Objective:To address the lack of research on invasive group B Streptococcus(GBS)infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.Methods:Medical record...Objective:To address the lack of research on invasive group B Streptococcus(GBS)infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.Methods:Medical records from patients with GBS infection isolated from the sterile site,such as blood and cerebrospinal fluid from 14 July 2019 to 15 December 2020,were reviewed from six major hospitals in Peninsular Malaysia.Inclusion criteria were invasive GBS,sterile sites and non-repeated GBS isolated from the same patients in the same admission.Viable isolates were re-identified for GBS and serotyped.Results:A total of 118 patients were eligible,with a majority of non-pregnant adults(76.3%).Over half of the patients(62.7%)had underlying medical conditions,with diabetes as the most common disease,followed by respiratory disease,renal disease,cardiovascular disease and skin and soft tissue disease.The most common manifestations were sepsis,followed by soft tissue abscess,diabetic foot ulcer,wet gangrene and cellulitis.The overall mortality was 7.6%.The most common serotype was serotype桋.Conclusions:Invasive GBS infection among non-pregnant adults showed a rising trend,particularly among diabetic individuals.The study underscores the importance of reducing risk factors and highlights the necessity of developing GBS vaccination as a preventive strategy for both infants and adults.展开更多
目的检测新生儿B族链球菌(group B streptococcus,GBS)感染所致化脓性脑膜炎(purulent meningitis,PM)血清中维生素D、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(c-reactive ...目的检测新生儿B族链球菌(group B streptococcus,GBS)感染所致化脓性脑膜炎(purulent meningitis,PM)血清中维生素D、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(c-reactive protein,CRP)的表达水平,并探讨其临床价值。方法选取2017年5月至2020年5月在秦皇岛市第一医院出生的59例GBS感染的PM新生儿纳入观察组,同期59例非GBS感染的PM新生儿(晚发败血症)纳入对照组。检测所有受试者血清维生素D、CRP、IL-6、IL-10和TNF-α水平,并进行Pearson相关性分析;利用受试者操作特征(receiver operating characteristic,ROC)曲线分析血清维生素D和炎性细胞因子对新生儿GBS感染所致PM的诊断价值。统计学方法采用t检验、χ^(2)检验和Pearson相关性分析。结果观察组与对照组孕产妇胎膜早破[47.5%(28/59)与5.1%(3/59),χ^(2)=27.345]、产时窒息[52.5%(31/59)与18.6%(11/59),χ^(2)=14.787]和产褥感染[(44.1%(26/59)与(22.0%(13/59)),χ^(2)=6.473]的发生率比较,观察组明显高于对照组(P<0.05)。观察组血清维生素D水平显著低于对照组[(13.3±2.1)μg/L与(21.1±5.0)μg/L,t=11.345],IL-6[(87.1±14.5)μg/L与(63.9±11.9)μg/L,t=9.507]、IL-10[(49.6±15.2)μg/L与(29.3±10.0)μg/L,t=8.596]、TNF-α[(76.8±19.0)μg/L与(50.0±10.8)μg/L,t=9.410]和CRP[(21.5±5.0)μg/L与(13.7±3.7)μg/L,t=9.702]水平显著高于对照组(P值均<0.05)。