Westh H, Skibsted L, Korner B
Department of Clinical Microbiology, Bispebjerg Hospital, Copenhagen, Denmark.
Rev Infect Dis. 1990 May-Jun;12(3):416-22. doi: 10.1093/clinids/12.3.416.
Streptococcus pneumoniae is not a part of the resident vaginal flora. However, in some women S. pneumoniae can be a transient part of the vaginal flora, and pelvic infection can occur, especially if a predisposing condition exists (e.g., use of an intrauterine contraceptive device, a recent birth, or gynecologic surgery). In the preantibiotic era, pneumococcal genital infection was more common than today, and the rate of lethality was high--26% for localized infection and 74% for peritonitis. During the last 25 years, all 24 patients reported worldwide survived their pneumococcal genital infections, including nine patients at our hospital; in contrast, five of 12 women died between 1938 and 1952. Pneumococci can rarely be isolated as the only pathogen in cases of bartholinitis. Neonatal S. pneumoniae disease with an early onset has an intrapartum pathogenesis. Of 23 reported pediatric patients (including one whom we treated), 48% died and 13% survived with neurologic sequelae. The prognosis for these children has not improved during the last 10 years.
肺炎链球菌不是阴道常驻菌群的一部分。然而，在一些女性中，肺炎链球菌可能是阴道菌群的短暂组成部分，并且可能发生盆腔感染，特别是在存在易感因素时（例如，使用宫内节育器、近期分娩或妇科手术）。在抗生素时代之前，肺炎球菌性生殖器感染比现在更常见，致死率很高——局部感染为26%，腹膜炎为74%。在过去25年中，全球报告的24例患者均从肺炎球菌性生殖器感染中存活下来，其中包括我院的9例患者；相比之下，1938年至1952年间，12名女性中有5人死亡。在巴氏腺炎病例中，肺炎球菌很少作为唯一病原体被分离出来。早发型新生儿肺炎链球菌病具有产时发病机制。在报告的23例儿科患者（包括我们治疗的1例）中，48%死亡，13%存活但有神经后遗症。在过去10年中，这些儿童的预后并未改善。
