Modern day science has allowed us to make pregnancy and childbirth safer and more predictable than ever. However, we are not invincible to the many organisms that share our world and they can pose some serious risks for both the mother and the infant during this critical period in life. One such risk that many mothers don’t think about is the potential colonization of a bacteria called Group Beta Streptococcus (GBS) in their body during pregnancy, specifically around the time of birth. Lab testing and antibiotic prophylaxis can be thought of as risk-management and has proven to be effective at reducing GBS infection rates in infants born through the vaginal canal of mothers who are GBS carriers.
Group Beta Streptococcus (GBS) is a bacteria that is found in the vagina and rectum of 10-30% of all women. This bacteria comes and goes as it is normal flora for women, similar to yeast. Although most are asymptomatic, some may experience urinary tract infections while the bacteria is present in their body. Although GBS does not present much of a problem to the carrier, this specific bacteria can cause much harm to a newborn who passes through the vaginal canal during birth (ACOG, 2011). Pregnant women can take advantage of modern day screening procedures that look for the presence of GBS in late pregnancy to determine if antibiotic prophylaxis is warranted.
It is approximated that 50% of all newborns will colonize GBS on their skin during a vaginal birth. However, colonization
Gold standard procedures should be implemented with the aim of providing timely and accurate results. (Schentag) The culture result should be accompanied by its clinical significance, selective reporting of susceptibility testing results in accordance with hospital antimicrobial therapy guidelines and suggested management. (Schentag) This encourages appropriate prescribing and minimises unnecessary use of antimicrobials. The clinical microbiology team should also provide reports to AMS regarding resistant organisms.
This experiment was conducted to find the genus and species of an unknown bacteria prescribed by the lab teacher, which was unknown bacteria GA3 in my case. Identification of unknown bacteria techniques are used on an every day basis to figure out what type of bacteria it is and to find the best method of how to treat a patient with this bacteria (1). All five “I’s” of Microbiology were used in the testing for the unknown culture. Inoculation was used several times to put the unknown culture into agar plates or into biochemical test tubes. After Inoculation of these tubes or plates, they always were placed into the incubator for further growth and development. Isolation was used to make sure we got the correct bacteria we were testing for. After each further isolation, we gram stained the culture and inspected the culture under a microscope to further help in the identification process of the unknown bacteria. Multiple tests were done on the unknown culture to make sure we were confident in what kind of bacteria the unknown was.
The first step to identifying the unknown bacteria residing on the blood agar plate sent in from Khokana was to do a Gram stain on it. This is an important first step because it dictates further testing that will be necessary to arrive at a final conclusive result. Viewing the fixed and stained slide under the microscope revealed round chains of bacteria in a purple color signaling Gram-positive streptococci. A catalase test was performed with no bubbling present indicating a negative result. This further confirmed the shape and arrangement seen under microscopy. With this mind, the coagulase test was not done, as it would be of no use since that specifies for staphylococcus, specifically for Staphylococcus aureus. For streptococcus, an examination of hemolysis was necessary at this point. Shifting attention back to the original blood agar plate, gamma hemolysis was noted, thus narrowing the field down to two choices left. The unknown bacteria was either Streptococcus bovis or Entercoccus faecalis. This also means the Optochin and Bacitracin sensitivity tests would not be needed as those pinpoint alpha- and
Streptococcus pyogenes, also known as Group A streptococcus (GAS), is a β-hemolytic, Gram-positive bacterium that most commonly causes respiratory disease, including pharyngitis or tonsillitis, as well as skin infections such as impetigo and cellulitis. The organism is transmitted via respiratory droplets or by contact with fomites, and commonly infects young children. In addition to the common clinical presentations associated with S. pyogenes, some individuals develop the postinfectious sequelae of rheumatic fever and glomerulonephritis. Due to the severity of these medical consequences, prophylactic antibiotic use is often recommended for any patients with otherwise mild S. pyogenes infections (21).
Group B Streptococcus agalactiae is an important Gram-positive bacterial pathogen that cause a wide variety of clinical infections, ranging from septicemia to meningitis. The reported lethality of severe S. agalactiae infections is ranging from 4 to 6% in the United States. Of note, it has been suggested that the incidence of neonatal disease is considerably greater than reported, because the requirement for positive cultures from blood or cerebrospinal fluid may underestimates the true burden of disease. Therefore, in this review I focused on virulence factors of S. agalactiae in order to elucidate aspects of the infection.
