新生儿B组链球菌感染性疾病的研究

A Study of Neonatal Group B Streptococcal Infection

目的 了解 B组链球菌 (GBS)在我院新生儿病房感染性疾病中的发病情况。 方法 在新生儿感染及有产科危险因素者 141例中 ,取血标本 93例、脑脊液标本 6例做细菌培养。同时取血标本 141例、尿标本 6 5例及脑脊液标本 6例用对流免疫电泳 (CIE)方法进行 GBS抗原检测。 结果93例血和 6例脑脊液培养中仅 1例 GBS阳性 ,GBS血抗原阳性者 2 7例 (19.1% ) ,各为化脓性脑膜炎2例、败血症 6例、感染性肺炎 12例、脐炎 2例、早产儿生活能力低下 5例 ;早发感染 2 0例 (74% ) ,晚发感染 7例 (2 6 % )。 1例化脓性脑膜炎患儿的血和脑脊液及其母阴道分泌物均培养出同型的 GBS( / R型 ) ,DNA基因检测亦相同 ,证实为母婴传播。本组均用青霉素、氨苄青霉素或头孢类抗生素治疗 ,疗效佳 ,无一例死亡。对 34例入院当日的尿标本进行抗菌物质的检测 ,32例阳性。 结论 GBS是新生儿细菌感染的致病菌之一 ,CIE方法检测 GBS抗原敏感性高、特异性良好 。

Objective To determine the incidence of bacterial infection in neonates due to group B streptococcus(GBS) in our hospital. Methods The specimens were collected from 141 neonatal infants with infectious symptoms and maternal risk factors. 93 blood and 6 CSF samples were performed bacterial culture.141 blood sera, 65 urine and 6 CSF samples were tested for GBS antigen by countercurrent immunoelectrophoresis(CIE). Results In 141 neonatal infants, 27 cases were found GBS polysaccharide antigen positive(19.1%). Blood and CSF culture were positive only in 1 case. In 27 cases , there were 2 cases with meningitis, 6 cases with sepsis, 12 cases with infectious pneumonia , 2 cases with omphalitis, and 5 cases were only premature babies .There were 20 cases of early onset disease and 7 cases of late onset disease. There was one case that the same serotype(III/R) and DNA genes of GBS were found in the blood and CSF cultures of baby and his mother's vaginal swab culture . The antibacterial activity was found in the urine specimens of 32/34 cases in the first day on admission by micrococcus inhibition test, only 2 cases were negative. All patients were treated with Penicillin and Ampicillin. Conclusions (1)GBS is one of the pathogens in neonatal infection.(2)CIE method for identification of GBS polysaccharide antigen is sensitive and specific.(3)Penicillin was the first choice for neonatal GBS infection.