Children's Hospital Lucerne, SWITZERLAND;
Swiss Med Wkly. 2013 Sep 19;143:w13873. doi: 10.4414/smw.2013.13873. eCollection 2013.
Since publication of the initial guidelines for the prevention of group B streptococcal disease in 1996, the incidence of perinatal infection has decreased significantly. Intrapartum antibiotic prophylaxis together with appropriate management of neonates at increased risk for early-onset sepsis not only reduces morbidity and mortality, but also decreases the burden of unnecessary or prolonged antibiotic therapy. This article provides healthcare workers in Switzerland with evidence-based and best-practice derived guidelines for the assessment and management of term and late preterm infants (>34 weeks) at increased risk for perinatal bacterial infection. Management of neonates at increased risk for early-onset sepsis depends on clinical presentation and risk factors. Asymptomatic infants with risk factors for early-onset sepsis should be observed closely in an inpatient setting for the first 48 hours of life. Symptomatic neonates must be treated promptly with intravenous antibiotics. As clinical and laboratory signs of neonatal infection are nonspecific, it is mandatory to reevaluate the need for continued antibiotic therapy after 48 hours.
自 1996 年发布预防 B 群链球菌病的初始指南以来，围产期感染的发病率已显著下降。产时抗生素预防以及对有早发性败血症风险的新生儿进行适当管理不仅可降低发病率和死亡率，还可减少不必要或延长抗生素治疗的负担。本文为瑞士医护人员提供了基于证据和最佳实践的指南，用于评估和管理有围产期细菌感染风险的足月和晚期早产儿（>34 周）。有早发性败血症风险的新生儿的管理取决于临床表现和危险因素。无症状但有早发性败血症危险因素的婴儿应在住院环境中密切观察生命最初 48 小时。有症状的新生儿必须立即给予静脉内抗生素治疗。由于新生儿感染的临床和实验室征象是非特异性的，因此必须在 48 小时后重新评估继续抗生素治疗的必要性。
