Microbiological diagnosis of infections caused by Streptococcus group B in pregnant women and newborns

The relevance of the problem of group B streptococcus (GBS) in obstetric practice is beyond doubt. Attracting the close attention of leading specialists, introducing new solutions and based on practical accumulated experience, it is still not possible to prevent all cases of neonatal infections caused by GBS. The review article demonstrates the current presentation of the problem. Urban lifestyles and higher levels of education are predictors of colonization of pregnant women with GBS. Women who use combined oral contraceptives and are sexually active are at risk. Predisposing risk factors include African-American race in combination with sexually transmitted infections. Premature pregnancies colonized with GBS increase the risk of colonization in subsequent pregnancies by 50 %. Absolute factors for massive colonization of the birth tract by GBS are asymptomatic bacteriuria, associated GBS, and a history of a child colonized by GBS. Such virulence factors as hemolytic pigment and hyaluronidase contribute to the pathogenic potential of GBS. The protective function in the immune system is performed by Kaschenko–Gofbauer cells, but their role is ambiguous. 90% of newborns develop an early form of neonatal GBS infections and manifest themselves as sepsis, pneumonia, meningitis. Implemented measures to prevent early neonatal GBS infection have a number of shortcomings. False-negative results of culture screening for GBS antigen in 35–37 weeks of pregnancy increase the risks of vertical transmission, and false-positive results are grounds for prescribing irrational antibiotic prophylaxis at delivery. Moreover, antenatal microbiological screening for GBS and antibiotic prophylaxis at birth do not prevent the risks of late-onset neonatal GBS infection. The mechanism of horizontal transmission of GBS from mother to child is not fully understood, but risk factors include nosocomial sources, infected breast milk, or caregivers.

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Experience in the diagnosis of group B Streptococcus infections in pregnant women and newborns in a perinatal center

Наумкина

Кравченко

Куклина

2021

Klin. lab. diagn.

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Serogroup B streptococci (Streptococcus agalactiae) are one of the main etiological agents responsible for the occurrence of severe perinatal infections in both postpartum women and newborns. The experience of microbiological diagnostics of infections caused by streptococcus serogroup B (GBS) according to the data of the microbiological laboratory of the perinatal center is generalized. In the study of biomaterial from patients, the proportion of positive cultures of Streptococcus agalactiae was 2.2% in cervical samples, 8.8% in vaginal contents, 6.6%; 2.8% and 0.7% in amniotic fluid, placenta and urine, respectively. In 57% of cases, GBS was released at a concentration of more than 5 lg / ml and in 73% of cases as part of polymicrobial associations with other opportunistic microorganisms. In the biomaterial from newborns, GBS was found in 2.5% of positive findings in blood samples, 4.6% in tracheobronchial lavages and 2.7% in detachable skin of the armpit when taking material immediately after childbirth and 1, 1% and 0.7%, respectively, during examination in the second stage of nursing. 5 cases of GBS isolation in newborns ended in early neonatal mortality with definitive diagnoses of congenital pneumonia and IUI of newborns, while there was only partial coincidence of the results of microbiological studies of the genital tract of the mother and biomaterials from the newborn. Relatively frequent findings of GBS in newborns of the high-risk group in intensive care unit indicate intrauterine infection with this pathogen. The examination of smears from the cervical canal is not informative in relation toGBS infection in comparison with the examination of the vaginal contents and recto-vaginal smears. The results of the introduction of microbiological screening and its effectiveness in real practice to prevent the development of early and late forms of GBS infections in newborns require further analysis.

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Microbiological diagnosis of infections caused by Streptococcus group B in pregnant women and newborns

Cited by 3 publications

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Interrelations of urinary and genital tract microbiomes in reproductive age women

Interrelations of urinary and genital tract microbiomes in reproductive age women

Colonization of pregnant women with group B streptococcus: current view at the problem

Experience in the diagnosis of group B Streptococcus infections in pregnant women and newborns in a perinatal center

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