Comparative evaluation of Strepto B ID chromogenic medium and Granada media for the detection of Group B streptococcus from vaginal samples of pregnant women

Two types of selective media, the chromogenic medium Strepto B ID® and two non-chromogenic media Strepto B agar® and the Granada® medium, were tested and compared to blood agar plates (BAP) for screening of Group B streptococcus vaginal colonization in pregnant women. All tested media were comparable in terms of sensitivity however, their use in routine laboratories may markedly facilitate the rapid detection of GBS in vaginal samples.     

Depression and suicidality in the adolescents in Osijek, Croatia

Mood disorders in children and adolescents and their treatments have received increasing attention and clinical investigation over the last few decades. The core features of mood disorders are essentially the same across the life span. Developmental level, however, appears to influence the expression of certain mood symptoms with greater frequency than other within the framework of depressive disorders. Suicide is the fourth leading cause of death in children between the ages of 10 and 15 years and the third leading cause of death among the adolescents and young adults 15-25 years. In this article the authors presents cross-sectional study done on the sample of 286 adolescents. Adolescents fulfilled self-rating scale Beck Depression Inventory for the screening of the depression and suicidality. In our sample 3.85% of the adolescents fulfilled the criteria for severe depressive episode and the 5.94% of the adolescents fulfilled criteria for moderate depressive episode. Also on the item of suicidality (Item 9) 0.7% of the adolescents had very high score, while 8.4 had significant score for the suicidal risk. Our results are in concordance with similar epidemiological studies done world while.     

Epidemiological features of suicides in Osijek County,Croatia, from 1986 to 2000

Suicide is a devastating tragedy associated with social, cultural and psychological factors. It takes approximately 1,060 lives in the Republic of Croatia each year. We retrospectively reviewed all cases referred to in the Registrar office and Police Department at Osijek County from 1986 to 2000. The cases of suicide totaled 1,017. All of the cases were analyzed as to age, gender, marital status, occupation, place and time of suicide and method of suicide. The suicide rate for the entire population of the County averaged 20.5/100,000 inhabitants per annum. The age of the suicides ranged from 15 to 92. The male to female ratio was 2.1:1. The highest suicide incidence was among the age groups from 55 to 64 (19.27%), followed by age group from 45 to 54 (16.12%). The lowest suicide incidence was among the age group < 19 (3.4%). The incidence in the group 85 > years was also low (2.06%). The suicide was frequent among people who live alone: single, widowed, divorced (47.29%). Eighty percent of victims were found in surroundings familiar to them. These included various premises of their residences. The retired, the laborers and the unemployed (67.36%) were predominant among suicide victims. The most common methods of suicide were hanging (43%), followed by firearms (24%). No correlation was found with the day of the week or the month of the year. The study showed a slightly increased rate of suicide, from 21 cases at the beginning of the investigation (in 1986) to 22.3/100,000 population fifteen years later (in 2000).     

Seasonal dynamics of the Anopheles maculipennis complex in Osijek, Croatia.

Malaria was once endemic in the Osijek region of Croatia and although it has been eradicated, there are still several vector species of the Anopheles maculipennis complex in this area. During an eight-year investigation, using CDC traps with CO2 as an attractant, we collected a total of 3,508 mosquitoes. We determined the dynamics of members of this complex and found that they varied considerably with an average of two generations per season. Cross-correlations indicated that the Spearman's Index between the abundance rate and the water level was the highest 12 and 24 d before traps were set. This suggests that the long-term high water level created better conditions for continuous breeding of mosquitoes, which contributed to a significant increase in abundance rates of all species in the complex.     

The role of fruit drinks in daily diet of some Osijek inhabitants, Croatia

The aim of the study was to assess the role of fruit drinks in daily diet of Osijek inhabitants. A special questionnaire was administered to 199 patients visiting a family physician's office during December 2003. The concentration of vitamin C (L-ascorbic acid) was determined in 42 commercially available fruit drinks. Only 11% (22/199) of study subjects did not take fruit drinks. The mean concentration of vitamin C in all samples was 150.10 +/- 166.83 mg/L. The questionnaire revealed that 89% (177/199) of study subjects using fruit drinks were taking a mean of 0.4 L of fruit drink per day, yielding a mean of 60.04 mg of vitamin C, i.e. 100% of the recommended daily allowance of 60 mg. Study results indicated fruit drinks to be a significant source of vitamin C in daily diet, however, great variation in vitamin C intake according to socioeconomic status of study subjects and type of fruit drink should be noted.     

