Pediatrics. 2011 Sep;128(3):611-6. doi: 10.1542/peds.2011-1466. Epub 2011 Aug 1.
The Centers for Disease Control and Prevention (CDC) guidelines for the prevention of perinatal group B streptococcal (GBS) disease were initially published in 1996. The American Academy of Pediatrics (AAP) also published a policy statement on this topic in 1997. In 2002, the CDC published revised guidelines that recommended universal antenatal GBS screening; the AAP endorsed these guidelines and published recommendations based on them in the 2003 Red Book. Since then, the incidence of early-onset GBS disease in neonates has decreased by an estimated 80%. However, in 2010, GBS disease remained the leading cause of early-onset neonatal sepsis. The CDC issued revised guidelines in 2010 based on evaluation of data generated after 2002. These revised and comprehensive guidelines, which have been endorsed by the AAP, reaffirm the major prevention strategy--universal antenatal GBS screening and intrapartum antibiotic prophylaxis for culture-positive and high-risk women--and include new recommendations for laboratory methods for identification of GBS colonization during pregnancy, algorithms for screening and intrapartum prophylaxis for women with preterm labor and premature rupture of membranes, updated prophylaxis recommendations for women with a penicillin allergy, and a revised algorithm for the care of newborn infants. The purpose of this policy statement is to review and discuss the differences between the 2002 and 2010 CDC guidelines that are most relevant for the practice of pediatrics.
疾病控制与预防中心(CDC)关于预防围产期 B 群链球菌(GBS)疾病的指南最初于 1996 年发布。儿科学会(AAP)也在 1997 年就这一主题发布了一份政策声明。2002 年,CDC 发布了修订后的指南,建议进行普遍的产前 GBS 筛查;AAP 认可了这些指南,并在 2003 年的《红皮书》中根据这些指南提出了建议。此后,新生儿早发性 GBS 疾病的发病率估计下降了 80%。然而,2010 年,GBS 疾病仍然是新生儿早发性败血症的主要原因。CDC 根据 2002 年以后的数据评估结果,于 2010 年发布了修订后的指南。这些经过修订的全面指南得到了 AAP 的认可,重申了主要的预防策略——普遍的产前 GBS 筛查和产时抗生素预防,以文化阳性和高危妇女为目标——并包括了新的关于妊娠期间 GBS 定植的实验室方法、对于早产和胎膜早破的妇女进行筛查和产时预防的算法、对于青霉素过敏的妇女的更新预防建议,以及新生儿护理的修订算法。本政策声明的目的是审查和讨论与儿科学实践最相关的 2002 年和 2010 年 CDC 指南之间的差异。