Epidemiological observations of invasive group B Streptococcus infections in six major hospitals in Peninsular Malaysia

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.

新生儿GBS感染所致化脓性脑膜炎中血清维生素D和炎性细胞因子的表达及意义

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。

孕妇孕晚期生殖道GBS感染对胎膜早破、妊娠结局影响

目的:院内妊娠晚期孕妇生殖道B族链球菌(GBS)感染情况调查并探究对胎膜早破、妊娠结局的影响。方法:选取2021年6月-2023年7月于本院定期产前检查的妊娠晚期孕妇3970例GBS感染检测,根据感染情况分为感染组和非感染组,比较两组胎膜早破发生率及妊娠不良结局。结果:3970例孕妇中103例GBS感染,感染率2.6%,纳入感染组,非感染孕妇中随机选取103例纳入非感染组;感染组年龄≤30岁组感染率(68.0%)高于>30~35岁组及>35岁组,感染组胎膜早破发生率(18.5%)高于非感染组(4.9%),绒毛膜羊膜炎(6.8%)、新生儿肺炎(13.6%)、胎儿生长发育迟缓(8.7%)、新生儿感染(7.8%)、胎儿宫内窘迫(9.7%)发生率均高于非感染组(0、4.9%、1.0%、1.0%、1.9%)(均P<0.05);两组产妇分娩期发热、新生儿黄疸发生率未见差异(P>0.05)。结论:孕晚期孕妇发生GBS感染增加胎膜早破及不良妊娠结局发生风险,临床应及时采取措施治疗干预。

GBS、衣原体联合解脲支原体检测对胎膜早破患者妊娠结局的预测作用

目的 研究B族链球菌(GBS)、衣原体联合解脲支原体(UU)检测对胎膜早破患者妊娠结局的预测作用。方法 选取上海交通大学医学院附属新华医院2021年2月至2023年1月收治的胎膜早破产妇168例为观察组,另选取同期进行孕检且结果正常的165名孕妇为对照组。对比两组GBS、衣原体、UU阳性率;分析GBS、衣原体、UU单一检测对观察组不良妊娠结局的预测结果;分析GBS、衣原体、UU三者联合对观察组孕妇不良妊娠结局的预测结果。结果 观察组GBS阳性率、衣原体阳性率、UU阳性率均比对照组高,差异均有统计学意义(P<0.05)。GBS阴性122例,GBS阳性46例,GBS阳性胎膜早破孕妇不良妊娠结局发生率比对照组高,差异有统计学意义(P<0.05)。衣原体阴性128例,衣原体阳性40例,衣原体阳性胎膜早破孕妇不良妊娠结局发生率比对照组高,差异有统计学意义(P<0.05)。UU阴性117例,UU阳性51例,UU阳性胎膜早破孕妇不良妊娠结局发生率比对照组高,差异有统计学意义(P<0.05)。168例胎膜早破孕妇中,GBS、衣原体和UU均为阴性117例,GBS、衣原体和UU为单一一个或两个为阳性11例,GBS、衣原体和UU均为阳性40例;GBS、衣原体和UU均为阳性胎膜早破孕妇不良妊娠结局发生率均比单一或两个感染及阴性胎膜早破孕妇高,差异有统计学意义(P<0.05)。结论 胎膜早破孕妇的GBS、衣原体和UU阳性率均高于正常妊娠孕妇,且GBS、衣原体和UU联合检测可更准确地预测母体和胎儿不良结局。

