Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico, Modena, Modena, Italy.
Pediatr Infect Dis J. 2010 Feb;29(2):115-21. doi: 10.1097/INF.0b013e3181b83cd9.
Group B Streptococcus (GBS) is a leading cause of neonatal bacterial infections. Early-onset infections have decreased in recent years but, despite considerable efforts poured into prevention, cases continue to occur.
To analyze trends and identify determining factors for the persistence of the GBS infections. To evaluate the impact of antenatal screening and intrapartum chemoprophylaxis on the clinical presentation of the infection.
A prospective cohort, population-based study has been ongoing in Emilia-Romagna (Italy) since 2003. Invasive GBS infections, observed between 2003 and 2008 in infants aged < 7 days were analyzed.
Among 214,120 live births, 61 early-infections were observed. Fourteen infants (23.0%) were born preterm. Among 47 infants who were delivered at term, 28 were born to mothers who had no risk factors and 7 were born to mothers who had none other than GBS colonization. Forty-one women at term had been screened prenatally; among them, only 10 were documented as GBS culture-positive.Disease severity was highest in infants at lower gestational ages, but most meningitis cases were observed in term infants born to mothers who were GBS culture-negative at screening.Nine newborns had culture-proven infection despite having received intrapartum antibiotics. They were born to mothers with > or =1 obstetrical risk factors and 5 mothers had been treated during labor with macrolides.
Most infections presented in infants whose mothers had been screened as GBS culture-negative. Missed opportunities for prevention contributed more than prophylaxis failures to the early-onset disease burden.
B 群链球菌（GBS）是导致新生儿细菌感染的主要原因。近年来，早发性感染有所减少，但尽管在预防方面投入了大量努力，病例仍在继续发生。
分析趋势并确定导致 GBS 感染持续存在的决定因素。评估产前筛查和产时化学预防对感染临床表现的影响。
自 2003 年以来，意大利艾米利亚-罗马涅一直在进行一项前瞻性队列、基于人群的研究。分析了 2003 年至 2008 年期间观察到的 <7 天龄婴儿侵袭性 GBS 感染。
在 214120 例活产中，观察到 61 例早发性感染。14 名婴儿（23.0%）早产。在 47 名足月分娩的婴儿中，28 名婴儿的母亲无危险因素，7 名婴儿的母亲除 GBS 定植外无其他危险因素。41 名足月妇女接受了产前筛查；其中，只有 10 人被证实 GBS 培养阳性。疾病严重程度在胎龄较小的婴儿中最高，但大多数脑膜炎病例发生在筛查时 GBS 培养阴性的足月婴儿中。尽管接受了产时抗生素治疗，但仍有 9 名新生儿证实存在感染。他们的母亲有 >或=1 个产科危险因素，5 名母亲在分娩时接受了大环内酯类药物治疗。
大多数感染发生在母亲 GBS 培养阴性的婴儿中。预防的错失机会比预防失败对早发性疾病负担的影响更大。
