Detección e identificación de Streptococcus agalactiae en gestantes: aspectos relevantes y revisión narrativa de la literatura

Streptococcus agalactiae or Group B Streptococcus (GBS) is a relevant pathogen in perinatal health and is the leading cause of early onset infections with high lethality and late onset infections causing long term neurological sequels and substantial disabilities. Maternal colonization is the main risk factor for the early onset disease which can be prevented using intrapartum prophylaxis. The culture-based prenatal screening is the main diagnosis tool for detection of colonized pregnant women at risk. Aim: This review provides an update on the GBS disease and its effects focusing on recommendations to improve the GBS detection and identification with particular emphasis on the cutting-edge molecular diagnostic tools. This also aims to improve the limited infection control measures because of the poor understanding of these aspects. Methodology: To identify relevant literature a search on four databases was performed spanning studies over the last decade (up to 2023). Eighty-two papers were selected for this narrative review in accordance to SANRA guidelines. Results: Relevant aspects of the microbiology and epidemiology are discussed and particularly the limitations of the culture-based prenatal screening and the challenges associated with bacterial detection and identification using novel molecular tests. Conclusions: Prenatal screening based on vaginal-rectal culture has limitations and variability resulting in low sensitivity and poor outcomes. Molecular diagnosis has shown higher sensitivity and specificity over the culture and should be included in the routine testing to improve detection of maternal colonization allowing the effective intrapartum prophylaxis and prevention of neonatal infections.