围产期孕妇GBS感染情况及与不良妊娠结局及新生儿结局的相关性

目的:分析围产期孕妇B族链球菌(GBS)感染情况及其与不良妊娠结局及新生儿结局的相关性。方法:选取2021年11月—2023年3月在郑州市妇幼保健院就诊的1590例孕36~42周的孕妇作为研究对象,检测并统计围产期孕妇的GBS感染状况,并根据GBS感染情况,将孕妇进行分组。采用logistic回归分析围产期孕妇感染GBS的影响因素,比较两组孕妇的不良妊娠结局,对比两组的新生儿结局。结果:本研究的1590例围产期孕妇中,共有84例(5.28%)GBS为阳性,1506例(94.72%)GBS为阴性。阳性组及阴性组孕妇的平均年龄、平均孕周、平均产次等资料相比,差异无统计学意义(P>0.05);而两组孕妇的孕早期体质指数(BMI)、存在阴道炎、妊娠期糖耐量异常等资料相比,差异有统计学意义(t/χ^(2)=9.373、35.860、22.236,P<0.05)。logistic多因素回归分析结果显示,孕早期BMI、存在阴道炎、妊娠期糖耐量异常为影响围产期孕妇感染GBS的独立危险因素(P<0.05)。阳性组孕妇发生胎膜早破、宫内感染、产褥感染、产后出血等的概率均明显高于阴性组,差异有统计学意义(χ^(2)=6.939、24.067、27.741、35.902,P<0.05)。阳性组发生胎儿宫内窘迫、早产、新生儿肺炎、脑膜炎、败血症、病理性黄疸等的概率均明显高于阴性组,差异有统计学意义(χ^(2)=5.434、52.989、9.394、17.940、17.940、7.354,P<0.05)。结论:围产期孕妇出现GBS感染可明显增加不良妊娠结局的发生风险,因此,应对围产期孕妇开展GBS常规筛查,以保障母婴安全。若孕妇感染GBS,应尽早干预,以改善不良妊娠结局。

妊娠晚期阴道微生态改变与GBS感染的关系探究

目的:探讨妊娠晚期阴道微生态改变与B族链球菌(GBS)感染的关系。方法:选取2022年1月—2023年1月九江市妇幼保健院收治的疑似GBS感染的妊娠晚期孕妇80例,将生殖道GBS检测阳性的妊娠晚期孕妇40例纳入阳性组,另将生殖道GBS检测阴性的妊娠晚期孕妇40例纳入阴性组。比较两组患者阴道微生态指标(功能学指标、阴道菌群密集度、阴道菌群多样性、阴道清洁度、Nugent评分),采用多因素logistic回归分析妊娠晚期GBS感染与阴道微生态改变的相关性。结果:单因素分析结果显示,阳性组过氧化氢(H_(2)O_(2))、白细胞酯酶(LE)、唾液酸苷酶(SNA)、β-N-乙酰氨基葡萄糖苷酶(NAG)阳性率均高于阴性组,pH值、阴道清洁度、阴道菌群密集度、阴道菌群多样性异常率及BV诊断率均高于阴性组(P<0.05)。多因素logistic回归分析结果显示,低H_(2)O_(2)、高LE、高pH值、阴道清洁度异常、高Nugent评分是GBS感染的独立危险因素(P<0.05)。结论:阴道微生态改变与GBS感染密切相关,临床应重视对妊娠晚期孕妇H_(2)O_(2)、LE、pH值、阴道清洁度及Nugent评分的评估,以便对GBS感染进行早期诊断和干预。

PCT、IGF-1及HBP与新生儿GBS感染所致化脓性脑膜炎的关系

目的 探讨新生儿B族链球菌(GBS)感染所致化脓性脑膜炎(PM)血清和脑脊液中降钙素原(PCT)、胰岛素样生长因子(IGF)-1及肝素结合蛋白(HBP)的表达水平及临床意义。方法 选取2019年5月至2023年5月衡水市人民医院收治的44例因CBS感染的PM新生儿作为PM组,并选取同期疑似PM的新生儿44例作为对照组,比较两组及PM组不同病情程度患儿、不同预后患儿血清和脑脊液中降钙素原(PCT)、胰岛素样生长因子(IGF)-1及肝素结合蛋白(HBP)表达水平;治疗结束后,利用ROC分析血清及脑脊液PCT、IGF-1及HBP水平单项及多项联合预测新生儿GBS所致PM患儿的预后价值。结果PM组血清PCT、HBP水平均高于对照组,IGF-1水平低于对照组,脑脊液PCT、HBP、IGF-1水平均高于对照组,差异均有统计学意义(P<0.05)。重症组血清PCT、HBP水平均高于轻症组,IGF-1水平低于轻症组,脑脊液PCT、IGF-1、HBP水平均高于轻症组,差异均有统计学意义(P<0.05)。44例PM患儿预后不良发生率为27.27%,预后不良组血清PCT、HBP水平均高于预后良好组,IGF-1水平低于预后良好组,脑脊液PCT、IGF-1、HBP水平均高于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,血清及脑脊液PCT、IGF-1、HBP水平单项均具有预测GBS感染所致PM患儿的预后价值(P<0.05)。血清指标联合预测与脑脊液指标联合预测AUC值比较差异无统计学意义(P>0.05)。结论 血清和脑脊液中PCT、IGF-1、HBP表达水平变化与GBS所感PM新生儿病情程度及预后相关,可对病情程度及预后进行评估和预测。

Disease burden,antimicrobial resistance and molecular characterization of invasive group B Streptococcus among non-pregnant adults in Malaysia:A protocol study

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.

