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Detection of Streptococcus agalactiae in pregnant women and newborns
HÁLOVÁ, Eliška
S. agalactiae are common commensals of the nasopharynx, vagina and gastrointestinal tract. Now digestive tract is considered a very likely source of vaginal colonization. Colonization by the bacteria is in many cases asymptomatic. S. agalactiae causes a variety of infections in neonates and is a leading cause of neonatal morbidity and mortality. Transmission takes place vertically from colonized mother to fetus. A potential source of GBS infections may also be mother's milk. This type of transmission is very rare. S. agalactiae infection induces not only in neonates but also in adults, particularly in older persons and persons with other ongoing disease. In the theoretical part, I focused on the current knowledge about S. agalactiae, neonatal GBS infections and their prevention options. Then I assess current possibilities of identification and diagnostics of S. agalactiae, including the determination of antibiotic susceptibility. I outlined the current situation of the increasing resistance of S. agalactiae to macrolides and lincosamides and described the situation in several different countries. The practical part is performed on bacteriological department Ceske Budejovice Hospital, a.s. where I dealt with the whole process of identification and diagnostics of S. agalactiae. Firstly I did cultivate, or also preparing specimens for microscopic evaluation. I also identified S. agalactiae using CAMP assay, latex agglutination method or MALDI - TOF. For strains identified as S. agalactiae was performed for antibiotic sensitivity by the disc diffusion test. All the work I carried out under the supervision of the head of his thesis and laboratory staff according to standard operating procedures. Part of my work is devoted to the results. Their statistical processing, I found the colonization by S. agalactiae in a population of pregnant women. I also concentrated on the distribution of individual serotypes of this bacterium in newborns. For each strain isolated from pregnant women and infants I assess its sensitivity to penicillin, ampicillin, erythromycin and clindamycin. The practice in the laboratory showed that the most frequently used methods for identification of S. agalactiae are CAMP test and MALDI - TOF mass spectrometry. Latex agglutination today too often used.
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INFECTION AS A RISK FACTOR DURING PREGNANCY
HRUBEŠOVÁ, Martina
The thesis Infection as a risk factor during pregnancy is divided into two parts {--} theoretical and practical {--} and has a character of a research study. The theoretical part deals with aspects of infections during pregnancy. The main attention is paid to the questions of pregnant women colonized with group B Streptococci (GBS, Streptococcus agalactiae) which may cause a large scale of infectious diseases in newborns, including the life threatening sepsis. This part of the thesis is divided into seven chapters. They provide brief information on the etiological agent, risk factors, clinical picture of the disease, current possibilities of the disease diagnostics. The present day system of the optimal procedure of screening to identify women colonized with GBS and the procedure of the intrapartal antibiotic prophylaxis are also mentioned in the theoretical part. The objective of the practical part is to find the percentage of newborn infants delivered by mothers colonized with GBS who are also colonized with GBS despite their mothers having been treated by the intrapart antibiotic prophylaxis. The hypothesis I assumes that the intrapart antibiotic prophylaxis was administered to women colonized with GBS more than 4 hours before delivery. The hypothesis II presumes that newborns of GBS positive mothers who had been administered the antibiotic prophylaxis at least 4 hours before delivery were not colonized with GBS. The quantitative research was used to verify or reject the hypotheses. It was carried out by the retrospective analysis of medical records of women who gave birth between 1 June 2006 and 8 August 2007 at the maternity hospital in České Budejovice and had been colonized with GBS. The purpose of this thesis is to evaluate the antibiotic prophylaxis carried out in the maternity hospital in České Budejovice and to introduce the conclusions into practice and training.
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