Evaluation of intermittent preventive treatment of malaria against group B Streptococcus colonization in pregnant women: a nested analysis of a randomized controlled clinical trial of sulfadoxine/pyrimethamine versus mefloquine

被引：11

作者：

Capan-Melser, Meskuere ^{[1
,2
,3
]}

Ngoma, Ghyslain Mombo ^{[1
,2
,4
]}

Akerey-Diop, Daisy ^{[1
,2
]}

Basra, Arti ^{[1
,2
]}

Wuerbel, Heike ^{[1
,2
]}

Groger, Mirjam ^{[1
,3
]}

Mackanga, Jean R. ^{[1
,2
]}

Zoleko-Manego, Rella ^{[2
,5
]}

Schipulle, Ulla ^{[1
,2
]}

Schwing, Julia ^{[1
,2
]}

Loetsch, Felix ^{[1
,3
]}

Rehman, Khalid ^{[3
]}

Matsiegui, Pierre-Blaise ^{[5
]}

Agnandji, Selidji T. ^{[1
,2
]}

Adegnika, Ayola A. ^{[1
,2
]}

Belard, Sabine ^{[1
,2
,6
]}

Gonzalez, Raquel ^{[7
]}

Kremsner, Peter G. ^{[1
,2
]}

Menendez, Clara ^{[7
]}

Ramharter, Michael ^{[1
,2
,3
]}

机构：

[1] Hop Albert Schweitzer, Ctr Rech Med Lambarene, Lambarene, Gabon

[2] Univ Tubingen, Inst Trop Med, Tubingen, Germany

[3] Med Univ Vienna, Div Infect Dis & Trop Med, Dept Med 1, A-1190 Vienna, Austria

[4] Univ Sci Sante, Dept Parasitol, Libreville, Gabon

[5] Ngounie Med Res Ctr, Fougamou, Gabon

[6] Charite, Dept Pediat Pneumol & Immunol, D-13353 Berlin, Germany

[7] Univ Barcelona, Hosp Clin, Barcelona Ctr Int Hlth Res CRESIB, IS Global, Barcelona, Spain

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2015年 / 70卷 / 06期

关键词：

Streptococcus agalactiae; maternal GBS colonization; intermittent preventive treatment in pregnancy; sub-Saharan Africa; GABON; AGALACTIAE; INFECTION; LAMBARENE; CARRIAGE; EFFICACY;

D O I：

10.1093/jac/dkv041

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: Streptococcus agalactiae constitutes an important cause of neonatal infections in sub-Saharan Africa. Sulfadoxine/pyrimethamine-the current intermittent preventive treatment of malaria in pregnancy (IPTp)-has proven in vitro activity against group B Streptococcus (GBS). Because of specific drug resistance to sulfadoxine/pyrimethamine, mefloquine-an antimalarial without in vitro activity against GBS-was evaluated as a potential alternative. This study assessed the potential of sulfadoxine/pyrimethamine-IPTp to reduce the prevalence of GBS colonization in pregnant women in Gabon when compared with the inactive control mefloquine-IPTp. Methods: Pregnant women participating in a randomized controlled clinical trial evaluating mefloquine-IPTp versus sulfadoxine/pyrimethamine-IPTp were invited to participate and recto-vaginal swabs were collected at delivery for detection of GBS colonization. Prevalence of recto-vaginal GBS colonization was compared between IPTp regimens and risk factor and birth outcome analyses were computed. Results: Among 549 participants, 106 were positive for GBS colonization at delivery (19%; 95% CI = 16%-23%). Prevalence of maternal GBS colonization showed no significant difference between the two IPTp regimens (mefloquine-IPTp: 67 of 366 women = 18%; 95% CI = 14%-22%; sulfadoxine/pyrimethamine-IPTp: 39 of 183 women = 21%; 95% CI = 15%-27%). Risk factor analysis for GBS colonization demonstrated a significant association with illiteracy (adjusted OR = 2.03; 95% CI = 1.25-3.30). GBS colonization had no impact on birth outcome, anaemia at delivery, gestational age and birth weight. Conclusions: Sulfadoxine/pyrimethamine did not reduce colonization rates when used as the IPTp drug during pregnancy. Illiteracy was associated with GBS colonization.

引用

页码：1898 / 1902

页数：5

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