Vaginal Carriage of Group B Streptococcus in Pregnant Women in Rural Areas in Senegal

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.

妊娠期孕妇GBS感染及预防性抗生素干预对妊娠结局的影响

目的观察妊娠期孕妇B族链球菌(GBS)感染情况及分娩时预防性抗生素干预对妊娠结局的影响。方法将255例妊娠期孕妇按照GBS感染情况分为GBS阳性组85例及GBS阴性组170例,根据分娩时是否给与预防性抗生素干预,将GBS阳性孕妇分为抗生素组42例及对照组43例。比较GBS阳性组、GBS阴性组及抗生素组、对照组的妊娠结局(早产、胎膜早破、宫内感染、产褥感染)及新生儿结局(胎儿窘迫、新生儿感染、新生儿高胆红素血症)情况,并分析GBS菌株的耐药性。结果GBS阳性组早产、胎膜早破、宫内感染、产褥感染以及胎儿窘迫、新生儿感染、新生儿高胆红素血症发生率均高于GBS阴性组(P<0.05);抗生素组胎膜早破、宫内感染、产褥感染以及新生儿感染、新生儿高胆红素血症发生率均低于对照组(P<0.05)。GBS菌株对青霉素G、万古霉素、氨苄青霉素的敏感性最高,均为100.00%,对红霉素的耐药性最高,为43.53%。结论GBS感染会增加妊娠及新生儿不良结局,于分娩时给与预防性抗生素治疗能有效改善孕妇妊娠结局及新生儿结局。

GBS阳性合并足月胎膜早破孕妇的临床治疗及妊娠结局分析

目的探讨B族链球菌(GBS)阳性合并足月胎膜早破围分娩期抗生素预防性治疗对妊娠及新生儿结局的影响。方法选取2019年4月至2020年3月期间于南方医科大学深圳医院产科住院分娩的229例孕妇作为研究对象,所有孕妇均在孕35~37周行阴道与直肠分泌物GBS检测提示阳性。将GBS阳性且足月胎膜早破经阴道试产的60例孕妇作为研究组,将同期GBS阳性未合并胎膜早破经阴道试产的169例孕妇作为对照组。两组孕妇入院后均予围分娩期抗生素预防性治疗(IAP)。比较两组孕妇的妊娠结局(羊水污染、宫内感染、产后出血、中转剖宫产)与新生儿结局(新生儿感染、胎儿窘迫、新生儿高胆红素血症、新生儿窒息)。结果两组孕妇的年龄、孕周、孕次、产次比较,差异均无统计学意义(P>0.05);两组孕妇的羊水污染、宫内感染、产后出血、中转剖宫产的发生率比较,差异均无统计学意义(P>0.05);两组孕妇的胎儿窘迫、新生儿窒息、新生儿高胆红素血症、新生儿感染的发生率比较,差异均无统计学意义(P>0.05)。结论足月合并胎膜早破的GBS阳性孕妇存在感染高危,但GBS筛查联合及时有效的IAP治疗能有效地改善不良围产结局。

Influence of group B streptococcus and vaginal cleanliness on the vaginal microbiome of pregnant women

BACKGROUND The vaginal microbiome plays a critical role in the health of pregnant women and their newborns.Group B Streptococcus(GBS)and vaginal cleanliness significantly affect the vaginal microecosystem and are closely associated with vaginal diseases.AIM To explore the effects of GBS status and vaginal cleanliness on vaginal microecosystems.METHODS We collected 160 vaginal swabs from pregnant women and divided them into the following four groups based on GBS status and vaginal cleanliness:GBS-positive+vaginal cleanliness I–II degree,GBS-negative+vaginal cleanliness I–II degree,GBS-positive+vaginal cleanliness III–IV degree,and GBS-negative+vaginal cleanliness III–IV degree.Samples were subjected to 16S rRNA gene amplicon sequencing.RESULTS Alpha diversity analysis showed that the Shannon index did not significantly differ between the four groups.We identified significant variation in taxa abundance between the GBS-positive and GBS-negative groups and between the vaginal cleanliness I–II degree and III–IV degree groups.Principal coordinate analysis and non-metric multidimensional scaling analysis further confirmed the microbial diversity of the four groups.Moreover,the linear discriminant analysis demonstrated that Lactobacillus jensenii and Actinobacteria were strongly associated with GBS-positive status,and Lactobacillus iners,Lactobacillaceae,Lactobacillus,Lactobacillales,Bacilli and Firmicutes were closely correlated with GBS-negative status.CONCLUSION GBS status and vaginal cleanliness significantly affect vaginal microbiome differences in pregnant women.Our findings provide instructional information for clinical antibiotic treatment in pregnant women with different GBS statuses and vaginal cleanliness degrees.

