Prevalência de colonização por estreptococos do grupo B em gestantes atendidas em maternidade pública da região Nordeste do Brasil

Abstract

ObjetivO: avaliar a prevalência da colonização pelo estreptococo do grupo B (EGB) em gestantes em pródromos ou em trabalho de parto. MétOdOs: foram colhidas culturas vaginal e retal de 201 gestantes atendidas no setor de admissão de maternidade pública da região Nordeste do Brasil (São Luís, Maranhão). As amostras obtidas foram inoculadas em meio seletivo de Todd Hewith e, posteriormente, subcultivadas em placas de ágar sangue. O teste de CAMP (Christie, Atkins, Munch-Petersen) foi utilizado para identificação do EGB, confirmado sorologicamente pelo sistema de microteste kit Api 20 Strep da BioMérieux. As amostras positivas para EGB foram submetidas ao teste de sensibilidade para antibióticos. Foram estudadas as variáveis sociodemográficas, antecedentes gineco-obstétricos e desfechos perinatais. Na análise estatística foram utilizados os programas Epi-Info 3.3.2, da Organização Mundial de Saúde e o Statistical Package for Social Sciences, versão 14.0. A razão de prevalência foi utilizada como medida de risco, considerando como nível de significância p≤0,05, aceitando-se poder de 80%. ResultadOs: a prevalência da colonização materna pelo EGB foi de 20,4%. Não foi encontrada associação entre as variáveis sociodemográficas ou antecedentes gineco-obstétricos, com a maior presença de colonização pelo EGB. Houve dois desfechos infecciosos entre os recém-natos de mães colonizadas, porém as hemoculturas foram negativas. Foram encontradas taxas de resistência elevadas para os seguintes antibióticos: clindamicina, 25,4%; eritromicina, 23,6% e ceftriaxona 12,7%. COnClusões: a prevalência da colonização materna pelo EGB foi elevada, semelhante à descrita em outros estudos. As taxas elevadas de resistência aos antimicrobianos, especialmente ceftriaxona, indicam a necessidade de mais estudos para determinar a sorotipagem deste agente e os protocolos de orientação para uso racional de antimicrobianos. AbstractPuRPOse: to assess the prevalence of group B streptococcus colonization (GBS) in pregnant women in prodrome or in labor. MethOds: vaginal and rectal cultures were collected from 201 pregnant women, in the admission sector of a public maternity center in the northeast region of Brazil (São Luís, Maranhão). The samples obtained were inoculated in a Todd-Hewith's selective culture medium and after that they were sub-cultivated in blood-agar plates. The CAMP (Christie, Atkins, Munch-Petersen) test was used to identify GBS, which was then serologically confirmed by the BioMérieux Api 20 Strep kit microtest. GBS positive samples were submitted to an antibiotic sensitivity test. Sociodemographic variables, gynecological-obstetrical antecedents, and perinatal outcomes were studied. The Epi-Info 3.3.2 programs from World Health Organization and Statistical Package for Social Sciences 14.0 version were used for the statistical analysis. The prevalence ratio was used as risk measure, considering p≤0.05 as significance level, and accepting 80% power. Results: the prevalence of SGB colonization in the mothers was 20.4%. There was no a...

<b> COLONIZATION PREVALENCE AND SUSCEPTIBILITY OF Streptococcus agalactiae IN PREGNANT WOMEN AT HUSM </b>

“…6 In São Luis -Maranhão, the prevalence was 20.4% from 2005 to 2006. 10 The present study showed a colonization rate of slightly lower than the national ones (11.11%).…”

“…13 The prevalence of maternal GBS colonization varies from 5 to 40% concerning some factors such as the gestation period in which cultures are performed, the collection site, the bacteriological methods used to detect GBS and the origin and characteristics of the population studied. 1,2,10 In this study we chose to search GBS both vaginal and rectal sites, as there are reports that the colonization rate increases from 5 to 25% when the TABLE 2 -Susceptibility to antimicrobials offour pregnant women with culture vaginal and/or rectal GBS- positive ------------------------------------------------- …”

“…14 Since 2002, the CDC emphasizes the universal search for GBS colonization rather than the protocol based on risk factors, once studies showed that this strategy was more effective to define the use of intrapartum chemoprophylaxis, especially taking into account that many colonized pregnant women did not have risk factors for newborn infection. 1,5,14,15 In this context, studies that evaluate the rate of GBS colonization have been performed worldwide and the prevalence rates are variable: 8.6% in Mexico in 1999; 16 10.6% in Turkey in 2000, 17 9.1% in Iran in 2003, 5 7.6% inArgentina between 2004 and 2006. 18 In Brazil, these rates have become even higher.…”

“…1 Neurological sequelae occur in approximately 30-50% ofmeningitis survivors. 4,9 The presence ofmaternal colonization prevalence between 15 and 25% places Brazil in a level ofconcern when considering the possibility that high rates ofearlyonset neonatal infection are occurring without being identified, 10 as there are no manuals or technical recommendations on the theme in the country. 11 Our objective was to assess the prevalence of vaginal and/or rectal colonization by S. agalactiae and its susceptibility to antimicrobials in pregnant women from 35 to 37 weeks of gestation who were treated at University Hospital of Santa Maria (HUSM) in Santa Maria, RS.…”

Pesquisa do estreptococo do Grupo B em gestantes da Zona Leste de São Paulo

“…Studies conducted at hospitals in the Brazilian states of Paraná, Santa Catarina, São Paulo and Maranhão (2)(3)(8)(9) showed prevalences of 14.9%, 21.6%, 14.6% and 20.4% for GBS, respec vely.…”