Regan J A, Klebanoff M A, Nugent R P
Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York.
Obstet Gynecol. 1991 Apr;77(4):604-10.
Risk factors for cervicovaginal group B streptococcal colonization at 23-26 weeks' gestation were studied in 7742 women participating in the Vaginal Infections and Prematurity study. The prevalence of group B Streptococcus was 18.6%, and was greatest in (predominantly Caribbean) Hispanics from New York City, followed by blacks, whites, and other (predominantly Mexican) Hispanics. Group B Streptococcus was more common among older women and women of lower parity, and less common among women living with their partner compared with those living alone. Current smoking was associated with a decreased risk of colonization, and group B Streptococcus was less common among women with more education. Increased risk was seen only with extreme increases in sexual activity including both frequent intercourse and multiple partners during the previous year. The risk of colonization was greater when there was concurrent colonization with Candida sp, but group B Streptococcus was not associated with carriage of Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, and Mycoplasma hominis. External genital erythema and scaling, purulent vaginal discharge, and pH greater than 5 were associated with increased colonization. Although these associations can raise the clinical index of suspicion for group B streptococcal colonization in a given patient, the study data did not enable us to select a small group of women with a very high probability of colonization. We conclude that selective screening is not useful in detecting group B streptococcal colonization in pregnancy.
在参与阴道感染与早产研究的7742名女性中，对妊娠23 - 26周时宫颈阴道B族链球菌定植的危险因素进行了研究。B族链球菌的患病率为18.6%，在（主要是加勒比地区的）纽约市西班牙裔中最高，其次是黑人、白人以及其他（主要是墨西哥的）西班牙裔。B族链球菌在年龄较大和产次较低的女性中更为常见，与独居女性相比，与伴侣同住的女性中则较少见。当前吸烟与定植风险降低相关，且B族链球菌在受教育程度较高的女性中较少见。仅在前一年性活动极度增加（包括频繁性交和多个性伴侣）时，风险才会增加。当同时感染念珠菌属时，定植风险更高，但B族链球菌与沙眼衣原体、解脲脲原体、阴道毛滴虫和人型支原体的携带无关。外阴红斑和脱屑、脓性阴道分泌物以及pH值大于5与定植增加有关。尽管这些关联可能会提高对特定患者B族链球菌定植的临床怀疑指数，但研究数据无法让我们选出一小群定植可能性非常高的女性。我们得出结论，选择性筛查在检测孕期B族链球菌定植方面并无用处。
