Abstract
Objective To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. Methods This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, [...]
Highlights
Group B hemolytic Streptococcus (GBS), or Streptococcus agalactiae, is a Gram-positive coccus that is part of the usual rectovaginal flora, and can be found transiently in asymptomatic women.[1]
As from 1986, the Centers for Disease Control and Prevention (CDC) recommendation was to perform prophylactic antibiotic therapy (PAT) on pregnant women with risk factors.[5]. Later on, in 2002, with the revision of the protocol, adopting the recommendation of performing universal screening of all women between 35 and 37 weeks of gestation using rectovaginal culture for identifying pregnant women colonized by GBS and administering PAT, the incidence of Early-onset GBS disease (EOGBS) was reduced by more than 80%.(6,7) In the United States, the reduction was from 1.8 cases in the early 1990’s to 0.23 cases per 1,000 live births, in 2015
The prevalence of vaginal GBS colonization in pregnant women is 4% to 35%, which is similar to the female population in general.[1,8,9] Among pregnant women colonized by GBS, 50% to 75% of newborns exposed to GBS become colonized, and 1% to 2% of these infants develop EOGBS.[1]. The mortality rate declined to 5% in 2014, a 91% decrease of the rate found 28 years ago.[10,11]
Summary
Group B hemolytic Streptococcus (GBS), or Streptococcus agalactiae, is a Gram-positive coccus that is part of the usual rectovaginal flora, and can be found transiently in asymptomatic women.[1]. As from 1986, the Centers for Disease Control and Prevention (CDC) recommendation was to perform prophylactic antibiotic therapy (PAT) on pregnant women with risk factors.[5] Later on, in 2002, with the revision of the protocol, adopting the recommendation of performing universal screening of all women between 35 and 37 weeks of gestation using rectovaginal culture for identifying pregnant women colonized by GBS and administering PAT, the incidence of EOGBS was reduced by more than 80%.(6,7) In the United States, the reduction was from 1.8 cases in the early 1990’s to 0.23 cases per 1,000 live births, in 2015. The PAT-based prevention strategy of universal screening of all pregnant women has a higher cost than the strategy based on risk factors, and its efficacy has been questioned, because it may increase bacterial resistance and the occurrence of EOGBS in newborn infants of pregnant women with GBS-negative culture in antepartum screening.[4,12] Knowledge of GBS colonization prevalence in pregnant women should be considered for the implementation of an appropriate strategy for EOGBS prevention, which is different in several population groups.[9]
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