diplomsko delo
Marija Mančić (Author), Anamarija Zore (Reviewer), Miha Lučovnik (Mentor), Nastja Pavel (Co-mentor)

Abstract

Uvod: Pomemben vzrok obolevnosti in umrljivosti novorojenčkov po svetu predstavljajo bakterijske okužbe. Eden od povzročiteljev invazivnih neonatalnih okužb je streptokok skupine B, ki je po Gramu pozitivna bakterija. Namen: Namen diplomskega dela je na osnovi obstoječe znanstvene in strokovne literature predstaviti trenutno znanje o kolonizaciji s SGB med nosečnostjo in porodom ter njen vpliv na otroka. Hkrati želimo ugotoviti, kakšne so posledice okužbe za novorojenčka, vključno z vplivom antibiotične profilakse na mikrobiom novorojenčka, ter potrebe po uvedbi univerzalnega presejanja nosečnic. Metode dela: Uporabili smo deskriptivno ali opisno metodo. Pregledali ter preučili smo domačo in tujo literaturo s področja kolonizacije s streptokokom skupine B v času nosečnosti in med porodom. Obstoječo znanstveno literaturo smo iskali s pomočjo podatkovnih baz (CINAHL, PubMed, DiKUL, COBISS in Google Učenjak). Rezultati: Pri pregledu literature je avtorica ugotovila, da se okužba pri novorojenčku najpogosteje kaže s klinično sliko pljučnice, meningitisa in/ali sepse. Prvi pogoj, da pride do okužbe pri novorojenčku, je kolonizacija matere s streptokokom skupine B. Trenutno obstajajo trije pristopi za preprečevanje zgodnjih neonatalnih seps: antibiotična profilaksa na podlagi dejavnikov tveganja, univerzalno presejanje za kolonizacijo s streptokokom skupine B v nosečnosti in intrapartalno presejanje. Četrta možnost, preprečevanje okužb s cepivom proti streptokoku skupine B, najverjetneje v naslednjih nekaj letih še ne bo na voljo v klinični praksi. Potencialno slaba stran antibiotične zaščite med porodom je, da lahko povzroči disbiozo novorojenčkovega črevesnega mikrobioma, ki bi lahko privedla do večjega tveganja za gastrointestinalne in druge bolezni v odrasli dobi. Razprava in zaključek: Ključnega pomena pri preprečevanju trajnih posledic za zdravje otroka in tudi umrljivosti so zgodnja prepoznava, diagnoza in zdravljenje. V slovenskem prostoru trenutno presejanje za kolonizacijo s streptokokom skupine B ne spada v nabor obveznih diagnostičnih preiskav prenatalnega varstva. V naslednjih letih bomo morali povečati delež porodnic z dejavniki tveganja, ki bodo prejele obporodno antibiotično zaščito, ali pa uvesti univerzalno presejanje nosečnic za streptokok skupine B. S tem bomo lahko preprečili hude okužbe novorojenčka ali celo smrt. Za opredelitev vpliva obporodne antibiotične profilakse na pojavnost kroničnih bolezni v odrasli dobi pa bodo potrebne dodatne raziskave.

Keywords

diplomska dela;babištvo;nosečnost;neonatalne okužbe;steptokok skupine B;presejanje;mikrobiom;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [M. Mančić]
UDC: 618.2/.7
COBISS: 5563243 Link will open in a new window
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Downloads: 411
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Other data

Secondary language: English
Secondary title: Group B streptococcal colonisation in pregnancy and during labour
Secondary abstract: Introduction: An important cause of morbidity and mortality of newborns all over the world is bacterial infections. One of the causative agents of invasive neonatal infections is Streptococcus Group B, which is a Gram-positive bacterium. Purpose: The purpose of the diploma work is to present current knowledge of Streptococcus Group B colonisation during pregnancy, childbirth and its influence on the child based on existing scientific and professional literature. At the same time, the purpose is to determine the consequences of infections for the newborn, including the impact of antibiotic prophylaxis on the newborn microbiome and the need to introduce a universal screening of pregnant women. Methods: A descriptive method has been used. We examined local and foreign literature in the field of maternal colonisation and neonatal infection with Streptococcus Group B. We focused mainly on colonisation during pregnancy and during labour. The existing scientific literature was searched using databases (CINAHL, PubMed, DiKUL, COBISS and Google Scholar). Results: In reviewing the literature, the author found that the most common neonatal Streptococcus Group B infections include pneumonia, meningitis and / or sepsis. The first condition for infection in the newborn is the colonisation of the mother with Streptococcus Group B. There are currently three approaches to preventing early neonatal sepsis: antibiotic prophylaxis based on risk factors, universal screening for Streptococcus Group B carriers in pregnancy and intrapartial screening. The fourth option – vaccination against Streptococcus Group B will probably not be available for clinical practice in the near future. Detection of colonised pregnant women is very important for further treatment. In pregnant women who are positive for Streptococcus Group B, the antibiotic is applied during labour. The potential disadvantage of antibiotics is that they can lead to a disbiosis of a neonate intestinal microbiom, which may lead to a greater risk of gastrointestinal and other diseases in adulthood. Discussion and conclusion: Prevention as well as early detection, diagnosis and treatment are crucial in preventing neonatal mortality and morbidity due to invasive Streptococcus Group B infections. In Slovenia, screening for Streptococcus Group B is not yet part of routine prenatal care. In the following years a national consensus on either a more stringent implementation of a risk-based approach or introduction of universal prenatal Streptococcus Group B screening will have to be reached.
Secondary keywords: diploma theses;midwifery;pregnancy;neonatal infections;streptococcus group B;screening;microbiom;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za babištvo
Pages: 35 str.
ID: 10995548