Pearson相关性分析结果显示,观察组血清维生素D水平分别与IL-6、IL-10、TNF-α和CRP水平呈负相关(r=-0.662、-0.644、-0.564、-0.643,P<0.05);血清维生素D、IL-6、IL-10、TNF-α和CRP单独诊断GBS感染新生儿PM的曲线下面积(area under the curve,AUC)分别为0.831(95%CI:0.757~0.904)、0.887(95%CI:0.830~0.944)、0.859(95%CI:0.793~0.925)、0.888(95%CI:0.821~0.955)、0.879(95%CI:0.820~0.938),5项联合检测的AUC为0.991(95%CI:0.978~1.000)。结论GBS感染所致的PM新生儿血清中维生素D水平降低,炎性细胞因子水平增加,对于GBS感染所致的PM具有一定的辅助诊断价值。展开更多
目的分析B族链球菌(group B Streptococcus,GBS)筛查阳性孕母所分娩新生儿的转归及早期炎性指标检测的临床应用价值。方法选取2017年10月至2021年10月解放军总医院第五医学中心收治的GBS筛查阳性孕妇所分娩的135例高危新生儿为研究对象...目的分析B族链球菌(group B Streptococcus,GBS)筛查阳性孕母所分娩新生儿的转归及早期炎性指标检测的临床应用价值。方法选取2017年10月至2021年10月解放军总医院第五医学中心收治的GBS筛查阳性孕妇所分娩的135例高危新生儿为研究对象,根据孕母产前是否应用抗生素分为抗生素组(n=77)及对照组(n=58)。比较两组孕母情况、患儿一般情况、病理性黄疸发生率、不同时间点白细胞(white blood cell,WBC)计数、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平。通过受试者操作特征(receiver operating characteristic,ROC)曲线分析不同时间点WBC、CRP、PCT的临床应用价值。统计学方法采用独立样本t检验、χ^(2)检验、秩和检验。结果抗生素组新生儿炎性指标异常率明显低于对照组[26.0%(20/77)与48.3%(28/55),χ^(2)=6.311,P=0.012]。两组患儿分娩方式、羊水污染率、胎膜早破率、病理性黄疸发生率比较,差异均无统计学意义(P值均>0.05)。抗生素组6、24 h CRP水平均低于对照组[0.2(0.1,0.3)mg/L与0.2(0.1,0.4)mg/L,2.3(1.0,6.0)mg/L与4.0(2.8,10.5)mg/L,t=-3.137、-3.010,P值均<0.05]。135例高危新生儿中,发生早发型GBS败血症2例(1.5%)。48例(35.6%)患儿炎性指标异常,平均住院时间(6.3±1.3)d,均痊愈出院。生后24 h WBC及CRP联合检测对于发现新生儿感染意义最大,曲线下面积(area under the curve,AUC)为0.882。结论对GBS筛查阳性孕母分娩前应用抗生素预防治疗可以减少新生儿感染的发生,生后24 h WBC及CRP联合检测对于早期发现新生儿感染有重要意义。展开更多
目的研究足月B族链球菌(group B streptococcus,GBS)定植产妇的产程管理与围生结局。方法收集2020年10月~2021年11月在温州医科大学附属第二医院、育英儿童医院产科住院的GBS筛查阳性的足月产妇355例(GBS阳性组)和同期GBS筛查阴性的足...目的研究足月B族链球菌(group B streptococcus,GBS)定植产妇的产程管理与围生结局。方法收集2020年10月~2021年11月在温州医科大学附属第二医院、育英儿童医院产科住院的GBS筛查阳性的足月产妇355例(GBS阳性组)和同期GBS筛查阴性的足月产妇355例(GBS阴性组)的临床资料,比较产程特征、胎膜破裂持续时间及围生结局。结果与GBS阴性组比较,GBS阳性组产时发热、产后发热、住院时间、组织学绒毛膜羊膜炎、新生儿转科及新生儿败血症发生率均升高(P<0.05)。两者在产程发动方式、分娩方式、胎膜早破、临床绒毛膜羊膜炎、胎膜破裂持续时间、第一产程、活跃期、第二产程、产后出血、会阴损伤、新生儿出生体重、新生儿性别、胎儿宫内窘迫、新生儿黄疸方面比较,差异无统计学意义(P>0.05)。GBS阳性组中,根据不同胎膜破裂持续时间分为<12h组、≥12且<24h组和≥24h组。<12h组作为对照组。与对照组比较,≥12且<24h组第一产程、活跃期、第二产程、住院时间均显著长于对照组;胎膜早破及产钳助娩率高于对照组(P<0.05);≥24h组第一产程、第二产程、住院时间长于对照组,胎膜早破、产时发热、产后发热、组织学绒毛膜羊膜炎、剖宫产率均高于对照组(P<0.05)。GBS阳性组中,新生儿败血症与新生儿无败血症在产程发动方式、分娩方式、胎膜破裂方式、组织学绒毛膜羊膜炎、胎膜破裂时间及产程方面比较,差异无统计学意义(P>0.05)。结论GBS定植不影响产程进展,但增加母婴感染风险。GBS定植的足月产妇在胎膜破裂后24h内分娩,可缩短产程,减少分娩并发症,有利于改善不良围生结局。展开更多
基金the Research Grants from Universiti Putra Malaysia(UPM/800-3/3/1/GPB/2020/9683800)Ministry of Higher Education under the Fundamental Research Grant Scheme(FRGS/1/2023/WAB04/UPM/01/4).
