全球B群链球菌流行病学及血清型分布

Review of global epidemiology and serotype distribution of group B streptococcus

B群链球菌(group B streptococcus,GBS)也称无乳链球菌(Streptococcus agalactiae),是引发女性生殖道感染的重要原因之一,同时也引发胎膜早破、宫内感染等疾病,导致早产及晚期流产等,并可通过脐带或产道传染给新生儿,已成为新生儿感染的一个主要原因。根据荚膜多糖不同可分为10个血清型:Ⅰa、Ⅰb、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ、Ⅷ和Ⅸ型。据最新的研究报道,全球37个国家的73 791名孕妇中GBS的感染率平均为17. 9%,非洲最高为22. 4%,美洲为19. 7%,欧洲为19. 0%,东南亚最低为11. 1%。全球由侵袭性GBS引起婴幼儿(0~89 d)的感染中,非洲地区最高为1. 21/1 000活产儿,东南亚最低为0. 02/1 000活产儿。尽管全球各国流行血清型分布有一定的差异,但主要引起GBS疾病的血清型分布也基本一致,主要为Ⅲ、Ⅰa、Ⅰb、Ⅱ和Ⅴ五个血清型,可引起90%以上的婴幼儿侵袭性疾病。本文通过综述全球GBS流行病学及血清型的流行分布情况,为国内GBS候选疫苗的开发选型提供参考。

Group B streptococcus(GBS)is also known as Streptococcus agalactiae. It is one of the important reasons for reproductive tract infection in females,which also causes premature rupture of membranes and intrauterine infection,resulting in premature birth,late abortion and other diseases and is infected to newborns through the umbilical cord or birth canal,thus has become a major reason for neonatal infection. Based on the capsular polysaccharide,GBS is divided into ten serotypes,i. e. Ⅰ a,Ⅰ b,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ,Ⅶ,Ⅷ and Ⅸ. The latest research reports a mean GBS infection rate of 17. 9% among 73 791 pregnant women in 37 countries. The infection rate is the highest in Africa,which is 22. 4%,while is 19. 7% in America and 19% in Europe,and the lowest in Southeast Asia(11. 1%). However,the infection rate of invasive GBS in young infant(aged 0 ~ 89 d)was the highest in Africa(1. 21/1 000 live births)and the lowest in Southeast Asia(0. 02/1 000 live births). Although there are some differences in the global distribution of epidemic serotypes,the major serotypes causing the GBS-associated diseases are basically in agreement in distribution,which are mainly serotypes Ⅲ,Ⅰa,Ⅰb,Ⅱ and Ⅴ,resulting in more than 90% of invasive diseases in young infants.This paper reviews the global epidemiology and serotype distribution of GBS and provides a reference for development of domestic candidate GBS vaccine.