20 research outputs found
Prevalence, antimicrobial resistance and serotype distribution of group B streptococcus isolated among pregnant women and newborns in Rabat, Morocco
PURPOSE: Group B streptococcus (GBS) is an important cause of
neonatal sepsis worldwide. Data on the prevalence of maternal
GBS colonization, risk factors for carriage, antibiotic
susceptibility and circulating serotypes are necessary to tailor
adequate locally relevant public health policies. METHODOLOGY: A
prospective study including pregnant women and their newborns
was conducted between March and July 2013 in Morocco. We
collected clinical data and vagino-rectal and urine samples from
the recruited pregnant women, together with the clinical
characteristics of, and body surface samples from, their
newborns. Additionally, the first three newborns admitted every
day with suspected invasive infection were recruited for a
thorough screening for neonatal sepsis. Serotypes were
characterized by molecular testing. RESULTS: A total of 350
pregnant women and 139 of their newborns were recruited. The
prevalence of pregnant women colonized by GBS was 24 %. In 5/160
additional sick newborns recruited with suspected sepsis, the
blood cultures were positive for GBS. Gestational hypertension
and vaginal pruritus were significantly associated with a
vagino-rectal GBS colonization in univariate analyses. All of
the strains were susceptible to penicillin, while 7 % were
resistant to clindamycin and 12 % were resistant to
erythromycin. The most common GBS serotypes detected included V,
II and III. CONCLUSION: In Morocco, maternal GBS colonization is
high. Penicillin can continue to be the cornerstone of
intrapartum antibiotic prophylaxis. A pentavalent GBS vaccine
(Ia, Ib, II, III and V) would have been effective against the
majority of the colonizing cases in this setting, but a
trivalent one (Ia, Ib and III) would only prevent 28 % of the
cases
Characterization of Vaginal Escherichia coli Isolated from Pregnant Women in Two Different African Sites
The relevance of vaginal colonization of pregnant women by
Escherichia coli is poorly understood, despite these strains
sharing a similar virulence profile with other extraintestinal
pathogenic E. coli producing severe obstetric and neonatal
infections. We characterized the epidemiology, antimicrobial
susceptibility and virulence profiles of 84 vaginal E. coli
isolates from pregnant women from Rabat (Morocco) and Manhica
(Mozambique), two very distinct epidemiological settings. Low
levels of antimicrobial resistance were observed to all drugs
tested, except for trimethoprim-sulfamethoxazole in Manhica,
where this drug is extensively used as prophylaxis for
opportunistic HIV infections. The most prevalent virulence
factors were related to iron acquisition systems. Phylogroup A
was the most common in Rabat, while phylogroups E and
non-typeable were the most frequent in Manhica. Regardless of
the apparently "low virulence" of these isolates, the frequency
of infections is higher and the outcomes more devastating in
constrained-resources conditions, especially among pregnant
women and newborns
Les dyspareunies du post partum: un sujet non négligeable
La dyspareunie est une douleur éprouvée lors du rapport sexuel. Elle peut être superficielle ou profonde. Elle est fréquente en post partum et donc non négligeable. Elle a fait l’objet de plusieurs descriptions et plusieurs classifications. Les étiologies sont nombreuses : infectieuses, traumatiques, hormonales, psychiques et autres. Le traitement de la dyspareunie se base sur le traitement de la cause organique et le traitement psychologique du conditionnement à la douleur qui persiste après le traitement médical
Cesarean Scar Endometriosis: An Uncommon Surgical Complication on the Rise? Case Report and Literature Review
Endometriosis is defined by the presence and growth of ectopic functional endometrial tissue outside the uterus. Scar endometriosis has been described following obstetrical and gynecological surgery. It is a rare condition, though probably on the rise, due to the considerable increase of cesarean sections performed worldwide. Its physiopathology is complex; its symptomatology is rich and diverse but thorough clinical examination along with ultrasound imaging and potentially pretherapeutic cytologic evaluation are usually efficient in diagnosing the condition. Treatment is mostly surgical. We report the case of a cesarean section scar endometriosis, managed at a tertiary level center and emphasize the diagnosis and treatment options
Predictors of infertility stress among couples diagnosed in a public center for assisted reproductive technology
