The importance of early diagnosis in the neonatal period for group B Streptococcus

Abstract

Streptococcus agalactiae or Group B Streptococcus (GBS) correspond to Gram positive diplococcus, usually residing in the microbiota of the gastrointestinal and genitourinary tract of pregnant women. The transmission of GBS occurs mainly through vertical ascent, especially in the intrapartum period, being one of the main bacteria responsible for the development of sepsis in the neonatal period. Early diagnosis associated with adequate antibiotic prophylaxis predicts lower risks of neonatal infection, in addition to a lower rate of complications and infant mortality. To carry out the research, we used high-impact articles taken from MEDLINE, SciELO, Pubmed, CNPq and LILACS platforms (2015–2022) and compiled a recent theoretical reference, with the exception of the historical reference, under which there was no time limitation. In reference to the levels of preventive medicine it can be observed: The primary prevention shows that the possibility of developing vaccines is viable, but so far in phase II in international studies and with a lack of epidemiological studies regarding the specific capsular serotypes of each Brazilian regions, hindering the development of the measure. Regarding the microbiological screening of GBS indicated by the Ministry of Health in 2012, it should be performed between the 35th and 37th week of pregnancy, in contrast to more recent international literature. In secondary prevention, there are new ways of diagnosing GBS infection, for example, the Xpert GBS, a rapid test indicated to test women at risk of preterm birth or in labor who did not undergo the test during prenatal care. The secondary still involves the existing treatment, which would be through the use of first-choice antimicrobials, such as crystalline penicillin or ampicillin, however, in some cases they already have resistance, requiring microbiological evaluation with antibiogram. In conclusion, the topic is extremely important for maternal and child health. GBS infection is a preventable disease with a simple diagnosis, however, there is still a huge literature divergence and lack of Brazilian protocols emphasizing the relevance of screening for GBS, which should be performed extensively in pregnant women, with antibiotic prophylaxis only in specific cases and, if necessary, with a previous sensitivity analysis to antimicrobials, in order to obtain better results.