Allen Victoria M, Yudin Mark H
Halifax, NS.
Toronto, ON.
J Obstet Gynaecol Can. 2018 Feb;40(2):e181-e186. doi: 10.1016/j.jogc.2017.11.025.
To provide information regarding the management of group B streptococcal (GBS) bacteriuria to midwives, nurses, and physicians who are providing obstetrical care.
The outcomes considered were neonatal GBS disease, preterm birth, pyelonephritis, chorioamnionitis, and recurrence of GBS colonization.
Medline, PubMed, and the Cochrane database were searched for articles published in English to December 2010 on the topic of GBS bacteriuria in pregnancy. Bacteriuria is defined in this clinical practice guideline as the presence of bacteria in urine, regardless of the number of colony-forming units per mL (CFU/mL). Low colony counts refer to <100 000 CFU/mL, and high (significant) colony counts refer to ≥100 000 CFU/mL. Results were restricted to systematic reviews, randomized controlled trials, and relevant observational studies. Searches were updated on a regular basis and incorporated in the guideline to February 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
Recommendations were quantified using the evaluation of evidence guidelines developed by the Canadian Task Force on Preventive Health Care (Table).
BENEFITS, HARMS, AND COSTS: The recommendations in this guideline are designed to help clinicians identify pregnancies in which it is appropriate to treat GBS bacteriuria to optimize maternal and perinatal outcomes, to reduce the occurrences of antibiotic anaphylaxis, and to prevent increases in antibiotic resistance to GBS and non-GBS pathogens. No cost-benefit analysis is provided.
为提供产科护理的助产士、护士和医生提供有关B族链球菌（GBS）菌尿症管理的信息。
所考虑的结果包括新生儿GBS疾病、早产、肾盂肾炎、绒毛膜羊膜炎以及GBS定植复发。
检索了Medline、PubMed和Cochrane数据库，以查找截至2010年12月发表的关于妊娠GBS菌尿症主题的英文文章。在本临床实践指南中，菌尿症定义为尿液中存在细菌，无论每毫升菌落形成单位（CFU/mL）的数量。低菌落计数是指<100 000 CFU/mL，高（显著）菌落计数是指≥100 000 CFU/mL。结果仅限于系统评价、随机对照试验和相关观察性研究。检索定期更新，并纳入截至2011年2月的指南。通过搜索卫生技术评估和与卫生技术评估相关机构的网站、临床实践指南集、临床试验注册库以及国家和国际医学专业协会，识别灰色（未发表）文献。
使用加拿大预防保健工作组制定的证据评估指南对建议进行量化（表）。
益处、危害和成本：本指南中的建议旨在帮助临床医生识别适合治疗GBS菌尿症的妊娠，以优化孕产妇和围产期结局，减少抗生素过敏反应的发生，并防止对GBS和非GBS病原体的抗生素耐药性增加。未提供成本效益分析。
