Department of Paediatric Intensive Care Unit, Trousseau's Hospital, Paris, France.
Acta Paediatr. 2010 Jan;99(1):47-51. doi: 10.1111/j.1651-2227.2009.01510.x.
Group B Streptococcus (GBS) is one of the leading causes of sepsis and meningitis in newborn. The objective of this study was to describe the characteristics of GBS meningitis in children aged between 7 and 89 days (late onset disease - LOD group) and to compare them with children aged more than 3 months (ultra late onset disease - ULOD group).
Clinical and biological data were gathered by ACTIV/GPIP (a nationwide active surveillance network). The study population included 242 children hospitalized between 2001 and 2006 for GBS meningitis (220 in the LOD group and 22 in the ULOD group).
Univariate analysis revealed that gestational age (GA) was significantly lower in the ULOD group as compared with the LOD group (respectively 35.6 weeks vs. 37.9 weeks, p = 0.002). Prevalence of early preterm birth (before the 32nd week GA) was significantly higher in the ULOD group than in the LOD group (32% vs. 7%, p = 0.002). No significant difference was found between the two groups for biological characteristics of lumbar puncture, GBS serotypes, complications and survival rate.
These data suggest that LOD and ULOD would be the same clinical and bacteriological entity, except for prematurity, which seems significantly associated with ULOD.
B 型链球菌(GBS)是导致新生儿败血症和脑膜炎的主要原因之一。本研究的目的是描述 7-89 天龄(晚发型疾病-LOD 组)和 3 个月以上(超晚发型疾病-ULOD 组)儿童 GBS 脑膜炎的特征,并将其与后者进行比较。
通过 ACTIV/GPIP(全国性主动监测网络)收集临床和生物学数据。研究人群包括 2001 年至 2006 年期间因 GBS 脑膜炎住院的 242 名儿童(LOD 组 220 名,ULOD 组 22 名)。
单因素分析显示,ULOD 组的胎龄(GA)明显低于 LOD 组(分别为 35.6 周和 37.9 周,p = 0.002)。ULOD 组早早产儿(GA 小于 32 周)的比例明显高于 LOD 组(32%对 7%,p = 0.002)。两组在腰椎穿刺的生物学特征、GBS 血清型、并发症和生存率方面无显著差异。
这些数据表明,LOD 和 ULOD 可能是同一临床和细菌学实体,除了早产,早产与 ULOD 明显相关。