加拿大儿科感染性疾病研究协作网络（PICNIC）关于加拿大新生儿B族链球菌感染的研究。

The Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of neonatal group B streptococcal infections in Canada.

作者信息

Davies H D, Leblanc J, Bortolussi R, McGeer A

机构信息

Departments of Pediatrics, Microbiology and Infectious Diseases, University of Calgary and the Child Health Research Unit, Alberta Children's Hospital, Calgary, Alberta;

出版信息

Paediatr Child Health. 1999 May;4(4):257-63.

PMID:20212931

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2827718/

Abstract

OBJECTIVES

To determine the presentation and medical outcomes of neonatal group B streptococcus (GBS) disease in Canada, and describe maternal and obstetrical risk factors.

DESIGN

Retrospective review of health records and laboratory databases using standardized data collection forms.

SETTING

All neonates diagnosed with GBS infections in 1992 at 13 Canadian paediatric centres.

RESULTS

A total of 105 infants meeting the criteria for neonatal GBS disease were identified. The majority of cases (78 or 74.3%) had early-onset disease (EOD); 78.9% (60 of 76) of these cases presented within 24 h of delivery. Rates of EOD (less than seven days) varied from 0.44/1000 live births to 2.1/1000 live births, with an overall rate of 1.2/1000 live births. Pneumonia was the most common clinical illness (43.8%), followed by bacteremia without focus (23.8%) and meningitis (16.2%). At least one maternal risk factor for neonatal GBS disease was noted in 46 of 78 (59%) infants with EOD. A median of one dose (range one to 23 doses) of intrapartum antibiotics was given in 18 of 75 (24%) of the pregnancies. Overall, the mean gestational age at birth was 36.2+/-4.7 weeks, with 38 of 96 (39.6%) infants having a gestational age at birth younger than 37 weeks (31 of 73 [42.5%] EOD cases were born with a gestational age younger than 37 weeks). The median birth weight was 3099 g (range 610 g to 4830 g). Thirty of 94 (31.9%) infants had a birth weight less than 2500 g. Seventeen (16.2%) infants died.

CONCLUSIONS

In 1992, neonatal GBS disease was a significant cause of morbidity and mortality in Canadian infants. More than half of the cases identified in this study could have been potentially preventable by the use of intrapartum antibiotics for women with known risk factors. There is a need for prospective studies to better define risk factors and preventative measures for neonatal GBS infections in Canada.

摘要

目的

确定加拿大新生儿B族链球菌（GBS）疾病的临床表现和医学转归，并描述母亲和产科风险因素。

设计

使用标准化数据收集表对健康记录和实验室数据库进行回顾性研究。

研究地点

1992年加拿大13家儿科中心所有被诊断为GBS感染的新生儿。

结果

共确定了105例符合新生儿GBS疾病标准的婴儿。大多数病例（78例，占74.3%）为早发型疾病（EOD）；其中78.9%（76例中的60例）在分娩后24小时内发病。EOD（小于7天）的发病率从0.44/1000活产至2.1/1000活产不等，总体发病率为1.2/1000活产。肺炎是最常见的临床疾病（43.8%），其次是无明确病灶的菌血症（23.8%）和脑膜炎（16.2%）。在78例EOD婴儿中，有46例（59%）至少存在一项母亲患新生儿GBS疾病的风险因素。75例妊娠中有18例（24%）在分娩期给予了中位数为一剂（范围为1至23剂）的抗生素。总体而言，出生时的平均孕周为36.2±4.7周，96例中有38例（39.6%）婴儿出生时孕周小于37周（73例EOD病例中有31例[42.5%]出生时孕周小于37周）。出生体重中位数为3099克（范围为610克至4830克）。94例中有30例（31.9%）婴儿出生体重小于2500克。17例（16.2%）婴儿死亡。