Hakim Marwan, Jabour Adel, Anton Miriam, Hakim Meggie, Kheirallah Sahar
Department of Obstetrics and Gynecology, Nazareth Hospital, Nazareth, Israel.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Isr Med Assoc J. 2018 May;20(5):291-294.
The recommendation of the U.S. Centers for Disease Control and Prevention regarding universal screening for Group B Streptococcus (GBS) at 35-37 weeks gestational age in pregnancy is not accepted in Israel. The National Council for Obstetrics, Neonatology and Genetics recommends intrapartum prophylaxis, mainly based on risk factors, to prevent early neonatal GBS infection. This policy is based on past studies demonstrating low colonization rates of the bacteria in Israeli pregnant women and very low neonatal sepsis rates.
To determine the applicability of the high-risk group prophylaxis policy for Arab Israeli pregnant women.
Vaginorectal swabs from Arab Israeli pregnant women who attended the labor ward between October 2015 and February 2016, were obtained before any pelvic examination for GBS identification using Quidel's AmpliVue® GBS assay. Women who tested positive received intrapartum antibiotic prophylaxis to prevent neonatal infection. Obstetric data were collected from each woman from a standardized questionnaire. Data regarding the delivery and neonates were collected as well.
The study comprised 188 Arab pregnant women who met the inclusion criteria and signed a consent form to participate in the study. Of these, 59 had positive tests, and a carriage rate of 31%. No neonatal colonization of GBS was found.
The carrier rate in Arab pregnant women in northern Israel is higher than the national average, at least partially due to the more sensitive method of GBS detection used in the present study.
美国疾病控制与预防中心关于在妊娠35 - 37周对B族链球菌(GBS)进行普遍筛查的建议在以色列未被采纳。国家妇产科、新生儿科和遗传学委员会建议基于危险因素进行产时预防,以预防新生儿早期GBS感染。该政策基于过去的研究,这些研究表明以色列孕妇中该细菌的定植率较低,新生儿败血症发生率也非常低。
确定高危组预防策略对以色列阿拉伯裔孕妇的适用性。
对2015年10月至2016年2月期间入住分娩病房的以色列阿拉伯裔孕妇,在进行任何盆腔检查之前,采集阴道直肠拭子,使用Quidel公司的AmpliVue® GBS检测法进行GBS鉴定。检测呈阳性的女性接受产时抗生素预防以预防新生儿感染。从一份标准化问卷中收集每位女性的产科数据。同时收集有关分娩和新生儿的数据。
该研究纳入了188名符合纳入标准并签署同意书参与研究的阿拉伯裔孕妇。其中,59人检测呈阳性,携带率为31%。未发现新生儿GBS定植。
以色列北部阿拉伯裔孕妇的携带率高于全国平均水平,至少部分原因是本研究中使用了更敏感的GBS检测方法。