Protocol for a Diagnostic Accuracy Study of Polymerase Chain Reaction for Detecting Group B <i>Streptococcus</i>Colonisation in Early Labour or with Spontaneous Ruptured Membranes

Background: Group B Streptococcus [GBS] is a bacterium which transiently colonises the genital tract and can be transmitted from mother to baby at birth. Babies colonised with GBS can develop early-onset group B streptococcus disease [EOGBSD] which can lead to extended hospital stay, disability and death. One of the primary methods for determining which women are most likely to be GBS positive at the time of birth is antenatal universal culture-based screening. Recently Polymerase Chain Reaction [PCR] screening has emerged as a point-of-care method for screening women during the intrapartum period. This study will compare the diagnostic accuracy of this new technology and antenatal culture-based screening at 35 to 37 weeks gestational age, with the reference standard of formal culture-based testing in labour. Methods: This prospective observational study will take place in an Australian hospital. Consecutive women with one or more live fetuses, intending to have a vaginal birth will be asked to participate. Planned screening for GBS colonisation using microbiological culture on a self-collected specimen will occur at 35 to 37 completed weeks gestational age as per our usual hospital policy. A PCR GBS test by Xpert GBS (Cepheid) will be performed on admission to labour ward or at the time of rupture of membranes. The reference standard will be a formal GBS culture on a combined lower vaginal and perianal swab. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios will be estimated for both antenatal screening and the intrapartum Xpert GBS (Cepheid) point-of-care test and compared to the reference standard. Results: It is expected that the study will be completed by mid to late 2020. Conclusion: This study has the potential to improve the accuracy of GBS screening of pregnant women and therefore health outcomes for mothers and babies. There is also the potential for a cost savings to the health system.

Prevalence of Group B Streptococcus among Pregnant Women in Bobo-Dioulasso (Burkina Faso)

Background: Group B Streptococcus (GBS) or Streptococcus agalactiae, which asymptomatically colonizes the female genital tract, is one of the leading causes of septicemia, meningitis and pneumonia in neonates. This study was conducted in Bobo Dioulasso, Burkina Faso to determine the prevalence of GBS colonization among pregnant women. Methods: Six hundred and eleven (611) pregnant women were screened for GBS colonization between July and December 2016. Vaginal swab samples were aseptically collected from the subjects after oral informed consent. Standard microbiological methods were used to isolate and identify GBS isolates. The antibiotic susceptibility profile of GBS isolates was assessed using the Kirby-Bauer disk diffusion method. Results: Colonization prevalence was 6.05%. No risk factors associated with the carriage rate was statistically identified. All isolates were susceptible to Amoxicillin, Ampicillin, Cefotaxime, Levofloxacin, Vancomycin and Nitrofurantoin. Resistance to antibiotics was found for erythromycin (35.14%), lincomycin (16.22%) and penicillin G (10.81%). Conclusion: Although a low carriage (6.05%) rate and isolates were susceptible to many antibiotics found in this study, a policy of systematic screening of pregnant women at least in the third trimester must be promoted.

