RESUMOObjetivo: verificar a prevalência de estreptococo do grupo B (EGB) em gestantes no terceiro trimestre da gravidez e explorar os fatores potencialmente associados à colonização. Métodos: uma amostra de 273 gestantes no terceiro trimestre da gravidez, provenientes do ambulatório de pré-natal do Hospital Universitário do Sul do Brasil, foi investigada. Culturas de amostra vaginal e anorretal foram obtidas e inoculadas em meio seletivo de Todd-Hewitt suplementado com 10 µg/ml de colistina e 15 µg/ml de ácido nalidíxico e posteriormente subcultivadas em ágar sangue de carneiro desfibrinado. Todas as colônias suspeitas foram submetidas ao teste de aglutinação para detecção do antígeno específico do grupo B. O teste de Camp foi utilizado para identificação do EGB das variedades não hemolíticas. Analisaram-se também os dados demográficos, socioeconômicos, reprodutivos e clínico-obstétricos. A razão de prevalência (RP) foi utilizada como medida de risco. Considerou-se como significante o intervalo de confiança no nível de 95% (α=0,05). Resultados: a prevalência de colonização pelo EGB foi de 21,6% (59), sendo que 9,9% (27) das gestantes tiveram positividade em ambos os sítios, 6,95% (19) foram positivas somente no sítio vaginal e 4,75% (13) da amostra tiveram positividade apenas no sítio anal. A prevalência de EGB foi ligeiramente mais alta nas gestantes com idade inferior a 20 anos, naquelas com menor escolaridade e nas gestantes primíparas, e o dobro entre aquelas que não relataram aborto espontâneo, porém sem significância estatística. Não foi encontrada diferença na prevalência de EGB de acordo com história de doenças sexualmente transmissíveis e tabagismo. Quando os dados foram analisados conjuntamente, os fatores detectados como potencialmente associados à colonização pelo EGB foram: primíparas com mais de 30 anos (RP=1,55) e mulheres com mais de um parceiro sexual e freqüência de atividade sexual aumentada (55,6 vs 20,5%; p<0,05). Conclusão: confirma-se a necessidade rotineira de cultura para EGB em ambos os sítios (vaginal e anal) de todas as gestantes no terceiro trimestre de gestação. PALAVRAS-CHAVE:Streptococcus agalactiae; Gravidez; Prevalência; Colonização ABSTRACT Purpose: to determine the prevalence of group B Streptococcus (GBS) in pregnant women in the third trimester of pregnancy and explore the factors potentially associated with colonization. Methods: a sample of 273 pregnant women in the third trimester of pregnancy, from the prenatal care center in Southern Brasil, was investigated. Vaginal and anorectal samples were collected and innoculated in Todd-Hewitt selective broth supplemented with 10 µg/mL colistin and 15 µg/mL nalidixic acid and afterwards cultured on defibrinated sheep blood agar plates. All suspected colonies were submitted to the agglutination test for detection of the specific group B antigen. The Camp test was used for GBS identification in non-hemolytic varieties. Demographic, socioeconomic, reproductive, and clinico-obstetric data were also analyzed. Prevalence ratio (PR) was...
Objective To compare the efficacy of high‐risk human papillomavirus (HR‐HPV) and DNA image cytometry (DNA‐ICM) status for identifying high‐grade cervical intraepithelial neoplasia or worse (≥CIN2). Methods This cross‐sectional study was performed in women undergoing follow‐up procedure after a previous abnormal cervical cytology. Cervical cells were collected for HPV detection and DNA ploidy measurement. Biopsy samples were taken for histological confirmation. Sensitivity and specificity values for ≥CIN2 detection with HR‐HPV and DNA‐ICM were determined. Results HR‐HPV was present in 74.5% of the women. The most frequent HPV infection was HPV 16, followed by HPV 31, 33 and 58. Aneuploidy was observed in 60.6% of all cases. Referral cytology revealed 78.0% sensitivity and 68.6% specificity for detecting a ≥CIN2 lesion. The HR‐HPV test alone showed 92.7% sensitivity, albeit it was not statistically different from DNA‐ICM (88.1%, P > .05). Positivity for HPV or DNA‐ICM resulted in 100% sensitivity. Higher specificity was observed for the combination of HR‐HPV and DNA‐ICM (88.6%), with no difference from DNA‐ICM alone (85.7%, P > .05). Conclusion DNA‐ICM or HR‐HPV positivity identified all cases of ≥CIN2 in women undergoing follow‐up procedure after a previous abnormal cervical cytology. Routine cervical cancer screening could be improved by the incorporation of DNA‐ICM as a complementary method to primary screening to identify which women need closer follow‐up.
Objective: Evaluate the performance of different DNA image cytometry (DNA-ICM) ploidy parameters in the categorisation of DNA-ICM results and identification of high-grade cervical intraepithelial neoplasia or worse (≥ CIN2).Methods: Cervical samples from 232 women were collected for DNA-ICM analysis and biopsy confirmation. Five DNA parameters were used to define DNA aneuploidy: number of cells with exceeding events (EE) over 2.5cEE, 4cEE, 5cEE and 9cEE, and aneuploid stemlines. DNA-ICM results were categorised as normal, suspicious, and abnormal.Results: For individual DNA ploidy parameters, sensitivity values for 50 cells with 2.5cEE, 45 cells with 4cEE, 1 cell with 9cEE and aneuploid stemline were 72.95%.
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