Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection

Ohlsson, Arne; Shah, Vibhuti; Stade, Brenda

doi:10.1002/14651858.cd003520.pub3

Cited by 31 publications

(21 citation statements)

References 53 publications

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“…Although these compounds show preclinical efficacy in controlling GBS in animal models, it has yet to be established if any of them are feasible or cost-effective for human use. As an alternative to antibiotic treatment, intrapartum chlorhexidine vaginal washes have been considered, but resulted in no significant reduction of EOD, but did significantly lower neonatal colonization ( 270 ). Another alternative strategy explores the growing trend of probiotics agents to limit pathogen overgrowth while promoting healthy native vaginal flora ( 271 , 272 ).…”

Section: Alternative Targeted Prevention Strategies Against Gbs Colonmentioning

confidence: 99%

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

2018

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Group B Streptococcus (GBS) colonizes the gastrointestinal and vaginal epithelium of a significant percentage of healthy women, with potential for ascending intrauterine infection or transmission during parturition, creating a risk of serious disease in the vulnerable newborn. This review highlights new insights on the bacterial virulence determinants, host immune responses, and microbiome interactions that underpin GBS vaginal colonization, the proximal step in newborn infectious disease pathogenesis. From the pathogen perspective, the function GBS adhesins and biofilms, β-hemolysin/cytolysin toxin, immune resistance factors, sialic acid mimicry, and two-component transcriptional regulatory systems are reviewed. From the host standpoint, pathogen recognition, cytokine responses, and the vaginal mucosal and placental immunity to the pathogen are detailed. Finally, the rationale, efficacy, and potential unintended consequences of current universal recommended intrapartum antibiotic prophylaxis are considered, with updates on new developments toward a GBS vaccine or alternative approaches to reducing vaginal colonization.

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Section: Alternative Targeted Prevention Strategies Against Gbs Colonmentioning

confidence: 99%

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

2018

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“…Disease progression is rapid, with 90% of EOD presenting within 24 hours of delivery, and frequently already manifest at birth 10. This, along with the failure of chlorhexidine vaginal douches during labour to reduce EOD,19 suggests that most EODs commence in utero.…”

Section: Pathogenesismentioning

confidence: 99%

Challenges in reducing group B Streptococcus disease in African settings

et al. 2016

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Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis in high-income settings and is associated with high rates of neonatal mortality and morbidity. There is now increasing evidence to suggest that there is a high GBS disease burden in resource-limited countries, and it is therefore critically important to identify suitable and practical preventive strategies. In Europe and North America, intrapartum antibiotic prophylaxis (IAP) has led to a dramatic reduction of early-onset GBS disease. However, the methods for identifying pregnant women who should receive IAP and how to reduce late-onset GBS disease are not without controversy and are challenging for most sub-Saharan African countries. GBS vaccines are approaching phase III trials but are still under development. This review aims to explore the current evidence related to strategies for reducing invasive GBS disease in an African setting, the development of a GBS vaccine and whether preventative measures against GBS disease can be practically implemented.

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“…По данным Кохрановского систематического обзора 2014 г. (4 исследования, 1125 недоношенных и доношенных новорожденных), при сравнении исходов для младенцев матерей, получавших в родах обработку влагалища хлоргексидином и плацебо, в первые 7 дней жизни не обнаружено различий по частоте развития сепсиса и/или менингита, пневмонии, ассоциированных со стрептококком группы В, у новорожденных, колонизированных в течение первых 7 дней жизни стрептококком группы В, а также не зарегистрировано ни одного случая неонатальной летальности в связи с ранним началом В-стрептококковой инфекции [16]. [7,9].…”

Section: не рекомендуется рутинная обработка влагалища хлоргексидиномunclassified

Prevention of septic complications in obstetrics: The guidelines of the Ministry of Health of the Russian Federation and the World Health Organization 2015

Belokrinitskaya¹,

Frolova²

2016

Ross. vestn. akush.-ginekol.

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Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection

Abstract: Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection.

Cited by 31 publications

References 53 publications

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

Challenges in reducing group B Streptococcus disease in African settings

Prevention of septic complications in obstetrics: The guidelines of the Ministry of Health of the Russian Federation and the World Health Organization 2015

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