妊娠妇女与无性生活女性阴道分泌物微生物组学分析

目的 探讨妊娠妇女与无性生活女性阴道分泌物中菌群结构差异,为临床女性泌尿生殖系统疾病研究提供可靠的依据。方法 运用高通量二代测序技术检测20例妊娠妇女和29例无性生活女性阴道分泌物中微生物;采用秩和检验进行组间显著性差异分析,使用生物信息学软件进行数据处理。结果 49份样本共注释出14个门、23个纲、33个目、28个科、38个属和23个种水平物种。妊娠妇女与无性生活女性阴道分泌物中菌群结构差异显著。妊娠妇女在种水平仅有Atopobium vaginae、Campylobacter ureolyticus、Lactobacillus coleohominis、德氏乳杆菌、瑞氏乳杆菌、惰性乳杆菌、罗伊乳杆菌、白假丝酵母和近平滑假丝酵母共9个物种。结论 妊娠能引起女性阴道分泌物菌群结构发生改变,且菌种数量明显减少。Lactobacillus coleohominis和德氏乳杆菌可能在维持妊娠妇女阴道菌群平衡和自净作用中起到关键性作用。     

Prevalence of hepatitis B virus infection in pregnant women in the Montreal area.

From January 1982 to June 1984, 30,315 serum specimens from pregnant women at nine hospitals in the Montreal area were screened for hepatitis B surface antigen (HBsAg). Of the specimens 103, from 98 women, were positive, a prevalence rate of 3.4 per 1000. The ethnic origin of the 98 women and the number who were also positive for e antigen (HBeAg) were as follows: French-Canadian, 29 (3 HBeAg-positive); Asian, 28 (14); Haitian, 32 (0); other, 7 (0); and unknown, 2 (0). The prevalence rates of HBsAg positivity according to ethnic origin at one of the hospitals were 73.9 in Asians, 33.1 in Haitians, 0.9 in French Canadians and 8.0 in women of other extraction. If the prevalence rate found in this study is true for the 95 000 live births that occur yearly in the province of Quebec, there are an estimated 323 infants at risk for hepatitis B virus (HBV) infection each year in the province. Screening programs for detecting HBV carriage in pregnant women should be instituted, since recent studies have shown combined active-passive immunization to be effective in preventing perinatal transmission of HBV infection.     

Evidence for siderophore-dependent iron acquisition in group B streptococcus

Mutagenesis of group B streptococcus (GBS) with TnphoZ, a transposon designed to identify secreted protein genes, identified the gene homologues fhuD and fhuG. The encoded proteins participate in siderophore (hydroxamate)-dependent iron(III) transport in other bacterial species. Sequence analysis of the genome determined that fhuD and fhuG are members of a polycistronic operon comprised of four genes, fhuCDBG, that encode a putative ATPase, cell surface receptor and two transmembrane proteins respectively. We hypothesized that FhuD was a siderophore receptor. Western analysis of cell extracts localized FhuD to the bacterial cell membrane. Fluorescence quenching experiments determined that purified FhuD bound hydroxamate-type siderophores. FhuD displayed highest affinity for iron(III)-desferroxamine, with a K(D) (microM) = 0.05, identical to that described for FhuD2 from Staphylococcus aureus. The role of Fhu in siderophore-iron transport was also characterized. A fhu mutant, ACFhu1, was equally sensitive to the iron-dependent antibiotic streptonigrin as the wild-type strain, suggesting that ACFhu1 was not reduced for intracellular iron concentrations in the absence of exogenous siderophore. However, ACFhu1 transported significantly less siderophore-bound iron in (55)Fe accumulation assays. These data provide the first evidence of siderophore-mediated iron acquisition by GBS.     

