Alós Cortés Juan Ignacio, Andreu Domingo Antonia, Arribas Mir Lorenzo, Cabero Roura Luis, de Cueto López Marina, López Sastre José, Melchor Marcos Juan Carlos, Puertas Prieto Alberto, de la Rosa Fraile Manuel, Salcedo Abizanda Salvador, Sánchez Luna Manuel, Sanchez Pérez María José, Torrejon Cardoso Rafael
SEIMC, Servicio de Microbiología, Hospital de Getafe, Madrid, España.
Enferm Infecc Microbiol Clin. 2013 Mar;31(3):159-72. doi: 10.1016/j.eimc.2012.03.013. Epub 2012 Jun 2.
Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.
B族链球菌（GBS）仍然是早发型新生儿败血症最常见的病因。2003年，西班牙妇产科学会、新生儿科学会、传染病与临床微生物学会、化疗学会以及家庭与社区医学学会发布了预防早发型新生儿GBS感染的更新建议。建议在妊娠35至37周时对所有孕妇进行检查，以确定她们是否感染GBS，并对所有感染GBS的孕妇进行产时抗生素预防（IAP）。在西班牙广泛应用IAP后，新生儿GBS感染显著减少。如今，大多数早发型GBS新生儿感染病例是由于GBS检测结果假阴性、实验室与产科单位之间缺乏沟通以及预防方案实施失败所致。2010年，美国疾病控制与预防中心（CDC）发布了新的建议，鉴于此以及现有的新知识和经验，促成了这些新建议的发布。这些修订建议的主要变化包括：更新了识别妊娠GBS携带者和检测GBS抗生素敏感性的微生物学方法，以及用于IAP的抗生素；明确了尿液中GBS存在的意义，包括妊娠期尿路感染和无症状菌尿的诊断标准；还修订了早产和胎膜早破时的IAP以及与母亲GBS携带者状态相关的新生儿管理。这些建议仅针对预防GBS早发型新生儿感染，对晚发型新生儿感染无效。
