Publication: Selección de un probiótico para la erradicación de "Streptococcus agalactiae" durante el embarazo
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2019-04-29
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Universidad Complutense de Madrid
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Abstract
La sepsis neonatal contribuye sustancialmente a la morbilidad y la mortalidadneonatal, y constituye un problema de salud pública muy relevante en todo el mundo.De acuerdo con la edad en la que se inician los síntomas, la sepsis neonatal se divide ensepsis de inicio temprano (EOS) y sepsis de inicio tardío (LOS). Tradicionalmente se haconsiderado que las EOS refleja infecciones transplacentarias o ascendentes del tractogenitourinario materno mientras que las LOS se asocian con infecciones nosocomialeso adquiridas en la comunidad, con una incidencia máxima entre los días 10 y 22 despuésdel nacimiento.Streptococcus agalactiae (Streptococcus del grupo B, GBS, EGB) es uno de losmicroorganismos más frecuentemente implicados en casos graves de EOS. Mujeres,hombres y niños de todas las edades pueden estar colonizados de manera asintomáticapor este microorganismo, que utiliza el tracto gastrointestinal, la vagina y la uretra comoprincipales reservorios. La tasa de colonización materna generalmente oscila entre el 12y el 28%. El escrutinio recto-vaginal en la semana 35-38 de embarazo, y la subsiguienteaplicación de la profilaxis antibiótica intraparto (IAP) en aquellas madres positivas, esla estrategia más común para prevenir las infecciones neonatales por GBS. Sin embargo,dicha estrategia no previene los abortos y nacimientos prematuros relacionados con elGBS puede conducir a tasas crecientes de resistencia a antibióticos entremicroorganismos clínicamente relevantes, y tiene un impacto muy negativo en laadquisición, composición y desarrollo de la microbiota infantil. Las vacunas frente alGBS no están disponibles en la actualidad y, por lo tanto, existe la necesidad deestrategias alternativas para evitar la colonización por GBS durante el embarazo. En estecontexto, el objetivo general de esta Tesis Doctoral fue la selección de una cepaprobiótica segura con la capacidad para erradicar el GBS de los tractos intestinal ygenitourinario de las mujeres embarazadas.Para..
Neonatal sepsis contributes substantially to neonatal morbidity and mortality, andis a major global public health challenge worldwide. According to the age of onset,neonatal sepsis is divided into early-onset sepsis (EOS) and late-onset sepsis (LOS).EOS has been variably defined based on the age at onset, with bacteremia or bacterialmeningitis occurring at ≤72 h in infants hospitalized in the neonatal intensive care unitversus <7 days in term infants. EOS reflects transplacental or ascending infections fromthe maternal genitourinary tract, whereas LOS is associated with the postnatalnosocomial or community environments, with a peak incidence reported to be betweendays 10 and 22 after birth.Streptococcus agalactiae (Group B Streptococci, GBS) is one of themicroorganisms most frequently involved in severe neonatal EOS cases. Women, menand children of all ages can be asymptomatically colonized with GBS, acting thegastrointestinal tract, vagina and urethra as reservoirs. The maternal colonization rateusually ranges from 12 to 28%. Recto-vaginal GBS screening at week 35-38 ofpregnancy, and subsequent intrapartum antibiotic prophylaxis (IAP) to positive mothers,is the most common strategy used to prevent neonatal GBS neonatal infections.However, such strategy does not prevent GBS-related abortions, stillbirths and pretermbirths, may lead to increasing rates of antibiotic resistance among clinically relevantmicroorganisms, and has a very negative impact on the acquisition, composition anddevelopment of the infant microbiota. GBS vaccines are not available at present and,therefore, there is a need for alternative strategies to avoid GBS colonization duringpregnancy. In this context, the general objective of this PhD Thesis was the selection ofa safe probiotic strain with the ability to eradicate GBS from the intestinal andgenitourinary tracts of pregnant women...
Neonatal sepsis contributes substantially to neonatal morbidity and mortality, andis a major global public health challenge worldwide. According to the age of onset,neonatal sepsis is divided into early-onset sepsis (EOS) and late-onset sepsis (LOS).EOS has been variably defined based on the age at onset, with bacteremia or bacterialmeningitis occurring at ≤72 h in infants hospitalized in the neonatal intensive care unitversus <7 days in term infants. EOS reflects transplacental or ascending infections fromthe maternal genitourinary tract, whereas LOS is associated with the postnatalnosocomial or community environments, with a peak incidence reported to be betweendays 10 and 22 after birth.Streptococcus agalactiae (Group B Streptococci, GBS) is one of themicroorganisms most frequently involved in severe neonatal EOS cases. Women, menand children of all ages can be asymptomatically colonized with GBS, acting thegastrointestinal tract, vagina and urethra as reservoirs. The maternal colonization rateusually ranges from 12 to 28%. Recto-vaginal GBS screening at week 35-38 ofpregnancy, and subsequent intrapartum antibiotic prophylaxis (IAP) to positive mothers,is the most common strategy used to prevent neonatal GBS neonatal infections.However, such strategy does not prevent GBS-related abortions, stillbirths and pretermbirths, may lead to increasing rates of antibiotic resistance among clinically relevantmicroorganisms, and has a very negative impact on the acquisition, composition anddevelopment of the infant microbiota. GBS vaccines are not available at present and,therefore, there is a need for alternative strategies to avoid GBS colonization duringpregnancy. In this context, the general objective of this PhD Thesis was the selection ofa safe probiotic strain with the ability to eradicate GBS from the intestinal andgenitourinary tracts of pregnant women...
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Tesis de la Universidad Complutense de Madrid, Facultad de Veterinaria, Departamento de Nutrición y Ciencia de los Alimentos, leída el 11-02-2019