1차 분만병원 수준에서의 임신 후기 산모의 질내 B군 연쇄상 구균 집락 형성의 임상적 특성에 대한 평가
Clinical Features of Group B Streptococcus Colonization in Vagina During Late Pregnancy at a Primary Maternity Hospital
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to assess the epidemiologic and clinical features of maternal Group B Streptococcus (GBS) colonization in vagina during their third trimester. Methods: This study included 644 pregnant women who had undergone GBS culture test in their third trimester in 2018. We collected data from the primary level of care maternity hospital through the retrospective chart review. We compared patients’ demographics, maternal obstetrical complications and neonatal adverse events between GBS positive (n=41) and GBS negative (n=603) groups. To find out clinical predictors of GBS positive result, univariable chi-square test and multivariable logistic regression analysis were applied. Results: The colonization rate of GBS in maternal vagina was 6.4% in their third trimester. GBS positive group showed significant association with the third trimester anemia (hemoglobin level <10.5 g/dL) (p=0.013) and oligohydramnios (p=0.024; odds ratio, 7.32; 95% confidence interval ,1.28–41.31). All specimens were susceptible to penicillin G and cephalosporin. The antibiotic resistance to both erythromycin and clindamycin was 31%. Conclusion: The colonization rate of GBS in maternal vagina was 6.4% and third trimester maternal anemia was associated with the GBS carrying status.
Abstract
Purpose: The aim of this study was to assess the epidemiologic and clinical features of maternal Group B Streptococcus (GBS) colonization in vagina during their third trimester. Methods: This study included 644 pregnant women who had undergone GBS culture test in their third trimester in 2018. We collected data from the primary level of care maternity hospital through the retrospective chart review. We compared patients’ demographics, maternal obstetrical complications and neonatal adverse events between GBS positive (n=41) and GBS negative (n=603) groups. To find out clinical predictors of GBS positive result, univariable chi-square test and multivariable logistic regression analysis were applied. Results: The colonization rate of GBS in maternal vagina was 6.4% in their third trimester. GBS positive group showed significant association with the third trimester anemia (hemoglobin level <10.5 g/dL) (p=0.013) and oligohydramnios (p=0.024; odds ratio, 7.32; 95% confidence interval ,1.28–41.31). All specimens were susceptible to penicillin G and cephalosporin. The antibiotic resistance to both erythromycin and clindamycin was 31%. Conclusion: The colonization rate of GBS in maternal vagina was 6.4% and third trimester maternal anemia was associated with the GBS carrying status.
참고문헌 (22)
- American College of Obstetricians and Gynecologists, "ACOG Practice Bulletin No. 95: anemia in pregnancy", Obstet Gynecol, 112, pp.201~207 (2008)
- 최길웅, "임신부에서 group B streptococci 감염의 임상적 의의", Obstetrics & Gynecology Science, 45(5), pp.811~815 (2002), 대한산부인과학회
- Committee on Obstetric Practice, "Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 797", Obstet Gynecol, 135, pp.e51~e72 (2020)
- Hannah ME, "Maternal colonization with group B Streptococcus and prelabor rupture of membranes at term: the role of induction of labor. TermPROM Study Group", Am J Obstet Gynecol, 177, pp.780~785 (1997)
- Hasperhoven GF, "Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent earlyonset group B streptococcal disease : a systematic review and meta-analysis", BJOG, 127, pp.680~691 (2020)
- Hong JS, "Genital group B Streptococcus carrier rate and serotype distribution in Korean pregnant women : implications for group B streptococcal disease in Korean neonates", J Perinat Med, 38, pp.373~377 (2010)
- Ji Y, "Outcome of a screening program for the prevention of neonatal early-onset group B Streptococcus infection : a population-based cohort study in Inner Mongolia, China", J Med Microbiol, 68, pp.803~811 (2019)
- 김다현, "Prevalence of group B streptococcus colonization in pregnant women in a tertiary care center in Korea", Obstetrics & Gynecology Science, 61(5), pp.575~583 (2018), 대한산부인과학회[DOI]
- Eun Ju Kim, "Risk Factors for Group B Streptococcus Colonization Among Pregnant Women in Korea", Epidemiology and Health, 33, pp.1~7 (2011), 한국역학회
- 김경아, "신생아 패혈증의 원인균에 대한 전국 조사", Clinical and Experimental Pediatrics, 45(1), pp.55~63 (2002), 대한소아청소년과학회
- Se Jin Kim, "Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit", Clinical and Experimental Pediatrics, 62(1), pp.36~41 (2019), 대한소아청소년과학회
- A survey on fertility and family health and welfare nationwide in 2018, "Korea Institute for Health and Social Affairs (KIHASA)", KIHASA, ~ (2018)
- Lee SM, "Blood culture proven early onset sepsis and late onset sepsis in very-low-birth-weight infants in Korea", J Korean Med Sci, 30(Suppl), pp.S67~S74 (2015)
- Nanduri SA, "Epidemiology of invasive early-onset and late-onset Group B streptococcal disease in the United States, 2006 to 2015 : multistate laboratory and population-based surveillance", JAMA Pediatr, 173, pp.224~233 (2019)
- 오지은, "임신부에서 분리된 B군 연구균의 중합효소연쇄반응과 염기서열분석을 통한 혈청형 분석", Pediatric Infection and Vaccine, 16(1), pp.47~53 (2009), 대한소아감염학회
- Russell NJ, "Maternal colonization with group B Streptococcus and serotype distribution worldwide : systematic review and meta-analyses", Clin Infect Dis, 65(suppl_2), pp.S100~S111 (2017)
- Schrag SJ, "Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014", Pediatrics, 138, pp.e20162013~ (2016)
- 심규홍, "Trends in Epidemiology of Neonatal Sepsis in a Tertiary Center in Korea: A 26-Year Longitudinal Analysis, 1980-2005", Journal of Korean Medical Science, 26(2), pp.284~289 (2011), 대한의학회
- Van Dyke MK, "Evaluation of universal antenatal screening for group B Streptococcus", N Engl J Med, 360, pp.2626~2636 (2009)
- Verstraelen H, "Subclinical iron deficiency is a strong predictor of bacterial vaginosis in early pregnancy", BMC Infect Dis, 5, pp.55~ (2005)
- Weston EJ, "The burden of invasive early-onset neonatal sepsis in the United States, 2005-2008", Pediatr Infect Dis J, 30, pp.937~941 (2011)
- World Health Organization, "WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience", World Health Organization, ~ (2016)