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产时预防时代早发型B族链球菌感染持续存在的情况

Continued early onset group B streptococcal infections in the era of intrapartum prophylaxis.

作者信息

Pulver L S, Hopfenbeck M M, Young P C, Stoddard G J, Korgenski K, Daly J, Byington C L

机构信息

Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA.

出版信息

J Perinatol. 2009 Jan;29(1):20-5. doi: 10.1038/jp.2008.115. Epub 2008 Aug 14.

DOI:10.1038/jp.2008.115
PMID:18704032
Abstract

OBJECTIVE

The objective of the study was to determine the rate of early onset group B streptococcus (EOGBS) infection in Utah and identify potential areas of failure in EOGBS prevention.

STUDY DESIGN

We queried the microbiology records of Intermountain Healthcare for infants with culture-confirmed EOGBS between 1 January 2002 and 31 May 2006 and calculated rates of EOGBS per 1000 deliveries. We reviewed the infant and maternal records of each EOGBS case to identify possible failures in EOGBS prevention.

RESULT

There were 54 cases of EOGBS among the 127 205 births (0.42/1000 births). Of all, 12 were preterm. Of the 39 (93%) women prenatally screened for GBS, 31 (79%) had negative results and 7/8 (88%) women with positive prenatal GBS screens either did not receive intrapartum antibiotic prophylaxis (IAP) or received inadequate IAP. Of the 54 infants with EOGBS, 3 (6%) died.

CONCLUSION

Utah's rates of EOGBS were higher than the national average. Factors associated with EOGBS include missed screening opportunities, inadequate IAP, and false-negative maternal GBS culture.

摘要

目的

本研究的目的是确定犹他州早发型B族链球菌(EOGBS)感染率,并确定EOGBS预防中潜在的失败领域。

研究设计

我们查询了山间医疗保健机构2002年1月1日至2006年5月31日期间培养确诊为EOGBS的婴儿的微生物学记录,并计算了每1000例分娩中EOGBS的发生率。我们审查了每例EOGBS病例的婴儿和母亲记录,以确定EOGBS预防中可能存在的失败情况。

结果

在127205例分娩中有54例EOGBS病例(0.42/1000例分娩)。其中,12例为早产。在39名(93%)产前进行GBS筛查的女性中,31名(79%)结果为阴性,8名产前GBS筛查呈阳性的女性中,7名(88%)要么未接受产时抗生素预防(IAP),要么接受的IAP不足。在54例EOGBS婴儿中,3例(6%)死亡。

结论

犹他州的EOGBS发生率高于全国平均水平。与EOGBS相关的因素包括筛查机会错过、IAP不足以及母亲GBS培养假阴性。

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