Vaginal Colonization and Antibiotic Susceptibility Pattern of Group B <i>Streptococcus</i>Isolated from Pregnant Women in Maternitéde l’Hôpital Des Soeurs de Pauvres de Bergame de Kimbanseke, Kinshasa, Democratic Republic of Congo

Group B Streptococcus (GBS) is a Gram-positive bacterium which often colonizes maternal vaginal and rectal epitheliums and can be transmitted to the neonate during delivery. GBS infections may cause significant maternal and neonatal morbidity, including sepsis, pneumonia and meningitis. In Democratic Republic of Congo, few studies have been done on GBS colonization of pregnant women. This study was conducted in Kinshasa, Democratic Republic of Congo in order to determine the prevalence of GBS vaginal colonization among pregnant women at a gestational age of 35 - 37 weeks and the antibiotic susceptibility. Vaginal swabs of 104 pregnant women were inoculated onto Chromatic Strepto B medium. GBS isolates were identified by Gram staining, catalase test, blue-green colonies and confirmed to be GBS by Strepto B latex test kit. Antibiotic susceptibility test was done using the disc diffusion method. The prevalence of GBS vaginal colonization was 23.07%. Of the isolates studied 100%, 75%, 62.5%, 50% were sensitive to vancomycin, clindamycin, cefazolin, and erythromycin respectively. Our findings seem to suggest that maternal GBS colonization rate in this study was higher compared to a previous report from Bukavu in Democratic Republic of Congo. All isolates were found to be sensitive to vancomycin which was the most effective antibiotic for the treatment of GBS infections.

Risk Factors for Group B <i>Streptococcus</i>Colonization and Drugs Sensitivity Pattern in a Nigerian Obstetric Population

Background: Group B Streptococcus (GBS) is a major cause of bacterial infections in the perinatal period, of which colonization prevalence among Northern-Nigerian pregnant women is scarce. We attempted to determine 1) its prevalence, 2) risk factors for GBS colonization and 3) drugs-susceptibility. Methodology: This cross-sectional study involved 185 pregnant women between 35 - 37 weeks of gestation at tertiary health center of Sokoto, Nigeria. Vaginal/rectal swabs were collected, were cultured for GBS and tested for drug-susceptibilities. The study was conducted between December, 2017 and April, 2018. Results: One hundred and eighty five (185) pregnant women participated in this study. GBS vaginal-colonization-rate was 3.8% (7/185). A significance relationship was observed between GBS-colonization and socio-economic class, as 57.10% (4/7) of the GBS positive women were of low-socio economic class (p 0.035). No associations were observed between GBS-colonization and the followings: maternal age, parity, poor obstetric outcome-history. All the 7 GBS positive cultures were sensitive to Clindamycin. One was sensitive to both Clindamycin and Ceftriaxone. None was sensitive to Penicillin. Conclusion: The prevalence of GBS colonization was low in this area. Maternal socio-economic class is found to be a risk of GBS-colonization.

孕妇孕晚期GBS定植及新生儿早发型GBS感染趋势

目的观察孕晚期B族链球菌(GBS)的定植情况以及母婴垂直传播率,评估新生儿早发型GBS疾病(EOD)的发病趋势。方法选择2014年1月至2015年3月在南京医学院附属苏州母子医疗保健中心住院分娩的3487例孕妇进行阴道GBS筛查,根据美国疾病控制中心(CDC)推荐的培养筛查策略评估孕妇孕晚期GBS的定植率;对1018对孕妇-新生儿配对病例进行垂直传播筛查,追踪新生儿结局,统计母婴垂直传播率及新生儿EOD的发病率。结果在培养筛查组,3487例孕妇标本中有142例GBS培养阳性,孕妇阴道GBS定植率为4.07%;在母婴垂直传播筛查组,1018对配对标本中,有52例孕妇GBS培养阳性,其分娩新生儿有4例阳性,垂直传播率为7.69%。在1062例纳入研究的新生儿中有1例发生EOD,其发病率为0.94%。(1/1062)。结论虽然孕妇孕晚期GBS定植率低,但其垂直传播率及新生儿EOD发病率均较高。有必要于有条件的地区进一步推行GBS产前筛查和相关治疗。

