The influence of the colonization of Streptococcus agalactis in the lower genital tract during pregnancy on the perinatal outcome / 中国综合临床

Objective:To investigate the effect of the colonization of group B streptococcus (GBS) in pregnant women and the use of intrapartum antibiotic prophylaxis (IAP) on perinatal outcomes.Methods:The clinical data of 1 078 pregnant women and their newborn babies delivered in Tongzhou and Xicheng hospital areas of Beijing Friendship Hospital from January 2020 to February 2021 were analyzed retrospectively. The clinical characteristics, complications, perinatal outcomes and neonatal prognosis of the pregnant women with positive and negative GBS were compared according to the GBS colonization, and the effects of IAP on the clinical characteristics, complications, perinatal outcomes and neonatal prognosis of the pregnant women with positive GBS was compared. The measurement data with normal distribution is expressed by x±s, two independent sample t-test was used for comparison between groups. Counting data were expressed in cases or cases (%), Inter group comparison χ 2 test. Results:Among 1 078 pregnant women, 93 were GBS positive (8.6%, GBS positive group), and 93 cases matching the clinical data of the GBS positive group were selected as the GBS negative group. There was no significant difference in age, gestational age, number of pregnancies, number of births, mode of delivery, abnormal blood pressure, abnormal blood glucose, abnormal thyroid function and the proportion of any complication in the GBS positive group (P values were 0.630, 0.613, 0.311, 0.761, 0.163, 0.601, 0.467, 0.388, 1.000, respectively). The proportion of neonates in GBS positive group transferred to pediatrics, the incidence of neonatal infection, pneumonia, anemia and bacterial infection rate were higher than those in GBS negative group (57.0%(53/93) vs 23.7%(22/93), 10.8%(10/93) vs 3.2%(3/93), 29.0%(27/93) vs 14.0%(13/93), 21.5%(20/93) vs 8.6%(8/93), 22.6%(21/93) vs 6.5%(6/93)) (χ 2 values were 21.47, 4.05, 6.24, 6.05, 9.75, respectively; the P values were <0.001, 0.044, 0.012, 0.014, 0.002, respectively). The hospitalization time of neonates transferred to pediatrics was longer than that of GBS negative group (4(0,5) d vs 0(0,0) d, Z=-4.03, P<0.001). The proportion of neonates in IAP group transferred to pediatrics and the incidence of pathological jaundice and adverse outcomes were lower than those in non IAP group (51.1% (24/47) vs 78.1% (25/32), 44.7% (21/47) vs 78.1% (25/32), 42.6% (20/47) vs 65.6% (21/32)) (χ 2 values are 5.92, 8.76 and 4.06, respectively, P values are 0.015, 0.003 and 0.044 respectively). The hospitalization time of neonates transferred to pediatrics was shorter than that of non IAP group (3(0,5) d vs 5(2,7) d, Z=-2.60, P=0.009). There was no significant difference between the two groups in terms of delivery mode, water breaking time, birth weight of neonates, infection, pneumonia, bacteremia/sepsis, and anemia ( P values were 0.073, 0.085, 0.479, 0.538, 0.157, 0.161, 0.238). Conclusions:GBS colonization in the lower genital tract does not increase the incidence of intrauterine infection, premature rupture of membranes and spontaneous preterm delivery in pregnant women, but the risk of bacterial infection and adverse outcomes in newborns is higher, the rate of paediatric transfer is higher, and the hospital stay is longer. IAP can reduce the incidence of neonatal pathological jaundice and shorten the hospital stay.