B族链球菌的培养.docVIP

Group B Streptococcus Cultures Preanalytical considerations 1.principle Group B Streptococcus (GBS)( Streptococcus agalactiae) has been recognized as the leading infectious cause of perinatal morbidity and mortality in the United States. In pregnant women, it is associated with asymptomatic bacteriuria, urinary tract infection ,and amnionitis and in women who have recently delivered , it cause endometritis and wound infection .Early-onset neonatal disease (during the first week of life )results from transmission of GBS during labor or delivery from mother to infant ; late-onset disease (from 1 to 3 months after birth) is thought to be acquired in the nursery . both are characterized by septicemia, pneumonia, or meningitis and can result in death or permanent neurological sequelae. In 1986 Boyer and Gotoff (7), in a carefully controlled study , demonstrated that intrapartum ampicillin prophylaxis can prevent Early-onset neonatal GBS disease in women with positive prenatal cultures for GBS and certain perinatal risk factors ,In 1992 the American Academy of Pediatrics issued guidelines for prevention of neonatal GBS disease(1), which included prenatal cuitures at 26 to 28 weeks’gestation. In 1996 and 1997 . the American Academy of Pediatrics(2), the American College of Obstetrics and Gynecologists(3), and the CDC (8,9) issued guidelines that included a combination of treating all women in risk groups and/or culturing at 35 to 37 weeks’ gestation to identify carriers for whom treatment would most likely prevent disease . The rationale for this change in the timing of culturing was that at any given time 20% of women are colonized with GBS ,but it is colonization at the time of delivery that is associated with disease .By the end of 1998 it was estimated that the United States in that year alone , 3,900 cases of GBSdisease in neonates and 200 deaths from Early-onset GBS disease were prevented by the guidelines(22) in 2002(10), the CDC issued new guidelines based on 6 y