Schuchat A
Respiratory Disease Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Lancet. 1999 Jan 2;353(9146):51-6. doi: 10.1016/S0140-6736(98)07128-1.
During the 1990s the focus of group B streptococcus (GBS) disease research has shifted to prevention. Increased use of intrapartum antimicrobial prophylaxis in North America and Australia has led to substantial declines in perinatal disease. Vaccine development (initiated two decades earlier) has yielded results--for example, polysaccharide-protein conjugate vaccines given to women of reproductive age proved to be highly immunogenic and well tolerated. Also economic evaluations have assessed the cost-effectiveness of prevention strategies in different populations. Although GBS has traditionally been considered a perinatal pathogen, the burden of invasive GBS disease among nonpregnant adults has been measured. Adverse outcomes of pregnancy attributable to GBS were addressed through a multicentre study which confirmed the important role of heavy colonisation with GBS in preterm low-birthweight deliveries. Finally, the pathogen itself has continued to evolve: new capsular serotypes described in the past decade are now causing an important proportion of clinical infections.
在20世纪90年代，B族链球菌（GBS）疾病研究的重点已转向预防。北美和澳大利亚增加了产时抗菌药物预防的使用，导致围产期疾病大幅下降。疫苗研发（始于二十年前）已取得成果——例如，给予育龄妇女的多糖-蛋白结合疫苗被证明具有高度免疫原性且耐受性良好。此外，经济评估还评估了不同人群中预防策略的成本效益。尽管GBS传统上被认为是一种围产期病原体，但已对非孕妇成年人侵袭性GBS疾病的负担进行了衡量。一项多中心研究探讨了GBS所致的不良妊娠结局，该研究证实了GBS重度定植在早产低体重分娩中的重要作用。最后，病原体本身也在持续演变：过去十年中描述的新的荚膜血清型目前导致了相当比例的临床感染。
