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2019 年哥伦比亚波哥大转诊中心预防与无乳链球菌定植相关的早发性新生儿败血症建议的遵守情况。

Adherence to recommendations for preventing early neonatal sepsis associated with Streptococcus agalactiae colonization in a referral center in Bogotá, Colombia, 2019.

机构信息

Universidad Nacional de Colombia, Bogotá (Colombia)..

出版信息

Rev Colomb Obstet Ginecol. 2022 Sep 30;73(3):265-273. doi: 10.18597/rcog.3917.

Abstract

OBJECTIVES

To assess adherence to screening recommendations for the prevention of neonatal sepsis, and describe the prevalence of colonization by Group B streptococcus (GBS) as well as the perinatal outcomes associated with colonization by this bacterium.

MATERIAL AND METHODS

Retrospective cohort study that included pregnant women at term and their newborns, seen at a private high-complexity clinic in Bogota, between July 1 and December 31, 2019. Adherence to screening and intrapartum antibiotic prophylaxis in pregnant women colonized with group B streptococcus, as well as the prevalence of colonization and early adverse perinatal outcomes were assessed.

RESULTS

Overall, 1928 women were included. Adherence to screening was 68.0 % (95 % CI: 66-70.1) and 87.9 % to intrapartum antibiotic administration (95 % CI: 87.8-88); non-indicated use of antibiotics occurred in 14.7 % of the women, for 86.3 % final adherence to antibiotic prophylaxis. The prevalence of GBS colonization was 12.5 % (95 % CI: 10.7-14.3); the incidence of neonatal hospitalization was 27.5 % (95 % CI: 16.3-33.7). There were no cases of mortality or early neonatal sepsis attributable to screening status, colonization or prophylactic antibiotics for GBS.

CONCLUSIONS

Additional studies in other centers are required in order to determine adherence to this guideline, particularly in those that receive users affiliated to the subsidized regime which covers the most vulnerable population. Also, new population studies of GBS prevalence and cost-effectiveness of universal screening compared to risk factor-based antibiotic prophylaxis are needed.

摘要

目的

评估预防新生儿败血症筛查建议的依从性,并描述 B 组链球菌(GBS)定植的流行情况,以及与该细菌定植相关的围产期结局。

材料和方法

这是一项回顾性队列研究,纳入了 2019 年 7 月 1 日至 12 月 31 日期间在波哥大一家私立高复杂度诊所就诊的足月孕妇及其新生儿。评估了 GBS 定植孕妇的筛查和产时抗生素预防的依从性,以及定植的流行情况和早期不良围产期结局。

结果

共纳入 1928 名女性。筛查的依从率为 68.0%(95%CI:66-70.1),产时抗生素使用的依从率为 87.9%(95%CI:87.8-88);14.7%的女性未使用抗生素,最终抗生素预防的依从率为 86.3%。GBS 定植的流行率为 12.5%(95%CI:10.7-14.3);新生儿住院率为 27.5%(95%CI:16.3-33.7)。没有因筛查状况、定植或 GBS 预防性抗生素而导致的死亡或早发性新生儿败血症病例。

结论

需要在其他中心进行更多研究,以确定对该指南的依从性,特别是在那些接受补贴制度覆盖的最弱势群体的用户的中心。还需要进行新的 GBS 流行率和全人群筛查与基于危险因素的抗生素预防的成本效益研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a24d/9674380/c31080be515a/2463-0225-rcog-73-03-3917-gf1.jpg

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