Streptococcus Pyogenes is a very diverse bacteria with effects ranging from nothing or a mild sore throat, to flesh eating disease, causing death in 40-60% of patients. The major and most common illnesses associated with this bacteria
The organism adheres to the epithelial cells in its host by pilli. This opportunistic pathogen can affect people of all ages and specifically targets patients that have immune deficiencies, debilitating diseases, and infants in the NICU. Patients are at greater risk of contracting the organism if they have recently had a surgery, mechanical ventilation, central venous catheter, arterial catheterization, inhalation medication therapy, tracheal tubes, or have low apgar scores. It can cause a variety of diseases and infections such as urinary tract infections, meningitis, pneumonia, respiratory tract infections, keratoconjunctivitis, osteomyelitis, keratitis, endocarditis, cutaneous infections, and endophthalmitis. (Currey,
Group A. Streptococcus is a bacterium that causes many different types of infections. It is believed that at least 5-15% percent of the population are carriers of Group A Strep. These carriers tend to carry the bacteria on their skin or in their throats and usually remain asymptomatic.
The two strengths were the study enhances the observation made by other authors by measuring levels of specific bacterial species. G. vaginalis concentrations increased with menses in 81% monitored menstrual cycles, and levels decreased with the end of menstruation. During these surges of G.vaginalis, L iners levels also trended upwards while levels of the other two lactobacilli decreased. Schwebke et al, have similarly reported increases in Gardnerell/ Bacteroides morpho-types by gram stain and reduced quantities of lactobacilli during
Mothers who test positive and are at high risk for GBS infection will be given IV antibiotics to reduce their babies' chances of developing the infection after birth.
Medicines may be prescribed that are safe for a mother and her unborn baby. The medicine can help reduce symptoms or prevent another outbreak of the infection. If the infection happened before you became pregnant, medicine may be prescribed in the last 4 weeks of the pregnancy. This can help prevent a breakout of the infection at the time of delivery.
The female vaginal microbiome plays a pivotal role in the maintenance and protection of urogenital health. The extent by which it is able to defend and protect against potentially pathogenic bacteria and sexually transmitted infections (STIs) is strongly associated with a high-relative abundance of vaginal Lactobacillus spp. Lactobacillus spp. prevent colonization of potential pathogens through the production of lactic acid, bacteriocins and biosurfactants. Conversely, depletion of vaginal Lactobacillus spp. is associated with an increased abundance of anaerobic bacteria including Gardnerella, Prevotella and Dialister spp., an increase in vaginal pH (>4.5), and is strongly correlated with the polymicrobial, pro-inflammatory vaginal disorder,
Streptococcus pyogenes is a very common bacteria found in humans. It is very transmissible and can be caught through the air via coughing or sneezing. This form of Strep. illness is referred to as Streptococcal pharyngitis, also known as Strep. throat, which can complicate into Scarlet Fever. It is also possible to be infected through abrasions of the skin, which can result in cellulitis, impetigo, or even necrotizing fasciitis. Aside from human to human contact, these bacteria can also be found in unpasteurized milk. There is no vaccine for Streptococcal infections, though antibiotics such as penicillin still work very well against them.
Vaginal Seeding is the concept of swabbing a baby, born via cesarean section, with vaginal fluid from the mother to replicate the process of collecting flora while traveling through the birth canal. The reason for this concept is to expose the infant to the mother’s natural interior and exterior bacteria. These bacteria are thought to assist in alleviating certain conditions thought to be more closely associated with children born by way of C-section. While there appears to have been several studies and comparisons done on children born vaginally and children born via C-section, the debate stands whether the pros of the procedure outweigh the cons. There are some doctor’s and parents alike who agree with the concept and think it to be beneficial for the child. However, there are others who use lack of evidence and potential dangers of the technique as a premise of its many criticisms.
Cause/Risk Factors. E.coli, listeria, some strains of strep and the herpes virus can lead to sepsis in newborns. Group B strep infection of mother and or baby in utero; preterm delivery; ROM a 24 hours a labor; infection of placenta or amniotic fluid;