9. SUMMARY
In the aim of evaluating a vaginal colonization of
Streptococcus agalactiae, so as to judge the possibility of the
routine vaginal smear (VS) in pregnant women to prevent neonatal and puerperal
infections dues to this micro organism, we carry out a descriptive, cross
sectional and prospective study to evaluate vaginal colonization and the
antibiotics sensitivity profile of Group B Streptococci (GBS)
Objective: Evaluate the prevalence of vaginal
colonization and the antibiotics sensitivity profile of GBS in pregnant
women.
Portage vaginal et profil de sensibilité du
Streptococcus agalactiae aux antibiotiques chez la femme enceinte à
HGOPY
Methodology: From pregnant women coming for
VS at the HGOPY, we collected a cervical-vagina smear during the period
spanning from the 1st of March to the 30th of august
2008. Two swabs were collected from each patient. Macroscopic examination gave
us a description of the cell wall, the cervix and the abundance of discharge,
their color, odor, consistency. Microscopic examination of the specimen was
used to detect directly the presence of parasites, epithelial cells and
leucocytes. Gram stains enable us to distinguish gram positive (violet
coloration) and Gram negative (pink coloration), the morphology and colonies.
Bacteria colonies on agar medium (OXOID) were purified and identified by
bacteriological and biochemical tests. GBS were identified by latex grouping
test (PASTOREX STREP BIO-RAD) and CAMP test. The antibiotic sensitivity test
was done on Müeller Hinton agar medium enriched with 5% of defebriled
sheep blood, each strain was tested with 9 antibiotics. The strain of
Staphylococcus aureus ATCC 25923 was used as reference.
Results: Among 142 pregnant women recruited
for this study, 11 had GBS that is 7.7%. The frequency of GBS was 3.8% within
the first trimester, 7% in the second trimester and 11.1% in the third
trimester. The most encounted germ was Candida albicans as we had
always expected and made up 45.16% of germ isolated from mono microbial
culture. Streptococcus agalactiae was fourth with 8.60% and
Escherichia coli fifth with 4.3%.
CAMP test was negative with all the strains tested.
For antibiotics sensitivity of GBS strains, all were sensitive
with 100% to Penicilline G, to Amoxicilline, to Ampicilline, to Cefotaxime, to
Pristinamycine, to Erythromycine, and to Clindamycine, where as Cefuroxime had
a sensitivity of 81.81%. All the strains were resistant to Gentamycine.
Conclusion and recommendations: From our
results, the various conclusion could be drawn: GBS is present in the vagina to
pregnant women consulting at
Portage vaginal et profil de sensibilité du
Streptococcus agalactiae aux antibiotiques chez la femme enceinte à
HGOPY
the HGOPY with a prevalence of 7.7%. Penicillines and
macrolides are still the first choice antibiotic for a GBS infection. Reducing
the cost of VS and doing routine diagnosis during the last trimester of
gestation seems to be the best strategy against neonatal and puerperal
infections due to this germ
Portage vaginal et profil de sensibilité du
Streptococcus agalactiae aux antibiotiques chez la femme enceinte à
HGOPY
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