口服微生态制剂对孕妇肠道和阴道大肠杆菌K1和B族链球菌定殖的干预

【目的】本研究主要从临床探讨口服益生菌对孕妇微生态环境(阴道和肠道)中Escherichia coli K1和B族链球菌(GBS)定殖率的影响以预防新生儿血流播散性细菌性脑膜炎。【方法】收集2011年至2017年期间在广东省范围门诊就诊的2539例妊娠健康孕妇的阴道、直肠分泌物。选择符合要求的32孕周孕妇47例随机分成两组,其中益生菌组22例,对照组25例,用荧光定量PCR检测不同组孕妇体内服药前、后的微生态环境中大肠埃希菌的变化。然后选择50例GBS筛查阳性的35孕周孕妇,随机分成益生菌组和对照组,荧光定量PCR检测不同分组孕妇体内微生态环境中GBS定量变化。同时使用荧光PCR筛查对临床收集的2539例孕晚期(35周)孕妇生殖道、直肠分泌物标本进行GBS检测并计算携带率。【结果】研究前对不同组别孕妇的基本资料进行差异分析,结果显示两组在年龄差别、经产妇比例和受教育水平3个方面比较均无差异(P0.05),证明不同组间孕妇具有可比性。然后观察上述不同组别的孕妇服用益生菌体内微生态状况,用荧光定量PCR方法进行检测,结果显示用益生菌组在服药前后,阴道和直肠分泌物中大肠杆菌数量显著下降(F=32.866,P0.001),孕妇服用益生菌后E. coli K1的数量显著低于服用益生菌前(P0.05),且益生菌组与对照组相比大肠杆菌数量显著下降(P0.05,F=41.546,P0.001);同时检查服益生菌组孕妇体内GBS的变化,荧光定量PCR检测结果显示服用益生菌前后GBS的定殖数量有降低趋势,且与对照组相比有下降趋势。最后我们用荧光定量PCR筛查孕晚期妇女B族链球菌带菌状况,其GBS携带率为8.07%。【结论】本研究结果提示本文筛查的广东省孕晚期孕妇的B族链球菌平均携带率为8.07%,GBS可能是新生儿发生细菌性脑膜炎的危险因素之一;口服益生菌疗法可能通过抑制E. coli K1在孕妇肠道和生殖道的定殖以预防血流播散性新生儿细菌性脑膜炎。     

Prevalence of various antiphospholipid antibodies in pregnant women

Antiphospholipid antibodies (APAs) are characterized as a heterogeneous population of autoantibodies directed against different target antigens, predominantly anionic phospholipids or phospholipid-containing structures. The presence of APAs has been strongly associated with a variety of clinical disorders including adverse pregnancy complications such as spontaneous abortions, pregnancy-induced hypertension, preeclampsia and intrauterine growth retardation. The purpose of this study was to compare the prevalence of anticardiolipin antibodies (ACAs), which are routinely examined, with APAs directed against phosphatidylserine (APS), phosphatidylinositol (API), phosphatidylethanolamine (APE) and phosphatidylcholine (APC) in the sera of pregnant women. We examined 410 serum samples of pregnant women hospitalized in the department for pathological pregnancies. They underwent prenatal biochemical screening of fetal congenital abnormalities in the first and the second trimester of gravidity. Anticardiolipin IgG and IgM were measured using commercial ELISA kits (ImmuLisa Anti-Cardiolipin Antibody), whereas APS, APE, API and APC were determined by our modified ELISA kit. Among 410 pregnant women we found 21 patients (5.1%) positive for ACA IgG (>20 GPL) and 30 patients (7.3%) positive for ACA IgM (>10 MPL). It was found that 7.8% of pregnant women had at least one high-titer APA IgG and 9.8% high-titer APA IgM. One third of ACA IgG or IgM positive sera contained polyspecific autoantibodies reactive to at least two various phospholipids. In the group of IgG ACA positive women, 28.6% patients were positive for APS, 28.6% were positive or moderately positive for API, 23.8% for APC and 19% for APE. In the group of IgM ACA positive women, 33.3% were also positive for APS, 26.7% for APE, 26.7% for API and 23.3% for APC were present. IgG and IgM ACA negative patients exhibited a significantly lower incidence of other APA than the group of ACA positive pregnant women. It still remains to clarify if the routine examination of APA reacting with other anionic and zwitterionic antigens other than cardiolipin would improve the probability of identifying women liable to adverse pregnancy complications.     

