Berikopoulou Maria Maroudia, Pana Aikaterini, Liakopoulou-Tsitsipi Theodota, Vlahos Nikos F, Papaevangelou Vasiliki, Soldatou Alexandra
School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Department of Pediatrics, General Hospital of Sparta, 23100 Sparta, Greece.
Pathogens. 2021 Apr 1;10(4):418. doi: 10.3390/pathogens10040418.
Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks' gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients' records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures ( = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.
B族链球菌(GBS)是严重新生儿感染的主要病因。孕妇GBS定植与早发型和晚发型新生儿疾病(EOD/LOD)相关。在希腊,推荐采用基于筛查的策略,即在妊娠36⁰/₇至37⁶/₇周期间同时采集阴道和直肠培养物。我们试图检查对GBS筛查指南的遵守程度,并估计孕妇中GBS定植的患病率。尽管希腊遵循基于筛查的策略,但我们也检查了已知的EOD危险因素,并将它们与GBS定植联系起来。对三家医院和产科诊所的604名产后妇女进行了一项横断面研究。在获得书面知情同意后,通过一份简短的自我填写问卷和查阅患者记录收集数据。在34.6%的登记孕妇中,未进行培养。在其余孕妇中,12.8%进行了正确的阴道直肠样本采集。孕产妇总体定植率为9.6%。12.6%的参与者中至少发现了一个EOD危险因素。危险因素的存在与培养阳性相关(P = 0.014)。有或没有EOD危险因素的女性之间的培养采集率没有差异。对孕妇进行阴道直肠培养的普遍筛查的依从性较差。尽管可能低估了GBS携带状态,但近十分之一的参与者在孕期GBS呈阳性。至少应优先对有EOD危险因素的女性进行筛查,以实现EOD的预防和及时干预。