Group B Streptoccal infection, the risk factor for perinatal infection

IMSP Spitalul Clinic Municipal nr. 1Introduction: This paper is a prospective study that included mother-newborn pairs that were performed the screening for GBS porting. The goal of the study: Setting the incidence of maternal and neonatal colonization with group B Streptococcus, identifying risk factors for perinatal infection with group B Streptococcus, and early detection of infection in order to reduce neonatal morbidity and mortality. Materials and Methods: This study was conducted within PMSI MCH no.1, comprising mother-newborn pairs. The sample size of the study was 549 women in 2013 and 597 in 2014. For clinical and laboratory correlations were studied 29 children, 13 of them born in 2013 and 16 in 2014. The screening for pregnant women porting and the postpartum period for GBS was conducted by chromo-immunological rapid test and by culture. The material was processed statistically through mathematical and variation strings. Results: Analyzing the data of investigated mothers it was observed that the percentage of colonization with group B Streptococcus rose on account of enrollment in the study and mothers with term of pregnancy less than 34 weeks of gestation. A total of 1146 examined pregnant who have risk factors during pregnancy were detected in group B Streptococcus positive 5,9% (68) women. Intrapartum antibiotic prophylaxis has been applied in 8.57% of cases spite that women have risk factors that would have required intrapartum antibiotic prophylaxis. When analyzing neonatal cases of GBS-positive mothers, it was determined colonization in newborns who basically stay the same in the years 2013 and 2014, from 15,54% to 16.38%. From suggestive clinical signs of infection for newborn were recorded mainly cutaneous signs of growth in 2014 (50%) compared with 2013 (38,09%), the Cardiovascular – 23,80% in 2013 compared with 28,57% in 2014 and neurological 22,85% in 2014, compared with 19,04% in 2013. The neonatal sepsis in newborns colonized with GBS occurred in 13 cases (5%) in 2013 and in 2014 - in 16 children (11%). The most virulent combination was found to be E.coli+GBS and E. coli + + Str. hominis, which in all cases were manifested with clinical infections, the other combinations of bacterial agents in the present study were less incriminated in achieving infection in the newborn. Conclusions: The study demonstrated that severe forms of group B Streptococcus infection are more common than lighter ones, which can be explained by the increasing number of mothers colonized or by strains more invasive of GBS. Knowing the risk factors and the onset clinical signs of infection contributes to early detection of infection and intrapartum antibiotic prevention administered at least 4 hours before birth is the intervention that would allow a decreased risk of neonatal infection

Infecția materno-fetală la nou-născutul prematur

Background. Maternal-fetal infection (MFI) occupies top places in morbidity and mortality in premature babies. Objective of the study. We determined the clinical-anamnestic peculiarities of MFI depending on its manifestation. Material and Method. Case-control study, applying the clinicalanamnestic method, on a group of 133children from mothers at risk of infection, of which 47(35,33%) children with MFI(including 28(59,57%)with localized infections(pneumonia)and 19(40,42%)with sepsis) and 86(64,66%)children without MFI. 59 children had a birth weight<1500g and 74 children a birth weight>1500g. For frequency analysis the statistics X2 Results. 16(84,21%)children with sepsis, compared to 5(17,86%)children with pneumonia and 19(22,09%)children without MFI were born in extremely severe condition(p<0,001). Cardiovascular disorders had 12(63,16%)children with sepsis and 9(32,14%)children with pneumonia, compared to 10(11,63%)children without MFI(p<0,001).Digestive disorders were found in 10(52,63%)children with sepsis, compared to7(8,14%) children without MFI(p<0,001). Respiratory disorders(dyspnea) prevailed in7(53,85%)children with pneumonia, compared to6(18,75%)children without MFI. Respiratory distress syndrome(RDS) occurred in 7(98,47%) children with sepsis, compared to 6(46,15%) children with pneumonia(p<0,01). Conclusion. Neonatal sepsis is associated with extremely severe condition and is manifested mainly by cardiovascular and digestive disorders, as well as RDS. Introducere. Infecția materno-fetală (IMF) ocupă locuri de top în morbiditatea și mortalitatea la copilul prematur. Scopul lucrării. Am determinat particularitățile clinico-anamnestice ale IMF în funcție de manifestarea infecției. Material și Metode. Studiu caz-control, metoda clinico-anamnestică, pe un lot de 133 copii de la mame cu risc infecțios, dintre aceștia 47 (35,33%) copii cu IMF (inclusiv 28 (59,57%) infecții localizate (pneumonii) și 19 (40,42%) sepsis) și 86 (64,66%) copii fără IMF. 59 copii au avut greutatea sub 1500g la naștere și 74 copii greutate > de 1500 gr la naștere. Pentru analiza frecvențelor s-a calculat statistica X2 Rezultate. 16 (84,21%) copii cu sepsis, comparativ cu 5 (17,86%) copii cu pneumonie și 19 (22,09%) copii fără IMF s-au născut în stare extrem de gravă (p<0,001). Dereglări cardiovasculare au avut 12 (63,16%) copii cu sepsis și 9 (32,14%) copii cu pneumonie, comparativ cu 10 (11,63%) copii fără IMF (p<0,001). Dereglările digestive s-au atestat la 10 (52,63%) copii cu sepsis, comparativ cu 7 (8,14%) copii fără IMF (p<0,001). Dereglările respiratorii (dispnee) au prevalat la 7 (53,85%) copii cu pneumonii, comparativ cu 6 (18,75%) copii fără IMF. Sindromul de detresă respiratorie (SDR) a prevalat la 7 (98,47%) copii cu sepsis, comparativ cu 6 (46,15%) copii cu pneumonii (p<0,01). Concluzii. IMF generalizată este asociată cu stare extrem de gravă și se manifestă îndeosebi prin dereglări cardiovasculare și digestive, precum și SDR

Maternal-fetal infection of premature newborn

Perinatal Center, Municipal Clinical Hospital no. 1, Chisinau, Republic of Moldova, Perinatology Laboratory, Mother and Child Institute, Chisinau, Republic of Moldova, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction. Maternal-fetal infection (MFI) occupies top places in morbidity and mortality in premature babies. Purpose. We determined the clinical-anamnestic peculiarities of MFI depending on its manifestation. Material and methods. A case-control study was conducted applying the clinical-anamnestic method, on a group of 133 children from mothers at risk of infection, of which 47 (35,33%) children with MFI (including 28 (59,57%) with localized infections (pneumonia) and 19 (40,42%) with sepsis) and 86 (64,66%) children without MFI (Figure 1). 59 children had a birth weight (BW). Results. 16 (84,21%) children with sepsis, compared to 5 (17,86%) children with pneumonia and 19 (22,09%) children without MFI were born in extremely severe condition (p<0,01). Conclusions. Neonatal sepsis is associated with extremely severe condition and is manifested mainly by cardiovascular and digestive disorders, as well as RDS