Group B streptococci colonization in pregnant women: risk factors and evaluation of the vaginal flora.
ABSTRACT To determine the prevalence of group B streptococci (GBS) in our population, and to assess the association between risk factors and vaginal flora with maternal rectovaginal colonization.
Samples were obtained from 405 patients between 35 and 37 weeks of gestation. Swabs from the vaginal and perianal regions were cultured in Todd Hewitt and subcultured in blood agar. Colonies suggestive of GBS were submitted to catalase and CAMP test. The vaginal flora was evaluated on Gram stain vaginal smears. Socio-demographic and obstetric data were obtained by designed form. Considering maternal GBS colonization as the response variable, a logistic regression model was fitted by the stepwise method with quantitative and qualitative explanatory variables.
The prevalence of GBS colonization was 25.4%. The most frequent vaginal flora abnormalities were cytolytic vaginosis (11.3%), followed by bacterial vaginosis (10.9%), candidosis (8.2%) and intermediate vaginal flora II (8.1%). Logistic regression analysis revealed that maternal age, number of sexual intercourse/week, occurrence of previous spontaneous abortion, presence of candidosis and cytolytic vaginosis were associated with streptococcal colonization.
The prevalence of GBS is high in pregnant women and is associated with sexual intercourse frequency, previous spontaneous abortion and the presence of candidosis or cytolytic vaginosis.
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ABSTRACT: Today, ultra-high throughput screening (uHTS) methods enable screening of 100,000 samples/day or more to meet the demands for speed, with assay volumes miniaturised to 10 μl or below to reduce reagent consumption. Various methods have been employed and are now implemented on a common instrumental platform (EVOscreen™ by Evotec Technologies, Hamburg), which allows efficient selection of the best read-out mode for particular assay types, or even multiplexing of methods. Fluorescence correlation spectroscopy (PCS) is sensitive to changes in diffusion as seen when a fluorescent ligand binds to a receptor protein, for example. Fluorescence intensity distribution analysis (FIDA) allows detection of changes in specific brightness which could be caused for example by quenching, fluorescence resonance energy transfer (FRET) or accumulation of fluorophores on particles with multiple binding sites. By extending this method to 2-channel detection (2D-FIDA) using a polarising beamsplitter, anisotropy changes can be monitored, which is often the method of choice for small-ligand binding assays. Finally, using pulsed laser sources and single-photon counting electronics, fluorescence lifetimes can be measured providing a robust read-out parameter in various assay formats. We will present examples of assays and screens based on these detection modes which include the most important target classes and cover a variety of assay types. Several examples for these assay types and their validation for uHTS will be discussed.
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ABSTRACT: Miscarriage is a common complication encountered during pregnancy. The role of progesterone in preparing the uterus for the implantation of the embryo and its role in maintaining the pregnancy have been known for a long time. Inadequate secretion of progesterone in early pregnancy has been linked to the aetiology of miscarriage and progesterone supplementation has been used as a treatment for threatened miscarriage to prevent spontaneous pregnancy loss. To determine the efficacy and the safety of progestogens in the treatment of threatened miscarriage. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011) and bibliographies of all located articles for any additional studies. Randomised or quasi-randomised controlled trials that compare progestogen with placebo, no treatment or any other treatment given in an effort to treat threatened miscarriage. At least two authors assessed the trials for inclusion in the review, assessed trial quality and extracted the data. Data were checked for accuracy. We included four studies (421 participants) in the meta-analysis. In three studies all the participants met the inclusion criteria and in the fourth study, we included only the subgroup of participants who met the inclusion criteria in the meta-analysis. There was evidence of a reduction in the rate of spontaneous miscarriage with the use of progestogens compared to placebo or no treatment (risk ratio (RR) 0.53; 95% confidence interval (CI) 0.35 to 0.79). There was no increase in the rate of antepartum haemorrhage (RR 0.76; 95% CI 0.30 to 1.94), or pregnancy-induced hypertension (RR 1.00; 95% CI 0.54 to 1.88) for the mother. The rate of congenital abnormalities was no different between the newborns of the mothers who received progestogens and those who did not (RR 0.70; 95% CI 0.10 to 4.82). The data from this review suggest that the use of progestogens is effective in the treatment of threatened miscarriage with no evidence of increased rates of pregnancy-induced hypertension or antepartum haemorrhage as harmful effects to the mother, nor increased occurrence of congenital abnormalities on the newborn. However, the analysis was limited by the small number and the poor methodological quality of eligible studies (four studies) and the small number of the participants (421), which limit the power of the meta-analysis and hence of this conclusion.Cochrane database of systematic reviews (Online) 01/2011; DOI:10.1002/14651858.CD005943.pub4 · 5.94 Impact Factor
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ABSTRACT: Our understanding of the bacterial species inhabiting the female genital tract has been limited primarily by our ability to detect them. Early investigations using microscopy and culture-based techniques identified lactobacilli as the predominant members of the vaginal microbiota and suggested that these organisms might serve a protective function at the mucosal surface. Improvements in cultivation techniques and the development of molecular-based detection strategies validated these early findings and enabled us to recognize that the microbiota of the female genital tract is much more complex than previously suspected. Disruption of the vaginal microbial community due to invasion of exogenous organisms or by overgrowth of one or more endogenous species has important health implications for both the mother and newborn.Seminars in Fetal and Neonatal Medicine 09/2011; 17(1):51-7. DOI:10.1016/j.siny.2011.08.006 · 3.13 Impact Factor