Debatable problems in the prevention of intrauterine infections caused by group B streptococci: What strategy do we choose?


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Abstract

The paper gives the data available in the world literature and the results of the authors’ investigations dealing with the prevention of early-onset neonatal group B streptococci (GBS) septicemias. It discusses the issues of strategical approaches to prevention: to concentrate attention on selective screening for GBS carriage in all pregnant women at 35-37 weeks’ gestation with further preventive treatment during labor for found carriers or to give preference to the clinical risk factors for fetal infection at any gestational age to be identified during labor, by using rapid laboratory diagnostic methods (specific primers for PCR diagnosis, immunochromatographic tests). The authors propose an algorithm for examining pregnant women at risk for infection in the early pregnancy periods, by applying a differential approach to managing them after identification of GBS carriage (treatment or only follow-up) depending on anamnestic data and the status of the vaginal microbiota (GBS carriage with a high titer of lactobacilli or the presence of manifestations of an vaginal inflammatory process). The paper invites for discussion to elaborate a unique Russian strategy for the prevention of abnormal pregnancy and fetal infection due to GBS.

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About the authors

Alla S. Ankirskaya

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_ankirskaya@oparina4.ru
MD, Professor, consultant in the Microbiology Laboratory

Tatiana V. Priputnevich

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: priput1@gmail.com
PhD, Head of research Department of microbiology and clinical pharmacology

Vera V. Muravyeva

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_muravieva@oparina4.ru
PhD in Biology, senior researcher in the Microbiology Laboratory

Lyudmila A. Lyubasovskaya

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

PhD, clinical pharmacologist Department of microbiology and clinical pharmacology

T. E Karapetyan

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: tomamed02@mail.ru
M.D. in medical sciences, senior scientific researcher

Alina R. Melkumyan

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

PhD, Researcher in the Microbiology Laboratory

Valery Viktorovich Chubarov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_chubarov@oparina4.ru
Head of the Department of Clinical Epidemiology Department of microbiology and clinical pharmacology

Anna N. Kalakutskaya

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_kalakutskaya@oparina4.ru
PhD in Biology, senior researcher Department of microbiology and clinical pharmacology

References

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