Background: All around the world, infertility, in many ways, is recognized as a stressful and a critical experience that can have impact on social and marital life of a couple. Infertility stress may affect the treatment and its outcome for such couples. The objective of the present study is to assess the predictors of high stress of infertility among married couples. Materials and Methods: This cross-sectional study was conducted on 120 couples (240 patients) who were diagnosed with primary and secondary infertility from June 2017 to June 2018. A psychological self-assessment questionnaire (Perceived Stress Scale-10) was used as a tool to evaluate the presence of high infertility stress among couples after obtaining their consent. Furthermore, other socioepidemiological data of patients were collected. Statistical Analysis: Data were analyzed using SPSS software (version 20). Univariate statistical analysis was used followed by multiple logistic regressions between high infertility stress and the predictor variables. Results and Discussion: The prevalence of high infertility stress was 53.3% among women and 40.8% among men. For women, multivariate analysis showed leading associations of high infertility stress with level of education, infertility type, infertility duration, and etiologies of infertility. However, for men, multivariate analysis showed leading associations between high infertility stress and alcohol status and inadequate sleep and infertility type
Retroperitoneal Ectopic Pregnancy: Diagnosis and Therapeutic Challenges
Background. Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report. We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion. Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes
First report of a Klebsiella pneumoniae ST466 strain causing neonatal sepsis harbouring the blaCTX-M-15 gene in Rabat, Morocco
Klebsiella pneumoniae is one of the Gram-negative bacilli most commonly found in urine of pregnant women and causing neonatal sepsis. The aim of this study was to analyse in terms of epidemiology and antimicrobial resistance of 23 K. pneumoniae isolates collected from vaginal swabs or urine of pregnant women, from pharyngeal and ear swabs of apparently healthy newborns and from peripheral cultures and hemocultures of newborns with suspected invasive neonatal infection in Rabat, Morocco. The prevalence of K. pneumoniae was 0.6 and 0.9% among pregnant women and neonates, respectively. These strains showed lower antimicrobial resistance levels regarding the developed countries. Thus, only one strain from a neonate presented an ESBL. This is the first report of a K. pneumoniae strain causing neonatal sepsis harbouring the blaCTX-M-15 gene in an IncFII plasmid and belonging to ST466 in this area
First report of a Klebsiella pneumoniae ST466 strain causing neonatal sepsis harbouring the blaCTX-M-15 gene in Rabat, Morocco
Klebsiella pneumoniae is one of the Gram-negative bacilli most commonly found in urine of pregnant women and causing neonatal sepsis. The aim of this study was to analyse in terms of epidemiology and antimicrobial resistance of 23 K. pneumoniae isolates collected from vaginal swabs or urine of pregnant women, from pharyngeal and ear swabs of apparently healthy newborns and from peripheral cultures and hemocultures of newborns with suspected invasive neonatal infection in Rabat, Morocco. The prevalence of K. pneumoniae was 0.6 and 0.9% among pregnant women and neonates, respectively. These strains showed lower antimicrobial resistance levels regarding the developed countries. Thus, only one strain from a neonate presented an ESBL. This is the first report of a K. pneumoniae strain causing neonatal sepsis harbouring the blaCTX-M-15 gene in an IncFII plasmid and belonging to ST466 in this area
Prevalence, antimicrobial resistance and serotype distribution of group B streptococcus isolated among pregnant women and newborns in Rabat, Morocco
PURPOSE: Group B streptococcus (GBS) is an important cause of
neonatal sepsis worldwide. Data on the prevalence of maternal
GBS colonization, risk factors for carriage, antibiotic
susceptibility and circulating serotypes are necessary to tailor
adequate locally relevant public health policies. METHODOLOGY: A
prospective study including pregnant women and their newborns
was conducted between March and July 2013 in Morocco. We
collected clinical data and vagino-rectal and urine samples from
the recruited pregnant women, together with the clinical
characteristics of, and body surface samples from, their
newborns. Additionally, the first three newborns admitted every
day with suspected invasive infection were recruited for a
thorough screening for neonatal sepsis. Serotypes were
characterized by molecular testing. RESULTS: A total of 350
pregnant women and 139 of their newborns were recruited. The
prevalence of pregnant women colonized by GBS was 24 %. In 5/160
additional sick newborns recruited with suspected sepsis, the
blood cultures were positive for GBS. Gestational hypertension
and vaginal pruritus were significantly associated with a
vagino-rectal GBS colonization in univariate analyses. All of
the strains were susceptible to penicillin, while 7 % were
resistant to clindamycin and 12 % were resistant to
erythromycin. The most common GBS serotypes detected included V,
II and III. CONCLUSION: In Morocco, maternal GBS colonization is
high. Penicillin can continue to be the cornerstone of
intrapartum antibiotic prophylaxis. A pentavalent GBS vaccine
(Ia, Ib, II, III and V) would have been effective against the
majority of the colonizing cases in this setting, but a
trivalent one (Ia, Ib and III) would only prevent 28 % of the
cases