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[Group B streptococci in neonatal pathology: pathogenetic mechanism, diagnosis and prevention]
Insights
Group B Streptococcus (GBS) causes neonatal disease, with increased vaginal epithelial sensitivity linked to contraceptives. Avirulent strains show higher adhesion, impacting mixed infections and neonatal outcomes.
Area of Science:
- Microbiology
- Neonatal Health
- Epidemiology
Context:
- Group B Streptococcus (GBS) is increasingly recognized as a significant cause of human neonatal disease.
- Both vertical and horizontal transmission routes contribute to GBS infection spread.
- Adults can be pathogen carriers, presenting diverse sources and transmission pathways.
Purpose:
- To investigate the factors influencing Group B Streptococcus (GBS) adhesion to vaginal epithelium.
- To explore the role of GBS strain virulence and host factors in neonatal infections.
- To analyze the correlation between maternal GBS serotypes and neonatal outcomes.
Summary:
- Increased vaginal epithelial sensitivity to GBS adhesion was observed with certain contraceptive use.
- Avirulent GBS strains exhibited higher adhesive activity than virulent strains, particularly relevant in viral-bacterial co-infections.
- A study isolated over 80 GBS strains (serotypes Ia/C, Ib/C, II/C, III/R) between 1985-1987, with only 54% of GBS-carrying pregnancies resulting in favorable neonatal outcomes.
- Maternal isolate and abortus strain serotypes showed complete correlation.
Impact:
- Findings highlight the complex interplay between GBS, host factors (e.g., contraceptive use), and viral infections in disease pathogenesis.
- The study underscores the need for improved laboratory diagnostics and identification methods for GBS and its carriers.
- Results emphasize the significant risk of adverse neonatal outcomes associated with GBS carriage during pregnancy.
Abstract:
Group B streptococci have recently attracted the attention of researchers as the causative agents of human neonatal disease. They are currently encountered much more frequently than it was believed previously. Various types of adult pathogen carriers have been described; this accounts for the numerous sources and pathways of infection transmission, both vertical and horizontal. The transmission risk depends on many factors, vaginal colonization in the parturient being of special import. The level of the pathogen adhesion to the barrier epithelium is reflective of the tissue sensitivity to infection. Increased sensitivity of the vaginal epithelium to B streptococci adhesion in association with the intake of some contraceptives has been found. The adhesive activity of avirulent streptococci B strains is shown to be higher than in the virulent strains, which is especially important in mixed virus bacterial infections. The streptococcal infection of high mortality is underlain by activation of persisting avirulent streptococci B that manifest their pathogenicity as a result of the virus-specific modifications in the host cell membrane. During 1985-1987, in Leningrad Institute of Gynecology and Obstetrics over 80 strains of streptococci B were isolated, the leading serotypes being Ia/C, Ib/C, II/C, III/R. Only 54% of the studied pregnancies attended with the streptococcus carriage had a favourable neonatal outcome. The strain serotypes from maternal isolates and abortuses fully correlated. Further improvement of the laboratory diagnosis and means of the pathogen and its carriers identification is a current priority.