产时抗生素预防对新生儿B族链球菌感染的影响。

Effects of Intrapartum Antibiotic Prophylaxis on Neonatal Acquisition of Group B Streptococci.

作者信息

Toyofuku Meiwa, Morozumi Miyuki, Hida Mariko, Satoh Yoshitake, Sakata Hiroshi, Shiro Hiroyuki, Ubukata Kimiko, Murata Mitsuru, Iwata Satoshi

机构信息

Division of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.

Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.

出版信息

J Pediatr. 2017 Nov;190:169-173.e1. doi: 10.1016/j.jpeds.2017.07.039.

DOI:10.1016/j.jpeds.2017.07.039

PMID:29144242

Abstract

OBJECTIVES

To assess the incidence of colonization with group B streptococci (GBS) among neonates as influenced by maternal GBS carriage and intrapartum antibiotic prophylaxis (IAP).

STUDY DESIGN

Between October 2014 and May 2015, nasopharyngeal and rectal swab samples were collected from 730 neonates at 1 week and 1 month after birth. GBS and capsular serotype were identified by real-time polymerase chain reaction and by culture. IAP at delivery was determined retrospectively from hospital records.

RESULTS

Sixty-four neonates (8.8%) were GBS-positive by real-time polymerase chain reaction and culture. Among neonates born to mothers who were GBS carriers (n = 107), 94.4% (101/107) had maternal IAP; 19.6% nonetheless were GBS-positive, compared with 6.5% of neonates born to noncarrier mothers (P <.01). Among neonates born to mothers receiving IAP, more were positive only at 1 month of age than at both 1 week and 1 month. The frequency of GBS in neonates born to mothers receiving IAP was significantly lower than that in neonates born to mothers not receiving IAP (P <.05). Capsular serotypes V (25%) and III (23.4%) were common, followed by Ib (15.6%), Ia (14.1%), II (7.8%), IV (6.3%), nontypeable (4.7%), and VI and VIII (each 1.6%).

CONCLUSIONS

Delayed colonization with GBS occurs in infants born to GBS carrier mothers receiving IAP. GBS should be considered in all infants at 1 month after birth with signs of infection.

摘要

目的

评估母亲B族链球菌（GBS）携带情况及产时抗生素预防（IAP）对新生儿GBS定植发生率的影响。

研究设计

2014年10月至2015年5月期间，对730名新生儿在出生后1周和1个月时采集鼻咽和直肠拭子样本。通过实时聚合酶链反应和培养鉴定GBS及其荚膜血清型。从医院记录中回顾性确定分娩时的IAP情况。

结果

通过实时聚合酶链反应和培养，64名新生儿（8.8%）GBS呈阳性。在母亲为GBS携带者的新生儿中（n = 107），94.4%（101/107）的母亲接受了IAP；尽管如此，仍有19.6%的新生儿GBS呈阳性，而母亲非携带者的新生儿中这一比例为6.5%（P <.01）。在母亲接受IAP的新生儿中，仅在1个月龄时呈阳性的比在1周和1个月时均呈阳性的更多。母亲接受IAP的新生儿中GBS的发生率显著低于母亲未接受IAP的新生儿（P <.05）。常见的荚膜血清型为V型（25%）和III型（23.4%），其次是Ib型（15.6%）、Ia型（14.1%）、II型（7.8%）、IV型（6.3%）、不可分型（4.7%）以及VI型和VIII型（各1.6%）。