文摘Objective:To address the lack of research on invasive group B Streptococcus(GBS)infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.Methods:Medical records from patients with GBS infection isolated from the sterile site,such as blood and cerebrospinal fluid from 14 July 2019 to 15 December 2020,were reviewed from six major hospitals in Peninsular Malaysia.Inclusion criteria were invasive GBS,sterile sites and non-repeated GBS isolated from the same patients in the same admission.Viable isolates were re-identified for GBS and serotyped.Results:A total of 118 patients were eligible,with a majority of non-pregnant adults(76.3%).Over half of the patients(62.7%)had underlying medical conditions,with diabetes as the most common disease,followed by respiratory disease,renal disease,cardiovascular disease and skin and soft tissue disease.The most common manifestations were sepsis,followed by soft tissue abscess,diabetic foot ulcer,wet gangrene and cellulitis.The overall mortality was 7.6%.The most common serotype was serotype桋.Conclusions:Invasive GBS infection among non-pregnant adults showed a rising trend,particularly among diabetic individuals.The study underscores the importance of reducing risk factors and highlights the necessity of developing GBS vaccination as a preventive strategy for both infants and adults.
文摘目的检测新生儿B族链球菌(group B streptococcus,GBS)感染所致化脓性脑膜炎(purulent meningitis,PM)血清中维生素D、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(c-reactive protein,CRP)的表达水平,并探讨其临床价值。方法选取2017年5月至2020年5月在秦皇岛市第一医院出生的59例GBS感染的PM新生儿纳入观察组,同期59例非GBS感染的PM新生儿(晚发败血症)纳入对照组。检测所有受试者血清维生素D、CRP、IL-6、IL-10和TNF-α水平,并进行Pearson相关性分析;利用受试者操作特征(receiver operating characteristic,ROC)曲线分析血清维生素D和炎性细胞因子对新生儿GBS感染所致PM的诊断价值。统计学方法采用t检验、χ^(2)检验和Pearson相关性分析。结果观察组与对照组孕产妇胎膜早破[47.5%(28/59)与5.1%(3/59),χ^(2)=27.345]、产时窒息[52.5%(31/59)与18.6%(11/59),χ^(2)=14.787]和产褥感染[(44.1%(26/59)与(22.0%(13/59)),χ^(2)=6.473]的发生率比较,观察组明显高于对照组(P<0.05)。观察组血清维生素D水平显著低于对照组[(13.3±2.1)μg/L与(21.1±5.0)μg/L,t=11.345],IL-6[(87.1±14.5)μg/L与(63.9±11.9)μg/L,t=9.507]、IL-10[(49.6±15.2)μg/L与(29.3±10.0)μg/L,t=8.596]、TNF-α[(76.8±19.0)μg/L与(50.0±10.8)μg/L,t=9.410]和CRP[(21.5±5.0)μg/L与(13.7±3.7)μg/L,t=9.702]水平显著高于对照组(P值均<0.05)。