| 1. |
- Dykes, Anna-Karin, et al.
(författare)
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Chlorhexidine for prevention of neonatal colonization with group B streptococci. II. Chlorhexidine concentrations and recovery of group B streptococci following vaginal washing in pregnant women
- 1983
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 16:3, s. 167-172
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Tidskriftsartikel (refereegranskat)abstract
- The effect of a single washing of the urogenital tract with 0.5 g/l chlorhexidine was studied in 6 women in weeks 38-40 of pregnancy, among whom 5 were carriers of group B streptococci in urethra and/or cervix. The chlorhexidine concentrations varied between 25 and 200 mg/l during the first hour after washing in 5 of the 6 women, whereas one patient showed concentrations below 25 mg/l. With the exception of one patient, all individuals showed concentrations less than 25 mg/l at 3-24 h after washing. A clear suppression of the number of colony-forming units of GBS was already apparent after 60 min and was still evident 6 h after chlorhexidine washing.
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| 2. |
- Dykes, Anna-Karin, et al.
(författare)
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Chlorhexidine for prevention of neonatal colonization with group B streptococci. IV. Depressed puerperal carriage following vaginal washing with chlorhexidine during labour
- 1987
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 24:4, s. 293-297
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Tidskriftsartikel (refereegranskat)abstract
- The effect of vaginal washing with chlorhexidine acetate, 2 g/l at delivery, on the colonization of the urogenital tract with group B streptococci (GBS) 4 days later was investigated. Patients who were culture-positive for GBS in urethra and/or cervix in pregnancy weeks 32 and 36 as well as at delivery were included in a prospective study. The washing procedure was performed in 31 parturients, and 10 (32%) were culture-negative at day 4 after delivery. In contrast, only 7/47 (15%) non-washed controls were negative at day 4 (p = 0.044). The results demonstrate a prolonged suppressive effect of vaginal washing with chlorhexidine on the recovery of GBS from the urogenital tract in this highly selected patient group.
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| 3. |
- Dykes, Anna-Karin, et al.
(författare)
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Chronic carrier state in mothers of infants with group B streptococcal infections
- 1985
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Ingår i: Obstetrics and Gynecology. - 1873-233X. ; 66:1, s. 84-88
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Tidskriftsartikel (refereegranskat)abstract
- Seven of eight women who had given birth to infants with early onset or intrauterine infection caused by group B streptococci remained carriers of the same serotype of group B streptococci up to 38 months after their pregnancy. In contrast, only 34 of 88 group B streptococci carriers who had given birth to healthy infants harbored the same serotype at the 34 months' follow-up (P = .009). Among the control subjects, 29 of 71 showed increased serum levels at followup of antibodies against the serotype isolated at delivery, a significantly higher proportion compared with the mothers of infected infants/fetuses. The results indicate that mothers of group B streptococci-infected infants are chronic urogenital carriers of group B streptococci without responding immunologically against the organism.
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| 4. |
- Kvist Christensen, Karen, et al.
(författare)
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Chlorhexidine for prevention of neonatal colonization with group B streptococci. I. In vitro effect of chlorhexidine on group B streptococci
- 1983
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 16:3, s. 157-165
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Tidskriftsartikel (refereegranskat)abstract
- Forty-three strains of group B streptococci (GBS) of types Ia, Ib, II and III were tested for susceptibility to chlorhexidine in concentrations ranging from 256 to 0.25 mg/l using the agar and tube dilution methods. The strains showed minimum inhibitory concentration (MIC) values ranging from 0.5 to 1 mg/l. Serum added to the test medium (50%) increased the MIC values to 4-8 mg/l, while amniotic fluid (50%) had almost no effect, increasing the values to 1-2 mg/l. The minimum bactericidal concentration (MBC) ranged from 1 to 5 mg/l. The killing kinetics were related to the concentration of chlorhexidine and the length of exposure. For example, at a concentration of 63 mg/l, 7 h were required for a bactericidal effect in broth, as compared to 1 h at 500 mg/l chlorhexidine. 200 mg/l chlordexidine had no effect on the adherence of two GBS strains to vaginal epithelial cells, and no effect on the phagocytosis of GBS with mouse peritoneal macrophages.
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| 5. |
- Kvist Christensen, Karen, et al.