Regulation and function of pilus island 1 in group B streptococcus

Group B streptococcus (GBS) pili may enhance colonization and infection by mediating bacterial adhesion to host cells, invasion across endothelial and epithelial barriers, and resistance to bacterial ingestion and killing by host phagocytes. However, it remains unclear how pilus expression is regulated and how modulation of pilus production affects GBS interactions with the human host. We investigated the regulation and function of pilus island 1 (PI-1) pili in GBS strain 2603. We found that PI-1 gene expression was controlled by the CsrRS two-component system, by Ape1, an AraC-type regulator encoded by a divergently transcribed gene immediately upstream of PI-1, and by environmental pH. The response regulator CsrR repressed expression of Ape1, which is an activator of PI-1 gene expression. In addition, CsrR repressed PI-1 gene expression directly, independent of its regulation of Ape1. In vitro assays demonstrated specific binding of both CsrR and Ape1 to chromosomal DNA sequences upstream of PI-1. Pilus gene expression was activated by acidic pH, and this effect was independent of CsrRS and Ape1. Unexpectedly, characterization of PI-1 deletion mutants revealed that PI-1 pili do not mediate adhesion of strain 2603 to A549 respiratory epithelial cells, ME180 cervical cells, or VK2 vaginal cells in vitro. PI-1 pili reduced internalization and intracellular killing of GBS by human monocyte-derived macrophages, by approximately 50%, but did not influence complement-mediated opsonophagocytic killing by human neutrophils. These findings shed new light on the complex nature of pilus regulation and function in modulating GBS interactions with the human host.     

妊娠期女性常见阴道感染常规分析

【摘 要】 目的 调查妊娠期女性常见阴道感染的发病情况。方法 随机选取我院孕检妇女、妇科病普查妇女各200例,采用阴道分泌物常规镜检方法对其阴道分泌物进行常规分析。结果 200妊娠期孕检妇女中,检出清洁度Ⅰ～Ⅱ 88例（占受检人数的44%）、清洁度Ⅲ～Ⅳ 112例（占受检人数的56%）,阴道感染患者57例（占受检人数的28.5%）,其中外阴阴道假丝酵母菌病（VVC）37例（占受检人数的18.5%）、细菌性阴道病（BV）18例（占受检人数的9%）、滴虫性阴道炎（TV）2例（占受检人数的1%）;200例妇科病普查妇女中,检出清洁度Ⅰ-Ⅱ 94例（占受检人数的47%）、清洁度Ⅲ-Ⅳ 106例（占受检人数的53%）、阴道感染患者59例（占受检人数的29.5%）,其中外阴阴道假丝酵母菌病（VVC）34例（占受检人数的17%）、细菌性阴道病（BV）22例（占受检人数的11%）、滴虫性阴道炎（TV）3例（占受检人数的1.5%）。经卡方检验,妊娠期孕检妇女和妇科病普查妇女中VVC、BV和TV的发病率差异均无统计学意义（P>0.05）。 结论 大兴区妊娠期女性阴道感染以VVC为主。     

Grains from ear to ear: the morphology of spelt and free-threshing wheat from Roman Mursa (Osijek), Croatia

Cereals were a significant part of the Roman diet, yet knowledge about their cultivation, distribution and consumption in certain regions is particularly lacking. In Europe, studies generally suggest that from the Iron Age to the Roman period there was a reduction in barley cultivation, an increase in spelt over emmer, a preference for free-threshing wheat over glume wheats, as well as the increased cultivation of rye and oats. Up till now, there was little evidence on crop cultivation in Croatia, but the discovery of around 24,000 cereal grains from the oven of a 2nd-4th c. ad Roman villa in the modern town of Osijek provides important insights into diet and subsistence in the Roman province of Pannonia. Here, the dominance of free-threshing wheat, spelt and rye with only a relatively small amount of other cereals, chaff and weeds corresponds well with this pattern seen elsewhere in Europe. The relatively clean grain deposit suggests that this sample represents processed grain ready for final food preparation and consumption at the villa. The morphological variation and overlap seen between the carbonised spelt and free-threshing wheat grains, as well as the identification of ‘stunted’ cereal grains, is also discussed.