Pearson相关性分析结果显示,观察组血清维生素D水平分别与IL-6、IL-10、TNF-α和CRP水平呈负相关(r=-0.662、-0.644、-0.564、-0.643,P<0.05);血清维生素D、IL-6、IL-10、TNF-α和CRP单独诊断GBS感染新生儿PM的曲线下面积(area under the curve,AUC)分别为0.831(95%CI:0.757~0.904)、0.887(95%CI:0.830~0.944)、0.859(95%CI:0.793~0.925)、0.888(95%CI:0.821~0.955)、0.879(95%CI:0.820~0.938),5项联合检测的AUC为0.991(95%CI:0.978~1.000)。结论GBS感染所致的PM新生儿血清中维生素D水平降低,炎性细胞因子水平增加,对于GBS感染所致的PM具有一定的辅助诊断价值。
文摘目的分析B族链球菌(group B Streptococcus,GBS)筛查阳性孕母所分娩新生儿的转归及早期炎性指标检测的临床应用价值。方法选取2017年10月至2021年10月解放军总医院第五医学中心收治的GBS筛查阳性孕妇所分娩的135例高危新生儿为研究对象,根据孕母产前是否应用抗生素分为抗生素组(n=77)及对照组(n=58)。比较两组孕母情况、患儿一般情况、病理性黄疸发生率、不同时间点白细胞(white blood cell,WBC)计数、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平。通过受试者操作特征(receiver operating characteristic,ROC)曲线分析不同时间点WBC、CRP、PCT的临床应用价值。统计学方法采用独立样本t检验、χ^(2)检验、秩和检验。结果抗生素组新生儿炎性指标异常率明显低于对照组[26.0%(20/77)与48.3%(28/55),χ^(2)=6.311,P=0.012]。两组患儿分娩方式、羊水污染率、胎膜早破率、病理性黄疸发生率比较,差异均无统计学意义(P值均>0.05)。抗生素组6、24 h CRP水平均低于对照组[0.2(0.1,0.3)mg/L与0.2(0.1,0.4)mg/L,2.3(1.0,6.0)mg/L与4.0(2.8,10.5)mg/L,t=-3.137、-3.010,P值均<0.05]。135例高危新生儿中,发生早发型GBS败血症2例(1.5%)。48例(35.6%)患儿炎性指标异常,平均住院时间(6.3±1.3)d,均痊愈出院。生后24 h WBC及CRP联合检测对于发现新生儿感染意义最大,曲线下面积(area under the curve,AUC)为0.882。结论对GBS筛查阳性孕母分娩前应用抗生素预防治疗可以减少新生儿感染的发生,生后24 h WBC及CRP联合检测对于早期发现新生儿感染有重要意义。
文摘目的研究足月B族链球菌(group B streptococcus,GBS)定植产妇的产程管理与围生结局。方法收集2020年10月~2021年11月在温州医科大学附属第二医院、育英儿童医院产科住院的GBS筛查阳性的足月产妇355例(GBS阳性组)和同期GBS筛查阴性的足月产妇355例(GBS阴性组)的临床资料,比较产程特征、胎膜破裂持续时间及围生结局。结果与GBS阴性组比较,GBS阳性组产时发热、产后发热、住院时间、组织学绒毛膜羊膜炎、新生儿转科及新生儿败血症发生率均升高(P<0.05)。两者在产程发动方式、分娩方式、胎膜早破、临床绒毛膜羊膜炎、胎膜破裂持续时间、第一产程、活跃期、第二产程、产后出血、会阴损伤、新生儿出生体重、新生儿性别、胎儿宫内窘迫、新生儿黄疸方面比较,差异无统计学意义(P>0.05)。GBS阳性组中,根据不同胎膜破裂持续时间分为<12h组、≥12且<24h组和≥24h组。<12h组作为对照组。与对照组比较,≥12且<24h组第一产程、活跃期、第二产程、住院时间均显著长于对照组;胎膜早破及产钳助娩率高于对照组(P<0.05);≥24h组第一产程、第二产程、住院时间长于对照组,胎膜早破、产时发热、产后发热、组织学绒毛膜羊膜炎、剖宫产率均高于对照组(P<0.05)。GBS阳性组中,新生儿败血症与新生儿无败血症在产程发动方式、分娩方式、胎膜破裂方式、组织学绒毛膜羊膜炎、胎膜破裂时间及产程方面比较,差异无统计学意义(P>0.05)。结论GBS定植不影响产程进展,但增加母婴感染风险。GBS定植的足月产妇在胎膜破裂后24h内分娩,可缩短产程,减少分娩并发症,有利于改善不良围生结局。
