Cutland Clare L, Schrag Stephanie J, Thigpen Michael C, Velaphi Sithembiso C, Wadula Jeannette, Adrian Peter V, Kuwanda Locadiah, Groome Michelle J, Buchmann Eckhart, Madhi Shabir A
Emerg Infect Dis. 2015 Apr;21(4):638-45. doi: 10.3201/eid2104.141562.
Although group B Streptococcus (GBS) is a leading cause of severe invasive disease in young infants worldwide, epidemiologic data and knowledge about risk factors for the disease are lacking from low- to middle-income countries. To determine the epidemiology of invasive GBS disease among young infants in a setting with high maternal HIV infection, we conducted hospital-based surveillance during 2004-2008 in Soweto, South Africa. Overall GBS incidence was 2.72 cases/1,000 live births (1.50 and 1.22, respectively, among infants with early-onset disease [EOD] and late-onset [LOD] disease). Risk for EOD and LOD was higher for HIV-exposed than HIV-unexposed infants. GBS serotypes Ia and III accounted for 84.0% of cases, and 16.9% of infected infants died. We estimate that use of trivalent GBS vaccine (serotypes Ia, Ib, and III) could prevent 2,105 invasive GBS cases and 278 deaths annually among infants in South Africa; therefore, vaccination of all pregnant women in this country should be explored.
尽管B族链球菌(GBS)是全球范围内导致幼儿严重侵袭性疾病的主要病因,但低收入和中等收入国家缺乏该疾病的流行病学数据及危险因素相关知识。为确定在孕产妇HIV感染率高的环境中幼儿侵袭性GBS疾病的流行病学情况,我们于2004年至2008年在南非索韦托开展了基于医院的监测。GBS总体发病率为2.72例/1000例活产儿(早发型疾病[EOD]和晚发型疾病[LOD]的婴儿发病率分别为1.50例/1000例活产儿和1.22例/1000例活产儿)。暴露于HIV的婴儿发生EOD和LOD的风险高于未暴露于HIV的婴儿。GBS血清型Ia和III占病例的84.0%,16.9%的感染婴儿死亡。我们估计,使用三价GBS疫苗(血清型Ia、Ib和III)每年可在南非预防2105例侵袭性GBS病例和278例死亡;因此,应探讨在该国对所有孕妇进行疫苗接种。