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
and pili genes are also investigated.Methods:This multicentre,prospective,observational study is conducted in seven major tertiary hospitals in Malaysia among non-pregnant adults.Simultaneously,a retrospective study i...and pili genes are also investigated.Methods:This multicentre,prospective,observational study is conducted in seven major tertiary hospitals in Malaysia among non-pregnant adults.Simultaneously,a retrospective study is conducted in the selected hospitals with similar approaches.GBS isolates are subjected to phenotyping,serotyping by multiplex PCR,antimicrobial susceptibility testing and PCR-detection of GBS virulence and pilus genes.Seven housekeeping genes are amplified and sequenced for multi-locus sequence typing.Discussion:Findings from the study may contribute to the management of clinical practice to diagnose and prevent GBS related diseases in a timely manner.Prudent use of antibiotics is encouraged by monitoring antimicrobial resistance.展开更多
Vaginal carriage of Group B Streptococcus (GBS) is a maternal and child health issue. Our objective was to determine the prevalence of GBS carriage;identify the factors associated with this carriage and determine the ...Vaginal carriage of Group B Streptococcus (GBS) is a maternal and child health issue. Our objective was to determine the prevalence of GBS carriage;identify the factors associated with this carriage and determine the antibiotic sensitivity of the isolated strains. We conducted a cross-sectional and prospective study in rural Senegal (in the health district of Sokone). Socio-demographic, clinical and gynaeco-obstetrical data were collected. Vaginal swabs were taken by the midwives on specific settings in order to test for GBS and other High Risk Vaginal Bacteria (HRVB). Antibiotic susceptibility testing was done according to the recommendations of the CA SFM/EUCAST 2020. In total, 100 pregnant women were targeted and 97 pregnant women were included. Their age ranged from 18 to 40 years with 64.9% (63/97) of participants belonging to the “20 - 30” age group. The overall prevalence of Group B Streptococcus carriage was 15.5% (15/97). However, the proportion of women with at least one high risk infectious bacteria was 29.89% (29/97). No statistically significant differences were found between GBS carriage and the potential factors studied. However, the study also looked for the presence of other high-risk bacteria and coinfections were indeed found between GBS and E. coli and Staphylococcus aureus. Antibiotic susceptibility testing shows that GBS strains were fully susceptible to penicillin G, erythromycin, clindamycin, chloramphenicol, rifampicin and vancomycin. Sensitivities to norfloxacin and gentamycin were 73.3% and 86.7% respectively. In contrast, high resistance to tetracycline (86.7%) was observed. GBS carriage remains a major public health issue because of its consequences for the mother and the newborn. Correct screening and proper monitoring of strain susceptibility remain one of the most effective means of patient management and care.展开更多
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。
基金funded by the Ministry of Higher Education under Fundamental Research Grant Scheme(FRGS/1/2023/WAB04/UPM/01/4).
文摘and pili genes are also investigated.Methods:This multicentre,prospective,observational study is conducted in seven major tertiary hospitals in Malaysia among non-pregnant adults.Simultaneously,a retrospective study is conducted in the selected hospitals with similar approaches.GBS isolates are subjected to phenotyping,serotyping by multiplex PCR,antimicrobial susceptibility testing and PCR-detection of GBS virulence and pilus genes.Seven housekeeping genes are amplified and sequenced for multi-locus sequence typing.Discussion:Findings from the study may contribute to the management of clinical practice to diagnose and prevent GBS related diseases in a timely manner.Prudent use of antibiotics is encouraged by monitoring antimicrobial resistance.
文摘Vaginal carriage of Group B Streptococcus (GBS) is a maternal and child health issue. Our objective was to determine the prevalence of GBS carriage;identify the factors associated with this carriage and determine the antibiotic sensitivity of the isolated strains. We conducted a cross-sectional and prospective study in rural Senegal (in the health district of Sokone). Socio-demographic, clinical and gynaeco-obstetrical data were collected. Vaginal swabs were taken by the midwives on specific settings in order to test for GBS and other High Risk Vaginal Bacteria (HRVB). Antibiotic susceptibility testing was done according to the recommendations of the CA SFM/EUCAST 2020. In total, 100 pregnant women were targeted and 97 pregnant women were included. Their age ranged from 18 to 40 years with 64.9% (63/97) of participants belonging to the “20 - 30” age group. The overall prevalence of Group B Streptococcus carriage was 15.5% (15/97). However, the proportion of women with at least one high risk infectious bacteria was 29.89% (29/97). No statistically significant differences were found between GBS carriage and the potential factors studied. However, the study also looked for the presence of other high-risk bacteria and coinfections were indeed found between GBS and E. coli and Staphylococcus aureus. Antibiotic susceptibility testing shows that GBS strains were fully susceptible to penicillin G, erythromycin, clindamycin, chloramphenicol, rifampicin and vancomycin. Sensitivities to norfloxacin and gentamycin were 73.3% and 86.7% respectively. In contrast, high resistance to tetracycline (86.7%) was observed. GBS carriage remains a major public health issue because of its consequences for the mother and the newborn. Correct screening and proper monitoring of strain susceptibility remain one of the most effective means of patient management and care.
