B 组链球菌定植状态与分娩过程中抗生素的使用--一项单中心观察研究。

I. Jańczewska, J. Jassem-Bobowicz, K. Hinca, Katarzyna Stefanska, Iwona Domżalska-Popadiuk
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摘要

目的:孕妇的 B 群链球菌(GBS)定植是新生儿感染的主要原因。产前抗生素预防(IAP)是减少新生儿败血症的最有效方法。我们从抗生素的长期效果角度描述了 GBS 管理的依从性和 IAP 的实施情况。材料与方法该研究针对 2022 年 1 月至 2022 年 2 月期间在波兰格但斯克大学临床中心住院的 249 名育龄妇女进行。数据来自调查问卷和病历。我们分析了产妇的 GBS 定植情况、GBS 筛查和治疗指南的遵守情况、导致 GBS 定植的风险因素、IAP 的使用情况以及新生儿先天性感染的发生情况。50例(20%)GBS阳性,184例(74%)阴性,15例(6%)GBS状态不明。无论是否使用 IAP,GBS 阳性组和 GBS 阴性组在产妇年龄、分娩方式、出生时胎龄、产妇合并症、奇偶数、既往妊娠的 GBS 状况以及两组婴儿的感染发展方面均无明显差异。在所有接受研究的产妇中,158 名(63.5%)接受了抗生素治疗,91 名(36.5%)未接受治疗。研究表明,产前 GBS 筛查试验的阳性预测值较低,阴性预测值较高。对未进行筛查或仅进行部分筛查的产妇进行管理时,需要在使用 IAP 前评估风险因素。
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Group B Streptococcus colonization status and antibiotic use during labour - a single-centre observational study.
OBJECTIVES Group B streptococcus (GBS) colonization among pregnant women is the leading cause of neonatal infection. Intrapartum antibiotic prophylaxis (IAP) is the most effective method to reduce the incidents of neonatal sepsis. We describe compliance with GBS management and the implementation of IAP in the context of the long-term effect of antibiotics. MATERIAL AND METHODS The study was conducted among 249 childbearing women hospitalized between January 2022 and February 2022 at University Clinical Center in Gdansk, Poland. The data were obtained from the questionnaire and medical records. We analyzed maternal colonization with GBS, compliance with GBS screening and treatment guidelines, risk factors contributing to GBS colonization, IAP administration, and neonatal congenital infection occurrence. RESULTS Of all patients, 240 (96.4%) were screened for GBS, 215 (89.6%) between 35-37 weeks of gestation. Fifty (20%) were GBS-positive, 184 (74%) negative, 15 (6%) had unknown GBS status. There were no significant differences between the GBS-positive and GBS-negative groups in maternal age, mode of delivery, gestational age at birth, maternal comorbidities, parity, GBS status in previous pregnancies, and the development of infection among infants of both groups, regardless of IAP administration. Of all the studied women, 158 (63.5%) received antibiotics, 91 (36.5%) did not. The study showed the low positive and the high negative predictive value of the antenatal GBS screening test. CONCLUSIONS We found that compliance with the universal GBS screening is widespread. The management of women with absent or only partial screening test requires assessing the risk factors before administering IAP.
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