妊娠期B族链球菌感染和治疗策略的研究进展

Research advances in group B Streptococcus infection and treatment strategies during pregnancy

B族链球菌(GBS)是B族溶血性革兰氏阳性球菌,是新生儿感染的主要原因。GBS通常定植于人体下消化道和生殖道,在妊娠期间GBS的定植使孕产妇和胎儿、新生儿容易发生各种不良后果,包括胎膜早破、绒毛膜羊膜炎、早产、死产和新生儿感染。虽然在分娩前和分娩期间预防性使用抗生素可降低早发性新生儿感染的发生率,但没有消除所有侵入性GBS感染病例。妊娠期GBS感染的预防、治疗较复杂,可能受多种因素的影响,包括致病性、宿主因素、阴道微生物、假阴性和(或)抗生素耐药性的变化。对妊娠期GBS感染机制的更深入了解将有助于开发新的治疗方法和疫苗。开发一种可在妊娠期间或妊娠前使用的安全有效疫苗仍然是该领域的主要目标。本文就妊娠相关GBS感染和治疗策略的最新进展进行综述。

Group B Streptococcus(GBS)is a group B hemolytic Gram-positive bacterium,which is the main cause of neonatal infection.GBS is usually colonized in the lower digestive tract and reproductive tract of the human body.The colonization of GBS during pregnancy makes pregnant women,fetuses and newborns prone to various adverse consequences,including premature rupture of membranes,chorioamnionitis,premature delivery,stillbirth and neonatal infection.Although prophylactic use of antibiotics before and during delivery can reduce the incidence of early neonatal infection,it doesn’t eliminate all cases of invasive GBS infection.The prevention and treatment of GBS infection during pregnancy is complex and may be influenced by a number of factors,including changes in pathogenicity,host factors,vaginal microbes,false negatives and/or antibiotic resistance.A better understanding of the mechanisms of GBS infection during pregnancy will contribute to the development of new treatments and vaccines.The development of a safe and effective vaccine that can be used during or before pregnancy remains a major goal in the field.This article will discuss recent advances in pregnancy-associated GBS infection and treatment strategies.