     

B群链球菌耐药性及红霉素耐药机制的研究

目的探讨荆州地区GBS对常用抗生素的耐药谱和对红霉素的耐药机制。方法采用选择性培养法从阴道和肛门拭子中分离B群链球菌(GroupB Streptococci,GBS),用标准的K-B法对常用的7种抗生素进行药敏试验,然后针对红霉素耐药菌株检测耐药基因ermA、ermB和mefA。结果 176株GBS对头孢噻肟和万古霉素均敏感,对青霉素和氨苄青霉素虽然没有耐药但其中介率达到12.0%。对红霉素的耐药率和中介率分别为35.8%和6.8%;对克林霉素的耐药率和中介率分别为9.5%和12.5%。63株对红霉素耐药的GBS中有22株同时对克林霉素耐药(cMLS型),有41株对红霉素耐药而对克林霉素敏感(M型)。在22株cMLS型耐药的菌株中有18株检测到ermB基因,2株检测到检测到ermA基因。在M型耐药的菌株中有32株检测到mefA基因,6株检测到ermB基因,1株检测到检测到ermA基因。结论青霉素是治疗本地区GBS感染的有效药物,但本地区GBS对红霉素的耐药比较严重。mefA介导的外排机制可能是是本地区分离的GBS对红霉素耐药的主要机制。     

Vaginal microbiota in healthy pregnant women and prenatal screening of group B streptococci (GBS)

The microbiota of the lower female genital tract was evaluated from vaginal swabs obtained from 623 healthy pregnant women at gestation periods of 35–40 weeks. Isolated and identified microorganisms were expressed as percentages of total samples. As expected, lactobacilli made up the dominant vaginal microbiota (70%). Enterobacteriaceae, mainly Escherichia coli, Klebsiella spp. and Proteus, were present in 38% of the samples, which might reflect the possible contamination of vaginal tract with rectal microorganisms. Candida albicans was present in 10% of healthy pregnant woman assayed. Streptoccocci (Streptococcus sp. and Enterococcus faecalis with 3% and 4%, respectively) and other gram-positive cocci (Staphylococcus sp., 5%), along with other microorgansisms such as Gardnerella vaginalis (5%) and Pseudomonas aeruginosa (2%) may represent a potential infection risk. Streptococcus agalactiae (group B streptococci β-hemolytic, GBS) was detected in 7% of the samples. GBS infection is a leading cause of neonatal morbidity and mortality in the developed world. Furthermore, GBS was often co-isolated with C. albicans (54.5%) in the samples. A complete and detailed evaluation of the vaginal biota swab, with particular attention to the presence of potential pathogens such as GBS, is a preventive strategy that can provide useful information to obstetricians and gynecologist in managing the last days of pregnancy and delivery. Electronic Publication     

Maternal group B streptococcus infection, neonatal outcome and the role of preventive strategies

To determine the newborn infection rate with group B streptococcus infection (GBS) before and after American Academy of Pediatrics Protocol (AAP) implementation in Croatia, antenatal risk factors, neonatal outcome and necessity for introducing national policy for intrapartum chemoprophylaxis. To evaluate the role of intrapartum chemoprophylaxis in preterm labor at < 37 weeks of gestation, premature rupture of membranes at < 37 weeks of gestation, fever during labor, ruptures of membranes > 18 hours before delivery and previous delivery of a sibling with GBS disease. A total of 784 neonates admitted to the Neonatal Intensive Care Unit, from 1 January 2005 to 31 December 2005. 60 (10/1000 live born) developed early-onset infection (EOGBS). The dominant presentation for EOGBS was sepsis (65%), pneumonia (32.2%) and meningitis (3%). Mean gestational age was 34.5 (+/- 5.3) weeks. There were 2 neonatal deaths (3%) in EOGBS, both preterm. EOGBS disease was associated with following risk factors: rupture of the membranes > 12 hours (49.3%), chorioamnionitis (11.9%), status post cerclage (10.4%), diabetes mellitus (4.5%), delivery out of hospital (3%), uroinfection (1.5%). After AAP implementation the incidence of GBS infection decreased from 15/1000 to 10/1000 of live born infants. The mortality from EOGBS dropped from 5% to 3%. The incidence of GBS infection in our study was considerably higher than in all current reports. Reasons for that can be inadequate perinatal screen in some parts of the country and no established policy for intrapartum antibiotic treatment of women with risk factors. Our results documented that intrapartum chemo-prophylaxis for GBS infection significantly reduces perinatal mortality due to neonatal infection and sepsis.