早产儿侵袭性B族链球菌感染疾病分布特点与血清分型研究

Distribution and serotyping of invasive group B streptococcal infections in premature infants

目的探讨对早产儿侵袭性B族链球菌感染疾病分布特点与血清分型,为早产儿侵袭性GBS感染的预防和治疗提供参考。方法选取2016年1月-2018年5月在医院诊治的侵袭性GBS感染早产儿60例,采集患儿痰液、血液分泌物等标本进行病原菌分离培养、菌株鉴定,采用乳胶凝集法对GBS血清分型进行检测。结果患儿诊断肺炎7例、败血症14例、化脓性脑膜炎6例、肺炎合并败血症13例、败血症合并化脓性脑膜炎7例、肺炎合并败血症及化脓性脑膜炎13例,分别占11.67%、23.33%、10.00%、21.67%、11.67%、21.67%;肺炎患儿主要以发热及气促为临床表现,败血症以发热为主要临床表现,化脓性脑膜炎主要以发热、呼吸困难、四肢肌张力高为临床表现;患儿检出的60株GBS血清型分别为Ia型6株、Ib型8株、III型37株、V型2株,分别占10.00%、13.33%、61.67%、3.33%,以III型为主;败血症、化脓性脑膜炎、肺炎合并败血症、败血症合并化脓性脑膜炎、肺炎合并败血症及化脓性脑膜炎均以III型为主,分别占57.14%、83.33%、69.23%、55.56%、69.23%;早发型和晚发型GBS均以III型为主,血清分型比较差异无统计学意义(P>0.05)。结论早产儿侵袭性B族链球菌感染疾病以败血症、肺炎合并败血症、化脓性脑膜炎等多种疾病合并多见,血清分型均以III型为主,血清分型与疾病临床感染分型无关。

Objective To investigate the distribution and serotyping of invasive group B streptococcal infections in premature infants,and to provide reference for the prevention and treatment of invasive GBS infections in premature infants.Methods A total of 60 premature infants with invasive GBS infection diagnosed and treated in hospital from January 2016 to May 2018 were selected.Specimens of sputum and blood secretion were collected for isolation,culture and identification of pathogenic bacteria.Serotyping of GBS was detected by latex agglutination method.Results Seven cases of pneumonia,14 cases of sepsis,6 cases of purulent meningitis,13 cases of pneumonia complicated with sepsis,7 cases of sepsis complicated with purulent meningitis,13 cases of pneumonia complicated with sepsis and purulent meningitis were diagnosed,accounting for 11.67%,23.33%,10.00%,21.67%,11.67%,21.67%,respectively.Fever and shortness of breath were the main clinical manifestations of pneumonia,and fever was the main clinical manifestation of sepsis.The main clinical manifestations of purulent meningitis were fever,dyspnea and high muscle tension of extremities.The 60 serotypes of GBS were type Ia 6 strains,type Ib 8 strains,type III 37 strains and type V 2 strains,accounting for 10.00%,13.33%,61.67%and 3.33%respectively,mainly type III.Sepsis,purulent meningitis,pneumonia combined with sepsis,septic meningitis and pneumonia combined with septic meningitis.Septicemia and purulent meningitis were predominantly type III,accounting for 57.14%,83.33%,69.23%,55.56%,69.23%,respectively;early and late GBS were predominantly type III,with no significant difference in serotype(P>0.05).Conclusion Infectious diseases of invasive group B Streptococcus in premature infants are mainly septicemia,pneumonia with sepsis and purulent meningitis.Serotype III is the main serotype.Serotyping is not related to clinical infection.