Detección e identificación de Streptococcus agalactiae en gestantes: aspectos relevantes y revisión narrativa de la literatura
Detection and identification of Streptococcus agalactiae in pregnant women: Relevant aspects and a narrative literature review
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El Streptococcus agalactiae o Streptococcus del grupo B (SGB) es un patógeno relevante en salud materno-fetal y mundialmente es uno de los agentes etiológicos de sepsis neonatal temprana de alta letalidad y sepsis neonatal tardía causante de secuelas neurológicas permanentes y discapacidad infantil. La colonización materna es la principal fuente de transmisión de la sepsis temprana, la cual puede prevenirse mediante la profilaxis materna intraparto. El tamizaje prenatal mediante cultivo vagino-rectal constituye la principal herramienta para la detección de las gestantes colonizadas y en riesgo. Objetivo: Esta revisión pretende brindar información actualizada sobre la carga de la infección por SGB y sus efectos en gestantes y neonatos enfocándose en el proceso óptimo de detección e identificación de la bacteria, así como las alternativas de diagnóstico molecular. Lo anterior con el fin de mejorar el limitado control de la infección debido a la falta de comprensión de estos aspectos. Metodología: Para la revisión del tema se realizó una búsqueda de la literatura en 4 bases de datos incluyendo estudios de la última década (hasta 2023). Se seleccionaron 82 artículos que cumplieron con los criterios para la revisión narrativa, la cual se realizó en concordancia con la guía SANRA. Resultados: Se describen aspectos microbiológicos, epidemiológicos y particularmente se discuten las limitaciones del cultivo vagino-rectal prenatal y los retos para la detección e identificación de la bacteria considerando la utilización de pruebas moleculares de punta. Conclusiones: El rendimiento del cultivo o estándar de oro es variable, lo cual disminuye su sensibilidad y poder diagnóstico. En esta revisión se hace evidente la alta sensibilidad y especificidad de las pruebas moleculares lo que hace imperativo incluir estas pruebas complementarias en la detección antenatal de la bacteria permitiendo la aplicación efectiva de la terapia intraparto y la prevención de la infección neonatal.
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