Sziller István, Szabó Miklós, Valek Andrea, Rigó Barbara, Ács Nándor
Szent Imre Egyetemi Oktatókórház Szülészeti és Nőgyógyászati Osztály Budapest Tétényi út 12-16. 1115.
Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekklinika Budapest.
Orv Hetil. 2014 Jul 20;155(29):1167-72. doi: 10.1556/OH.2014.29932.
At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary.
The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary.
Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary.
Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes.
The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.
目前，匈牙利尚无预防早发型新生儿B族链球菌病的强制性指南。
本研究旨在深入了解匈牙利国内产科科室自发制定的预防策略。
向匈牙利71个产科科室分别发放标准化问卷。
总体而言，20位（27.4%）科室主任进行了回复，因此，匈牙利活产总数的39.9%纳入了本研究。尽管缺乏公共卫生指南，但每个科室都制定了自己的预防新生儿B族链球菌病的策略。在95%的病例中，阴道下段细菌培养是识别高危孕妇的方法。在5%的病例中，产时抗生素预防仅基于风险评估。在采用基于培养的预防措施的科室中，58%的科室在妊娠36周后对孕妇进行采样。100%的病例中首选抗生素为青霉素或氨苄西林。在研究参与者中，80%报告在临产或胎膜破裂后对定植孕妇进行多次给药。
作者得出结论，该研究的参与率较低。然而，预防早发型新生儿B族链球菌感染是匈牙利产科护理的重点。缺乏全国性的公共卫生政策并未阻止该国的产科机构制定自己的预防策略。在大多数病例和机构中，该政策与广泛接受的国际标准一致。
