Epidemiology of the group B streptococcus: Maternal and nosocomial sources for infant acquisitions

Anthony, Mark; Okada, Megumi; Hobel, M.D. Calvin J.

doi:10.1016/s0022-3476(79)80530-2

Cited by 115 publications

(43 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Commonly GBS in the maternal genital tract leads to colonization of 40 to 60% of neonates and in a small proportion of cases, 1 to 2%, colonization leads to the early onset of invasive disease [1,6,17,18].…”

Section: Introductionmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

View full text Add to dashboard Cite

Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

show abstract

Section: Introductionmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

View full text Add to dashboard Cite

show abstract

“…Despite many improvements in therapy and supportive care, the mortality from GBS sepsis remains unacceptably high (7). Many reports indicate that GBS colonization of the maternal birth canal is the most important source for neonatal sepsis (8)(9)(10). Studies of mother-infant pairs of vertically transmitted GBS have demonstrated significant differences between some of the pairs in the expression of typespecific capsular polysaccharide (1 1).…”

mentioning

confidence: 99%

Role of Capsule in Pulmonary Hypertension Induced by Group B Streptococcus

Philips¹,

Li²,

Gray

et al. 1992

Pediatr Res

View full text Add to dashboard Cite

ABSTRACT. The type-specific polysaccharide capsule of group B streptococcus (GBS) is thought to be an important factor in the pathogenesis of disease. We used an acutely instrumented piglet model to assess the hemodynamic effects of rapid infusions of two heat-killed GBS type Ib strains isolated from the spinal fluid of an infant with lateonset meningitis and from the vaginal culture of his mother. These strains expressed different amounts of capsule, as determined by buoyant density centrifugation and-electron microera~hs. and thev ~roduced different hemodvnamic ---effects in thk piglets.*~he mother's strain, whichv had a smaller capsule, caused significantly higher increases in pulmonary artery pressure and vascular resistance than did the infant's strain, which had a larger capsule. Transposon mutants were then made from the infant's isolate to further study the role of capsule in pulmonary hypertension. Two mutants lacking detectable capsular type-specific polysaccharide were compared with the original isolate and with an isogenic mutant containing transposons but having a large capsule. The nonencapsulated mutants caused significantly higher changes in pulmonary artery pressure and resistance than did the encapsulated strains. Pulmonary hypertension may play a role in the pathophysiology of GBS sepsis, but the presence of a large capsule may partially cloak the hemodynamically active component(s) of the bacteria. The lower initial host response to heavily encapsulated GBS may play a role in pathogenesis by helping the organisms avoid host defense mechanisms. (Pediatr Res 31: 386-390, 1992 human neonates with GBS sepsis (2, 4) and can be induced in animal models by infusion of GBS (5,6). Despite many improvements in therapy and supportive care, the mortality from GBS sepsis remains unacceptably high (7). Many reports indicate that GBS colonization of the maternal birth canal is the most important source for neonatal sepsis (8-10). Studies of mother-infant pairs of vertically transmitted GBS have demonstrated significant differences between some of the pairs in the expression of typespecific capsular polysaccharide (1 1). The presence of a large capsule is thought to be an important factor in pathogenesis and has been shown to be associated with increased virulence in a mouse model (12). Most virulence studies in animals have used death as an end point, rather than physiologic variables. Studies comparing the hemodynamic effects of paired isolates from infected infants and their mothers have not been reported. We used a piglet model to test the hypothesis that the hemodynamic effects of a pair of GBS type Ib isolates from an infected infant and its colonized mother that vary in the amount of capsular polysaccharide would be different. Isogenic transposon mutants of the infant's strain were then used to further study the role of capsule in the hemodynamic changes induced by these otherwise genetically similar GBS. MATERIALS AND METHODSAnimal preparation. Fifteen female piglets were anesthetized with halothane ...

show abstract

“…Since Propionibacterium is the pre dominant anaerobic organism of the skin, it is understandable that it should play the same role in the ocular conjunctiva because bacteria of the adjacent skin are provided to the eye. Hospital personnel have themselves been shown to carry Streptococcus of the group B [15] but were not cultured in the present study. Exposure to a common hospi tal environment reflects nosocomial acquisi tion of Streptococcus.…”

Section: Discussionmentioning

confidence: 78%

Nosocomial Infections of Ocular Conjunctiva in Newborns Delivered by Cesarian Section

Bezirtzoglou

Romond²

1991

Ophthalmic Res

View full text Add to dashboard Cite

Colonization of the ocular conjunctiva in newborns delivered by cesarian section occurs usually within the first day of life. We have studied the flora of the ocular conjunctiva at birth, from 19 newborns delivered by cesarian section, coming from two different maternity hospitals. Ocular conjunctiva cultures yielded the main predominant flora in both maternity hospitals considered. The most common genus of this flora are: Staphylococcus, Corynebacterium and Propionibacteriumacnes. Peptostreptococcusproductus, Neisseria, Eubacterhim and Clostridiumperfringens are isolated occasionally. In newborns delivered by cesarian section, this flora principally acquired may be the consequence of the presence of bacteria in the ambient air, as well as differences in care provided by the nosocomial personnel.

show abstract

Epidemiology of the group B streptococcus: Maternal and nosocomial sources for infant acquisitions

Cited by 115 publications

References 15 publications

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Role of Capsule in Pulmonary Hypertension Induced by Group B Streptococcus

Nosocomial Infections of Ocular Conjunctiva in Newborns Delivered by Cesarian Section

Contact Info

Product

Resources

About