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GBS 公众意识、宣传和预防——什么有效,什么无效,以及为什么我们需要一种针对产妇 GBS 的疫苗。

GBS public awareness, advocacy, and prevention--what's working, what's not and why we need a maternal GBS vaccine.

机构信息

Group B Strep Association, P.O. Box 16515, Chapel Hill, NC 27516, USA.

出版信息

Vaccine. 2013 Aug 28;31 Suppl 4:D58-65. doi: 10.1016/j.vaccine.2013.02.039.

Abstract

Group B Streptococcus (GBS) is the most common cause of severe early-onset (0-6 days) infection and a significant cause of serious late-onset (7-90 days) infection in infants. While most babies recover from their GBS infection, some are stillborn, more die in the first weeks of life and others suffer lifelong disability. Despite efforts in many developed countries to prevent these infections, the burden of GBS disease remains significant, particularly among the late onset infections, which are not preventable using current risk-based or screening strategies. Vaccination, once available, could prevent more cases of GBS infection than any other strategy, including preventing preterm labor and stillbirths caused by GBS infection, post-delivery GBS infection in the mother and late-onset GBS infection in the baby. Vaccination would also avoid allergic reactions to antibiotics and concern about the emergence of antibiotic resistant bacteria. We consider the history of the two largest group B Strep parent organizations (Group B Strep Association USA and Group B Strep Support UK) and the history of GBS prevention in their respective countries. We look at what is needed before a vaccine can be introduced and consider how acceptable a GBS vaccine would be from families' perspective. We also summarize what a perfect GBS vaccine would look like and what we should all strive to achieve.

摘要

B 群链球菌(GBS)是导致严重早发性(0-6 天)感染的最常见原因,也是导致严重迟发性(7-90 天)感染的重要原因。虽然大多数婴儿能够从 GBS 感染中恢复,但有些婴儿会胎死腹中,更多的婴儿会在生命的头几周死亡,还有一些婴儿会终身残疾。尽管许多发达国家都在努力预防这些感染,但 GBS 疾病的负担仍然很大,尤其是在迟发性感染方面,目前基于风险或筛查的策略无法预防这些感染。疫苗接种一旦可用,就可以预防比任何其他策略更多的 GBS 感染病例,包括预防由 GBS 感染引起的早产和死产、分娩后母亲的 GBS 感染和婴儿的迟发性 GBS 感染。疫苗接种还可以避免对抗生素的过敏反应和对出现抗生素耐药菌的担忧。我们考虑了两个最大的 B 群链球菌母体组织(美国 B 群链球菌协会和英国 B 群链球菌支持组织)的历史,以及它们各自国家的 GBS 预防历史。我们研究了在引入疫苗之前需要做哪些准备,并从家庭的角度考虑 GBS 疫苗的可接受程度。我们还总结了理想的 GBS 疫苗应该是什么样子,以及我们都应该努力实现的目标。

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