Incidência da colonização por Streptococcus agalactiae em gestantes de alto risco atendidas na rede pública de Uruguaiana/RS

Abstract

The S. agalactiae (SGB) is part of gastrointestinal and genitourinary microbiota tract, also found in the skim and pharynx. It is estimated that this bacteria colonizes 10 to 40% of pregnant women's vagina and/or rectus around the world, who are usually assymptomatic. The maternal colonization by this microorganism is the main risk factor to vertical transmission and infection development in newborns, so it is recommended a swab surveillance collection in pregnant womem at the end of third trimester, between 35 and 37 pregnancy weeks, with administration of antimicrobial during the delivery work on colonized patients. However in Brazil the SGB has not been properly valued in the etiology of infectious processes, despite the seriousness of the infection and the fact of it be susceptible to prophylactic benefits. National studies show a discrepant prevalence of 8.0% to 34% between the regions of the country and data of SGB colonization in high risk pregnant women are scarce. The aim of this study was to evaluate the incidence of SGB colonization from the 28th pregnancy week in high risk pregnant women attended in the public network of Uruguaiana city (RS), besides verifying a possible association between colonization by EGB and the presence of obstetric risk factors. It is about a descriptive and quantitative study, from a quiz about socioeconomical data and history of pregnant answered at the collection moment and the surveillance sample collected from the pregnant woman by a sterile vaginal/rectal swab, using the technique of microbiological culture (gold standard). A total of 95 high risk pregnant womem were included in the study, attended by the Santa Casa de Caridade Hospital, predominantly featuring a population of married women (92,6%), with high school degree (64,2%), self declarated caicasian (62,1%), with average age between 20-29 years old (48,2%). The incidence of colonization by SGB was of 7.4%. Two other studies carried in risk pregnant women also found percentages lower than 10%, however a recent study carried in the north of Brazil showed a discrepant colonization rate (34.0%). The most risk factors found in this population were systemic arterial hypertension (44,2%) and pregnant diabete mellitus (19,6%). However, there was no significant difference among colonized and non-colonized pregnant women by SGB and the risk factors. The number of cephalic births was 28 comparing to the 67 cesarean ones, with no deaths or intercorrences during the birth labors. The contribution of our study, points for the absence of a relation between pregnant risk factors and colonization by SGB. Although the SGB research in the prenatal examination is extremely important, our results call attention to the need of consider other relevant factors implicated in newborn deaths.