Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal.
Centro Hospitalar Universitário do Porto, Centro Materno Infantil do Norte, Porto, Portugal.
Clin Microbiol Rev. 2022 Apr 20;35(2):e0007921. doi: 10.1128/cmr.00079-21. Epub 2022 Feb 16.
Neonatal bacterial meningitis is a devastating disease, associated with high mortality and neurological disability, in both developed and developing countries. Streptococcus agalactiae, commonly referred to as group B Streptococcus (GBS), remains the most common bacterial cause of meningitis among infants younger than 90 days. Maternal colonization with GBS in the gastrointestinal and/or genitourinary tracts is the primary risk factor for neonatal invasive disease. Despite prophylactic intrapartum antibiotic administration to colonized women and improved neonatal intensive care, the incidence and morbidity associated with GBS meningitis have not declined since the 1970s. Among meningitis survivors, a significant number suffer from complex neurological or neuropsychiatric sequelae, implying that the pathophysiology and pathogenic mechanisms leading to brain injury and devastating outcomes are not yet fully understood. It is imperative to develop new therapeutic and neuroprotective approaches aiming at protecting the developing brain. In this review, we provide updated clinical information regarding the understanding of neonatal GBS meningitis, including epidemiology, diagnosis, management, and human evidence of the disease's underlying mechanisms. Finally, we explore the experimental models used to study GBS meningitis and discuss their clinical and physiologic relevance to the complexities of human disease.
新生儿细菌性脑膜炎是一种毁灭性疾病,在发达国家和发展中国家都与高死亡率和神经功能障碍有关。B 组链球菌(group B Streptococcus,GBS)通常被称为 B 型链球菌,仍然是 90 天以下婴儿细菌性脑膜炎的最常见病因。胃肠道和/或泌尿生殖道的 GBS 定植是新生儿侵袭性疾病的主要危险因素。尽管对定植的孕妇进行了产时预防性抗生素治疗,并改善了新生儿重症监护,但自 20 世纪 70 年代以来,与 GBS 脑膜炎相关的发病率和发病率并未下降。在脑膜炎幸存者中,相当数量的人患有复杂的神经或神经精神后遗症,这意味着导致脑损伤和毁灭性结局的病理生理学和发病机制尚未完全了解。开发新的治疗和神经保护方法以保护发育中的大脑至关重要。在这篇综述中,我们提供了关于新生儿 GBS 脑膜炎的最新临床信息,包括流行病学、诊断、治疗和疾病潜在机制的人类证据。最后,我们探讨了用于研究 GBS 脑膜炎的实验模型,并讨论了它们与人类疾病复杂性的临床和生理相关性。