巴西孕妇中的无乳链球菌:流行率、血清型和抗生素耐药性。
Streptococcus agalactiae in pregnant women in Brazil: prevalence, serotypes, and antibiotic resistance.
机构信息
Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, Brazil.
Department of Microbiology, Biomedical Science Institute, University of São Paulo (USP), São Paulo, Brazil.
出版信息
Braz J Microbiol. 2019 Oct;50(4):943-952. doi: 10.1007/s42770-019-00129-8. Epub 2019 Aug 20.
Brazilian data for maternal GBS colonization shows different prevalence rates. This conflicting data may be related to the absence of an official recommendation from the Federal Brazilian Health Authorities describing guidelines and protocols to perform GBS screening in pregnant women, in both public and private clinics. In the present review, we evaluated published reports addressing the prevalence of GBS in different regions of the country, methods used, and, when available, information regarding antibiotic resistance and serological typing of clinical isolates. According to this review, GBS prevalence in pregnant women in Brazil ranged from 4.2 to 28.4%, in the last 10 years. Serotype Ia was the most prevalent. The highest antibiotic resistance rates were found for tetarcycline, although its use to treat GBS infections is not common. Our results also show high resistance rates to clindamycin and erythromycin, which are commonly used as an alternative to penicillin in GBS infecctions. The increased antibiotic resistance, variations in serotype distribution, and high GBS prevalences need to be further investigated. Based on the present situation, recommendations regarding GBS surveillance in the country were raised and may improve our strategies for preventing neonatal infections.
巴西的母体 GBS 定植数据显示出不同的流行率。这些相互矛盾的数据可能与巴西联邦卫生当局缺乏官方建议有关,该建议描述了在公共和私人诊所对孕妇进行 GBS 筛查的指南和方案。在本次综述中,我们评估了发表的报告,这些报告涉及该国不同地区的 GBS 流行率、所使用的方法,以及在可用的情况下,有关临床分离株的抗生素耐药性和血清型分型的信息。根据本次综述,巴西孕妇在过去 10 年中 GBS 的流行率在 4.2%至 28.4%之间。血清型 Ia 最为流行。最高的抗生素耐药率出现在四环素,尽管其并不常用于治疗 GBS 感染。我们的结果还显示出对克林霉素和红霉素的高耐药率,这些药物通常作为青霉素治疗 GBS 感染的替代药物。需要进一步研究抗生素耐药性的增加、血清型分布的变化以及 GBS 的高流行率。基于目前的情况,提出了关于该国 GBS 监测的建议,这可能会改进我们预防新生儿感染的策略。