[Risk factors and screening strategy for group B streptococcal colonization in pregnant women: results of a prospective study].
OBJECTIVE
Group B Streptococcus (GBS) continues to be the most important bacterial cause of sepsis, meningitidis in newborns. American consensus guidelines have been published. They recommended the use of either risk-based strategy or screening-based approach for GBS colonization in pregnant women to identify candidates for intrapartum prophylaxis. Screening consists of obtaining vaginal and anorectal specimens for culture at 35 to 37 weeks' gestation. The aim of this prospective study was to assess the usefulness of systematic and concomitant GBS screening by rectal and vaginal swab in pregnant women. A questionnaire designed to determine the risk factors for colonization by GBS was completed.


METHODS
We have screened 370 pregnant women with rectal and vaginal swab.


RESULTS
Fifty seven (15.4%) women had positive GBS cultures. Of those women, the rectum and the vagina were the only site of colonization in 16 (4.3%) and 8 (2.2%) women respectively. None of the factors studied was significantly associated with GBS colonization.


CONCLUSIONS
Detection of GBS is enhanced by 40% by using vaginal and anorectal swabs compared to a vaginal swab alone. No studied factor appeared to predict GBS colonization, which incited us to screen all pregnant women.
Jauréguy
F
F
Service de Microbiologie, CH de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex. francoise.jaureguy@wanadoo.fr
Carton
M
M
Teboul
J
J
Butel
M-J
MJ
Panel
P
P
Ghnassia
J-C
JC
Doucet-Populaire
F
F
D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000627:therapeutic use; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005602:France; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010406:Penicillins / Q000627:therapeutic use; D011247:Pregnancy; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology*; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D014621:Vagina / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D004917:Erythromycin; D002443:Ceftriaxone; D000658:Amoxicillin
Facteurs de risque et stratégie de dépistage de la colonisation par le streptocoque du groupe B chez la femme enceinte: résultats d'une étude prospective.