Gibbs Ronald S, Schrag Stephanie, Schuchat Anne
Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, Colorado 80262, USA.
Obstet Gynecol. 2004 Nov;104(5 Pt 1):1062-76. doi: 10.1097/01.AOG.0000144128.03913.c2.
Group B streptococci (GBS) emerged dramatically in the 1970s as the leading cause of neonatal infection and as an important cause of maternal uterine infection. We review the epidemiology, diagnosis, and therapy of GBS perinatal infection. In 1996, the first national consensus guidelines were released. Since then, there has been a 70% reduction in early-onset neonatal GBS infection, but no decrease in late-onset neonatal GBS disease. In 2002, new national guidelines were released recommending 1) solely a screen-based prevention strategy, 2) a new algorithm for patients with penicillin allergy, and 3) more specific practices in certain clinical scenarios. Yet many clinical issues remain, including implementation of new diagnostic techniques, management of preterm rupture of membranes, use of alternative antibiotic approaches, improvement of compliance, prevention of low birth weight infants, emergence of resistant organisms, and vaccine development.
B族链球菌（GBS）在20世纪70年代急剧出现，成为新生儿感染的主要原因以及产妇子宫感染的重要原因。我们回顾了GBS围产期感染的流行病学、诊断和治疗。1996年发布了首个全国性共识指南。从那时起，早发型新生儿GBS感染减少了70%，但晚发型新生儿GBS疾病并未减少。2002年发布了新的全国性指南，建议1）仅采用基于筛查的预防策略，2）针对青霉素过敏患者的新算法，以及3）在某些临床情况下更具体的做法。然而，许多临床问题仍然存在，包括新诊断技术的实施、胎膜早破的管理、替代抗生素方法的使用、依从性的提高、低体重儿的预防、耐药菌的出现以及疫苗的研发。
