PREVALÊNCIA E PERFIL DE SUSCEPTIBILIDADE A DROGAS DE STREPTOCOCUS AGALACTIAE EM PARTURIENTES DO SUS, ATENDIDAS EM UMA MATERNIDADE DE JUIZ DE FORA / PREVALÊNCIA E PERFIL DE SUSCEPTIBILIDADE A DROGAS DE STREPTOCOCUS AGALACTIAE EM PARTURIENTES DO SUS, ATENDIDAS EM UMA MATERNIDADE DE JUIZ DE FORA

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Streptococcus agalactiae or Group B of Lancefield (GBS) can be part of the microbiota of the human beings, colonizing especially the gastrointestinal and the genitourinary tract. Its medical importance is associated to the transmission to neonates during the delivery, which can result in severe infection. The prevalence of the GBS among pregnant women ranges from 3% to 41%. International precautions were suggested (detection of the GBS during the prenatal and predelivery prophylaxis therapy) to the prevention of the prenatal disease, which resulted in a decrease in its incidence where they had been adopted. Our work had the aim of isolating and identifying lineages of the GBS in delivering women in a hospital in the city of Juiz de Fora-MG, and esteem its prevalence among these pregnant women. Vaginal and anorectal clinical specimens were collected, with an sterile swab, in 221 pregnant women in labor, between October 2007 and March 2008. The prevalence of GBS colonies was perfomed using classical microbiologic culture, following the specific identification through molecular biology. It was also performed the detection of microorganisms directly in clinical anorectal and vaginal specimens, also through molecular technique. After enriching culture in selective medium and isolating suggestive lineages, the isolated ones were analyzed by their morpho-tinctorial characteristics, absence of catalase production and esculin hydrolysis, and bile sensitiveness. The specific identification was based on the research of the codifying gene for Sip surface protein, conserved in GBS, as well as on the magnification of the specific region of the codifying DNA for the 16S region in the RNA, through molecular biology (PCR). Through the classical microbiological methodology, based on culture, GBS was detected in 21 out of the 221 pregnant women observed (9.5%), and 25 lineages were isolated and identified, taking into account the two isolation sites. Through molecular methodology, GBS was detected in 72 pregnant women observed (32.6%), also taking into consideration both analyzed sites. The susceptibility profile to antimicrobial was also analyzed, and the following drugs have been tested through the disc-diffusion method (Kirby-Bauer): peniciline, ampicillin, cefazolin, ciprofloxacin, vancomycin, erythromycin and clindamycin. The findings showed a reduction in the sensitivity to erythromycin (22.7%) and clindamycin (50%). Bearing in mind that in Brazil prevention strategies to reduce the prevalence of neonatal infection through GBS have not been adopted, and taking into account treatment costs, empirical prophylaxis and the high level of colonization, as observed in this work, one can notice the need for prospective and regional studies on the prevalence and susceptibility profile to GBS drugs, in order to contribute to the preparation of health policies aimed at reducing its vertical transmission

ASSUNTO(S)

perinatal streptococcal disease sepse neonatal neonatal sepsis streptococcus agalactiae doença estreptocócica perinatal ciencias da saude streptococcus agalactiae

ACESSO AO ARTIGO

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