Re: Streptokok v těhotenství

mám to za správný náhled, jen pokud je atb profylaxe, pak to "hlídání" není nijak významně odlišné od sledování novorozenců GBS negativních matek, bez atb profylaxe je přístup jistě jiný, zaměřený jak na časné tak pozdní GBS vyvolané onemocnění. I při neporušených obalech plod. vejce GBS často infikuje plodovou vodu a v tom případě jsou bezcenné i vaginální výplachy desinficienciem (chlohexidin). Až démokritovsky mechanistická představa, že obaly před infekcí chrání, je mylná. Spoléhání na intuitivní včasnou detekci projevů nemoci je v ohledu na symptomatoogii GBS infekce novorozenců příliš optimistické. PA nemá žádné znalosti a zkušenosti s GBS infekcí ani s patřičnou péčí o novorozence.


ACOG - For Release: March 21, 2011

Revised Guidance Issued on Prevention of GBS Infection

Washington, DC -- The American College of Obstetricians and Gynecologists (The College) today issued revised guidelines for the prevention and treatment of perinatal group B streptococcal (GBS) disease. The document summarizes the 2010 US Centers for Disease Control GBS guidelines, which The College has endorsed, and highlights important changes in clinical practice for ob-gyns.

GBS—a bacteria that can cause infections of the blood (sepsis), lungs, brain, or spinal cord in newborns—is fatal in about 5% of babies who carry it. An estimated 10%-30% of pregnant women are infected with GBS and up to 2% will transmit it to their newborns during delivery. Many GBS infections occur between six hours and seven days of birth, though late-onset infections can develop after the first week of life. Infants born to black and Hispanic women, and women younger than age 20 are at increased risk.

The College recommends that all pregnant women be screened for GBS at 35-37 weeks"" gestation and that preventive antibiotics be given to women who test positive during labor. "National guidelines to prevent mother-to-infant GBS transmission have led to an 80% reduction in early onset sepsis in neonates," said Ronald S. Gibbs, MD, a member of The College""s Committee on Obstetric Practice who helped develop the document. "Unfortunately, despite these strides, GBS remains the leading cause of infectious mortality and morbidity among newborns.

"While the core recommendations are the same, the new document provides further direction for clinicians in implementing and improving prevention strategies," Dr. Gibbs added. Included are updated case scenarios for GBS screening and antibiotic treatment for women with preterm labor or preterm premature rupture of membranes; management plans for newborns at risk of early-onset GBS disease; and updated antibiotic regimens for women with penicillin allergy.