(författare)
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Reduced colonization of newborns with group B streptococci following washing of the birth canal with chlorhexidine
- 1985
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Ingår i: Journal of Perinatal Medicine. - 1619-3997. ; 13:5, s. 239-243
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Tidskriftsartikel (refereegranskat)abstract
- Possible measures for prevention of neonatal group B streptococcal (GBS) septicemia include active or passiv immunoprophylaxis and administration of penicillin to mothers and infants. In a previous study we have found GBS to be extremely sensitive to chlorhexidine. Furthermore vaginal washing with chlorhexidine diminished the recovery of GBS from parturients. In order to study the effect of chlorhexidine washing upon the colonization of newborns, a study group of chronic GBS carriers, i.e. women who were GBS positive in the 32-36 gestational week as well as during labor was selected. In 18 of these females chlorhexidine washing was performed prior to delivery while 33 chronic carriers served as controls. Screening during labor was performed in 945 consecutive patients. Cultures were collected from the external ear, throat and umbilicus of all infants within 5 minutes of birth and at day 4 of life. At birth 22% of the infants of the chlorhexidine washed mothers were colonized with GBS, in contrast to 52% of the infants from the chronic GBS carriers (p less than 0.05). The proportion of infants harboring GBS at day 4 were similar in the two groups (Tab. I). Among the 945 consecutively screened women, 164 harbored GBS and 54 (33%) of their 164 infants were colonized at birth. The colonization rate of the infants from chronic GBS carriers was significantly higher, 17 of 33 infants (p less than 0.05). This may reflect that the risk of contracting GBS by infants increases with the quantity of GBS in the birth channel.
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| 6. |
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| 7. |
- Nilsson, Gerd, et al.
(författare)
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Chlorhexidine for prevention of neonatal colonization with group B streptococci. V. Chlorhexidine concentrations in blood following vaginal washing during delivery
- 1989
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 31:3, s. 221-226
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Tidskriftsartikel (refereegranskat)abstract
- Chlorhexidine 2 g/l was applied to the vagina of 96 women during delivery, whereas 28 served as controls. Both groups were given a shower using a chlorhexidine soap, and outer washing of the outer anogenital tract was also performed in all patients using chlorhexidine 2 g/l. Using a gas chromatographic method with a detection limit of 10 ng chlorhexidine per ml blood, 10-83 ng/ml was demonstrated in 34 (35%) of the study group patients, whereas the remaining study group patients and controls showed no detectable chlorhexidine. Performing the washing a second time after 6 hours in 14 patients and a third time in 3 patients after a further 6 hours did not result in increased serum levels. It was concluded that small amounts of chlorhexidine are absorbed through the vaginal mucosa and that chlorhexidine is not accumulated in the blood on repeated usage with 6 hour intervals during delivery.
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| 8. |
- Li, Jingmei, et al.
(författare)
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Prevalence of BRCA1 and BRCA2 pathogenic variants in a large, unselected breast cancer cohort
- 2019
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 144:5, s. 1195-1204
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer patients with BRCA1/2-driven tumors may benefit from targeted therapy. It is not clear whether current BRCA screening guidelines are effective at identifying these patients. The purpose of our study was to evaluate the prevalence of inherited BRCA1/2 pathogenic variants in a large, clinically representative breast cancer cohort and to estimate the proportion of BRCA1/2 carriers not detected by selectively screening individuals with the highest probability of being carriers according to current clinical guidelines. The study included 5,122 unselected Swedish breast cancer patients diagnosed from 2001 to 2008. Target sequence enrichment (48.48 Fluidigm Access Arrays) and sequencing were performed (Illumina Hi-Seq 2,500 instrument, v4 chemistry). Differences in patient and tumor characteristics of BRCA1/2 carriers who were already identified as part of clinical BRCA1/2 testing routines and additional BRCA1/2 carriers found by sequencing the entire study population were compared using logistic regression models. Ninety-two of 5,099 patients with valid variant calls were identified as BRCA1/2 carriers by screening all study participants (1.8%). Only 416 study participants (8.2%) were screened as part of clinical practice, but this identified 35 out of 92 carriers (38.0%). Clinically identified carriers were younger, less likely postmenopausal and more likely to be associated with familiar ovarian cancer compared to the additional carriers identified by screening all patients. More BRCA2 (34/42, 81.0%) than BRCA1 carriers (23/50, 46%) were missed by clinical screening. In conclusion, BRCA1/2 mutation prevalence in unselected breast cancer patients was 1.8%. Six in ten BRCA carriers were not detected by selective clinical screening of individuals.
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