Colonização por Estreptococos do grupo B (EGB) : ocorrência, desempenho do meio Hitchens-Pike-Todd-Hewitt (HPTH) e sensibilidade antimicrobiana de EGB em isolados clínicos de gestantes usuárias de serviço público de saúde

• Autor(a) principal: Melo, Simone Cristina Castanho Sabaini de
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
• Texto Completo: http://repositorio.uem.br:8080/jspui/handle/1/1996
• topic: Estreptococos do grupo B (EGB); Infecção neonatal; Gestantes; Prevalência; Teste de sensibilidade; Brasil.; Group B Streptococcus; Neonatal infection; Culture medium; Pregnant women; Sensitivity test; Brazil.; Ciências da Saúde; Medicina

Group B Streptococcus (GBS) or Streptococcus agalactiae may be part of the intestinal microbiota of the human beings, especially colonizing the gastro-intestinal and genitourinary tract. This species is often related to life-threatening diseases in newborns, such as septicemia, pneumonia and meningitis and is associated with complications during pregnancy and the postpartum period. The aim of this study was to analyze the occurrence of GBS in pregnant women users the public health service, the performance of medium Hitchens-Pike-Todd-Hewitt (HPTH) and antimicrobial susceptibility of strains of GBS. Descriptive analytical cross-sectional study carried out with 556 pregnant women, 496 of whom were between 35 and 37 weeks of pregnancy and 60 of them were ≥ 38 weeks. The study was conducted from September 2011 to March 2014 in northern Paraná State. Vaginal and anorectal clinical samples of each pregnant woman were inoculated on sheep blood agar, in HPTH and Todd-Hewitt medium. The clinical isolates studied were subjected to antimicrobial susceptibility testing by agar diffusion, according to the standards of the Clinical and Laboratory Standards Institute (CLSI). Of the 496 pregnant women, 141 (28.4%) were positive for GBS, based on the combination of the three culture media and on clinical samples. The detection rates were 22.2% for HPTH medium, 21.2% for sheep blood agar, and 13.1% for the Todd-Hewitt enrichment broth. Of the 60 women at ≥ 38 weeks of pregnancy, seven (11.7%) were positive for GBS, and there was growth in HPTH and sheep blood agar media. To the 141 women who were positive for GBS, 136 antimicrobial susceptibility tests were performed, in which 100% proved sensitive to penicillin. Erythromycin resistance showed 8.1% and clindamycin 2.2%. The results demonstrate that HPTH and sheep blood agar media were more sensitive than Todd-Hewitt broth enrichment for screening GBS in pregnant women, suggesting that the two media should be used together for vaginal and anorectal samples. All isolates of GBS showed sensitivity to the most frequently used drug for intrapartum prophylaxis: penicillin. Resistance to erythromycin and clindamycin was also detected, thus reducing the options for prophylaxis in women who are allergic to penicillin. Based on these results, it is recommended that the health unit perform universal screening of pregnant women and adequate prophylaxis when indicated.