Department of Pediatrics, Alpert Medical School, Brown University, Providence, RI, USA.
Am J Perinatol. 2013 Feb;30(2):143-7. doi: 10.1055/s-0032-1332804. Epub 2013 Jan 15.
Early onset neonatal group B streptococcal (GBS) sepsis is a serious neonatal illness with high morbidity and mortality. The disease can present in two forms: early clinical manifestation with respiratory distress soon after birth or late presentation with gradual onset of signs of sepsis. The former carries a high risk for serious cardiovascular complication with persistent pulmonary hypertension; the latter is often complicated with meningitis that may lead to serious neurodevelopmental impairment. An important advance in the past three decades is the development and implementation of preventive strategy for this disease by universal screening and identification of maternal GBS carriers and/or risk factors with subsequent use of intrapartum antibiotic prophylaxis. The strategy has resulted in a significant reduction of the disease from 1.5 to 0.3/1,000 live births over the past three decades. Some women may have unknown GBS status. The American Academy of Pediatrics has developed an algorithm as guidance for the management of the newborns.
早发型新生儿 B 群链球菌(GBS)败血症是一种严重的新生儿疾病,具有较高的发病率和死亡率。该病有两种表现形式:一种是出生后不久即出现呼吸窘迫等早期临床表现,另一种是逐渐出现败血症迹象的晚期表现。前者存在持续性肺动脉高压等严重心血管并发症的高风险;后者常并发脑膜炎,可能导致严重的神经发育损伤。过去 30 年来的一个重要进展是通过对母体 GBS 携带者和/或危险因素进行普遍筛查和识别,并随后使用产时抗生素预防,制定并实施了针对该病的预防策略。该策略使该病的发病率在过去 30 年中从每 1000 例活产儿 1.5 例降至 0.3 例。有些女性可能不知道自己是否为 GBS 携带者。美国儿科学会制定了一个算法作为新生儿管理的指南。