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牙买加西印度群岛大学医院的新生儿B族链球菌感染:十年经验

Neonatal group B streptococcal infection at the University Hospital of the West Indies, Jamaica: a 10-year experience.

作者信息

Trotman H, Bell Y

机构信息

Department of Obstetrics, Gynaecology and Child Health, University of the West Indies, Mona, Jamaica.

出版信息

Ann Trop Paediatr. 2006 Mar;26(1):53-7. doi: 10.1179/146532806X90619.

Abstract

AIM

To describe the incidence, clinical presentation and outcome of neonatal group B streptococcal (GBS) infection at the University Hospital of the West Indies (UHWI).

METHODS

A 10-year retrospective review of all inborn neonates admitted to the neonatal unit of UHWI with GBS infection between 1 January 1991 and 31 December 2000 was conducted. Differences in maternal and neonatal characteristics between early- and late-onset disease (EOD, LOD) were determined.

RESULTS

There were 32,029 live births and 29 neonates were admitted for GBS infection, an incidence of 0.91/1000 live births (95% CI 0.58-1.23/1000). Twenty-one (72%) neonates had EOD, a rate of 0.66/1000 live births (95% CI 0.38-0.94/1000) and eight (28%) had LOD, a rate of 0.23/1000 (95% CI 0.08-0.42/1000). Seventeen of the 21 (81%) cases of EOD occurred within the 1st 24 hours of life. The most common clinical diagnosis was septicaemia (17, 61%), followed by pneumonia (8, 28%) and meningitis (3, 11%). All five (100%) babies whose mothers' membranes were ruptured for >18 hours had EOD. The babies of all six (100%) women with intrapartum pyrexia went on to have EOD. A greater proportion of babies (63%) with LOD were preterm and of low birthweight. The most common presenting symptom was respiratory distress which occurred more frequently in neonates with EOD, p=0.006. One neonate died, giving a case fatality rate of 3.6%.

CONCLUSION

Although the incidence of GBS infection is relatively low at UHWI, further reduction in the incidence might be achieved by implementation of measures to prevent perinatal transmission.

摘要

目的

描述西印度群岛大学医院(UHWI)新生儿B族链球菌(GBS)感染的发病率、临床表现及转归。

方法

对1991年1月1日至2000年12月31日期间入住UHWI新生儿病房的所有患GBS感染的出生时即有的新生儿进行了为期10年的回顾性研究。确定早发型和晚发型疾病(EOD、LOD)在母亲和新生儿特征方面的差异。

结果

共有32029例活产,29例新生儿因GBS感染入院,发病率为0.91/1000活产(95%可信区间0.58 - 1.23/1000)。21例(72%)新生儿为早发型疾病,发病率为0.66/1000活产(95%可信区间0.38 - 0.94/1000),8例(28%)为晚发型疾病,发病率为0.23/1000(95%可信区间0.08 - 0.42/1000)。21例早发型疾病病例中的17例(81%)发生在出生后24小时内。最常见的临床诊断是败血症(17例,61%),其次是肺炎(8例,28%)和脑膜炎(3例,11%)。母亲胎膜破裂超过18小时的所有5例(100%)婴儿均为早发型疾病。所有6例(100%)产时发热妇女的婴儿均发生早发型疾病。晚发型疾病的婴儿中更大比例(63%)为早产儿和低体重儿。最常见的表现症状是呼吸窘迫,在早发型疾病新生儿中更频繁出现,p = 0.006。1例新生儿死亡,病死率为3.6%。

结论

尽管UHWI的GBS感染发病率相对较低,但通过实施预防围产期传播的措施可能进一步降低发病率。

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