妊娠晚期生殖道B族溶血性链球菌(GBS)感染及对妊娠结局的影响分析

目的:分析妊娠晚期生殖道B族溶血性链球菌(GBS)感染情况及对妊娠结局的影响。方法:500例妊娠晚期(35~37周)孕妇均行GBS细菌培养和药敏试验,根据结果将其分为阳性组(GBS细菌培养阳性)、正常组(未发生GBS感染),统计GBS感染阳性率;阳性组中,愿意接受临床治疗者为用药组,根据药敏分析结果予以治疗干预;对用药有顾虑者未予任何药物治疗者为未用药组。比较各组孕妇妊娠结局。结果:500例妊娠晚期孕妇筛查出GBS阳性84例(阳性组),占比16.8%;其中用药组55例,未用药组29例。共检出GBS 106株,其对青霉素、氨苄西林、红霉素耐药率高,对克林霉素、头孢曲松、万古霉素耐药率低。正常组、用药组、未用药组剖宫产率(29.8%、43.6%、51.7%)依次明显升高,自然分娩率(65.6%、50.9%、41.4%)依次明显降低,各组差异有统计学意义(P<0.05)。正常组、用药组羊水污染、宫内感染、胎儿窘迫、早产、产后出血、产褥感染发生率为比较无统计学意义(P>0.05),但未用药组上述并发症发生率均明显高于正常组、用药组,差异有显著性(P<0.05)。正常组、用药组新生儿败血症、新生儿GBS感染、新生儿肺炎、新生儿窒息发生率比较差异无统计学意义(P>0.05),但未用药组上述不良围产儿结局均明显高于正常组、用药组,差异有显著性(P<0.05)。结论:妊娠晚期生殖道GBS感染风险高,其可导致剖宫产率、并发症及围产儿不良结局发生率增加,针对性用药防治可改善妊娠结局。

孕晚期产前抗生素治疗B族链球菌感染对新生儿结局、血清炎症因子及B族链球菌药物敏感试验结果的影响

目的探究孕晚期产前抗生素治疗B族链球菌(GBS)感染对新生儿结局、血清炎症因子及GBS药物敏感试验结果的影响。方法选取2020年1月至2022年12月期间成都市新都区人民医院收治的60例GBS阳性孕妇所生的新生儿作为研究对象,依据孕母产前是否采用抗生素治疗分为对照组(n=29)和观察组(n=31)。对照组未给予预防性抗生素治疗,观察组根据药物敏感试验结果给予抗生素治疗。比较两组孕妇妊娠结局、新生儿结局以及新生儿出生6、24 h血清白细胞介素-6(IL-6)、降钙素原、C反应蛋白(CRP)水平,并分析新生儿GBS药物敏感试验结果。结果31例孕妇经药物敏感试验检查,对青霉素敏感度最高,故选择27例GBS感染孕妇进行青霉素治疗;对于青霉素过敏者有3例,2例应用克林霉素,1例应用头孢唑林。观察组孕妇不良妊娠结局总发生率为9.66%,低于对照组(31.03%),差异有统计学意义(P<0.05)。观察组新生儿不良结局总发生率、早发型GBS疾病(EOGBS)发生率分别为6.45%、6.45%,均低于对照组(27.59%、24.14%),差异均有统计学意义(P<0.05)。观察组新生儿出生后6 h血清IL-6、降钙素原、CRP水平分别为(76.21±7.96)pg/mL、(0.82±0.12)μg/L、(5.36±0.85)mg/L,24 h血清IL-6、降钙素原、CRP水平分别为(62.35±6.47)pg/mL、(0.61±0.09)μg/L、(3.15±0.64)mg/L,均低于对照组[6 h:(88.25±9.15)pg/mL、(0.92±0.15)μg/L、(8.25±1.63)mg/L;24 h:(66.21±7.11)pg/mL、(0.72±0.11)μg/L、(4.22±0.71)mg/L],差异均有统计学意义(P<0.05)。60例新生儿经药物敏感试验检查,对青霉素敏感度均大于90%。结论孕晚期产前抗生素治疗GBS感染,不仅可改善产妇妊娠结局,还可改善新生儿结局,降低EOGBS发生率,缓解炎症反应状态,且不影响新生儿药物敏感试验结果。

新生儿早发型GBS败血症1例并文献复习

目的介绍新生儿早发型B族溶血链球菌(GBS)败血症的临床表现、治疗及预防方法。方法报道1例血培养及脑脊液培养均为阳性的早发型GBS败血症患儿的临床表现、实验室检查及治疗经过,并进行文献复习。结果该病例为一例以化脓性脑膜炎为主要表现的早发型GBS败血症,先后经积极1周青霉素及4周万古霉素抗感染治疗,治愈出院,随访预后良好。结论 GBS是新生儿早发型败血症重要的致病菌,青霉素是治疗的首选药物,必要时也可使用万古霉素抗感染治疗,建议对孕妇开展产前GBS筛查并进行预防性治疗,尤其应对高危新生儿进行监测以减少早发型GBS败血症的发生和远期严重后遗症。免疫预防和疫苗预防有望成为更有效的预防策略。