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

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

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

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

Genetic Relatedness Among Streptococcus agalactiae Isolated from Cattle, Fish, and Humans.

Streptococcus agalactiae is well recognized to cause a variety of infections in many animal species and humans. We aimed to investigate genetic relatedness of S. agalactiae strains isolated from humans and animal origins, including cattle and fish, using capsular gene typing, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing techniques. Our results revealed that S. agalactiae strains with capsular type Ia and ST103 were observed from all bovine isolates (17/17) and one human isolate (1/5). S. agalactiae strains with capsular type III and ST283 were detected among isolates from fish (5/5) and from humans (2/5). Two PFGE clusters containing isolates from mixed origins were demonstrated: one cluster of five fish and one human isolate, and another cluster of one bovine and one human isolate. In conclusion, the close genetic relationship among S. agalactiae strains isolated from humans and animal origins was evident.

Population-based study of early-onset neonatal sepsis in Canada.

OBJECTIVE: To determine the incidence, types of organisms and resistance patterns involved in early-onset neonatal sepsis in Canada. STUDY DESIGN: Early-onset neonatal sepsis cases were identified through the Canadian Paediatric Surveillance Program. Neonates were excluded if they were asymptomatic or if intracranial procedures preceded a positive cerebrospinal fluid culture. RESULTS: One hundred and twenty-seven cases were identified (0.17 cases per 1000 live births). Group B Streptococcus accounted for 41.7%, Escherichia coli for 35.4%. Antibiotic resistance was present in 33.9% of all cases. 55.6% of E coli cases were resistant, most commonly to ampicillin. Infecting organism species were associated with gestational age, being very low birth weight, time at sepsis presentation, maternal antibiotic prophylaxis and rupture of membranes lasting over 18 hours. Group B Streptococcus was most common in term and E coli in preterm neonates. Twenty-two per cent of E coli cases presented after 48 hours, compared to 6% of Group B Streptococcus cases. CONCLUSION: We identify a lower rate of early-onset neonatal sepsis than historically suggested, with differing dominant organisms based on gestational ages and other factors, as well as high rates of resistance especially among E coli cases.

Burden and risk factors of invasive group B Streptococcus disease among neonates in a Chinese maternity hospital.

BACKGROUND: There is a lack of data regarding the prevalence of invasive group B streptococcus (GBS) infection among neonates in China. This study aimed to investigate the incidence and mortality of invasive GBS infection and to identify the risk factors in our hospital. METHODS: Seventy-four cases admitted between January 2011 and December 2016 was included in this study. A retrospective matched case-control study was conducted in a tertiary maternity and paediatric hospital. Risk factors for the acquisition of invasive GBS infection and mortality were analysed by univariable and multivariable analysis. RESULTS: We collected and analysed data from 74 infants aged < 3 months with invasive GBS infection. Among 67,985 live births, we calculated an incidence of 1.09 per 1000 live births (95%CI:0.81-1.37%); the incidence of Early-onset GBS disease (EOD, n = 65) and Late-onset GBS disease (LOD, n = 9) were 0.96‰(95%CI:0.73-1.19%) and 0.13‰(95%CI:0.04-0.22%), respectively. Overall, pneumonia accounted 63.1% (41/65) of EOD, and sepsis accounted 88.9% (8/9) cases of LOD, respectively. The overall case fatality rate was 8.11% (6/74), including 7.69% (5/65) among cases of EOD and 11.1% (1/9) among cases of LOD. No predictor of mortality was found. Membrane stripping (P = 0.005, aOR: 3.68, 95% CI: 1.48-9.13) and non-resident mother (P < 0.001, aOR: 5.88, 95% CI: 2.36-14.61) were independent risk factors for EOD; no increased risk was found for LOD. CONCLUSIONS: This study demonstrates remarkable country-specific variation in comparison with other countries. Our findings can improve awareness of neonatal GBS infection and lay a cornerstone to ensure accurate representation of the burden.

Genetic Diversity and Antimicrobial Drug Resistance of Serotype VI Group B Streptococcus, Canada.

Two genetically dissimilar sequence type 1 clades dominate the serotype VI group B Streptococcus population of strains causing invasive disease in Canada. Isolates of this rare serotype, recovered mainly from adult patients, were all susceptible to penicillin and vancomycin. However, we observed resistance to erythromycin and clindamycin.

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

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

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

Frequency of Group B Streptococcal Colonization in Pregnant Women Aged 35- 37 Weeks in Clinical Centers of Shahed University, Tehran, Iran.

BACKGROUND & OBJECTIVES: One of the important infectious factors in pregnant mothers and newborns is Group B Streptococcus (GBS). There is no perfect report about prevalence of GBS in Iran and in the case of preterm rupture of amniotic membrane or preterm labor all patients are treated by antibiotics without culture so this has led to adverse taking antibiotics and drug resistance. The present study is intended to determine the frequency of colonization of GBS in the pregnant mother (35-37 weeks), referred to medical centers of Shahed University. METHODS: Overall, 210 pregnant women (35-37 weeks), referred to medical center of Shahed University, Tehran, Iran were selected as sample group and after filling out the questionnaires about demographic data and midwifery status and the related information of post- partum, the rectovaginal culture was done for them. RESULTS: Among 210 samples, 7 (3.3%) included positive culture in terms of GBS colonization while all these cases were sensitive to penicillin, ampicillin, cephalothin, nitrofurantoin, and all of the samples were resistant against tetracycline and contrimoxazole. There was no relationship among age, job, education, number of pregnancy, blood pressure background, diabetes and preterm childbirth with positive culture. Similarly, because of limited number of positive cases it was not possible to examine the relationship among GBS colonization and infection in mother and newborn. CONCLUSION: There was a low frequency in GBS colonization in the studied hospitals and the study inside the country also confirms this finding.

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

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

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

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

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

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

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

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