Department of Bacteriology, Microbial Ecology and Parasitology, Jagiellonian University Medical College, Cracow, Poland.
Med Sci Monit. 2013 Jan 11;19:34-9. doi: 10.12659/msm.883733.
In 2008, the Polish Gynecological Society issued recommendations to screen pregnant women for GBS colonization and offer antibiotic prophylaxis at delivery. The goal of this study was to assess compliance with these recommendations among women delivering very low birth weight infants (VLBW) in Poland.
MATERIAL/METHODS: The 6 Polish Perinatological Institutions managing infections in the framework of the Polish Perinatological Network were subjected to the analysis. A retrospective case-cohort study for 2009 was conducted using the standard protocols and definitions. The collected data pertained to 812 pregnant women who gave birth to 910 babies with VLBW.
The statistical variation across the 6 studied centers associated with GBS prevention of infections was noted. Bacteriological examinations of samples taken from the vagina were performed only in 273 (34%) of the women, ranging between 2% and 93%, depending on the center. GBS carriage was proven in 19% of these women, ranging between 8% and 27%. The culture method was inadequate because of highly variable results. It was found that the rate of GBS determination is statistically connected with the number of women's screenings performed in the study centers. The intrapartum antibiotic prophylaxis (IAP) was used only in the half of GBS-positive women (47%). Six cases of early-onset GBS infections (5 blood stream infections and 1 pneumonia) were registered in the studied newborns, of which 4 neonates were born to women who received IAP against GBS. The incidence rate of GBS infection in VLBW neonates was 6.6 per 1000 live births, with a high death rate (up to 33%).
Poor compliance with GBS screening and antibiotic prevention were observed among women delivering very low birth weight infants. GBS infection was noted in a significant proportion of VLBW neonates; we believe a uniform policy should be put in place to manage these high-risk women and babies.
2008 年，波兰妇科协会发布了针对孕妇进行 GBS 定植筛查并在分娩时提供抗生素预防的建议。本研究的目的是评估波兰分娩极低出生体重儿（VLBW）的女性对这些建议的依从性。
材料/方法：对参与波兰围产期网络感染管理的 6 个波兰围产医学机构进行了分析。采用标准方案和定义，对 2009 年的回顾性病例对照研究进行了分析。收集了 812 名孕妇的数据，这些孕妇分娩了 910 名 VLBW 婴儿。
研究中注意到 6 个研究中心在 GBS 预防感染方面的统计学差异。仅对 273 名（34%）女性进行了阴道样本的细菌学检查，各中心的检查率在 2%至 93%之间。这些女性中有 19%证实携带 GBS，范围在 8%至 27%之间。由于结果差异较大，培养方法不够充分。研究发现，GBS 检测率与研究中心进行的女性筛查数量在统计学上有关。仅对一半的 GBS 阳性女性（47%）使用了产时抗生素预防（IAP）。在研究新生儿中发现了 6 例早发型 GBS 感染（5 例血流感染和 1 例肺炎），其中 4 名新生儿的母亲接受了 GBS 产时 IAP。VLBW 新生儿的 GBS 感染发生率为每 1000 例活产 6.6 例，死亡率较高（高达 33%）。
在分娩极低出生体重儿的女性中，GBS 筛查和抗生素预防的依从性较差。GBS 感染在很大比例的 VLBW 新生儿中被发现；我们认为应该制定统一的政策来管理这些高风险的女性和婴儿。
