Ma Teresa W L, Chan Viola, So C H, Hui Annie S Y, Lee C N, Hui Amelia P W, So P L, Kong C W, Fung Barbara, Leung K Y
a Department of Obstetrics and Gynaecology , Queen Elizabeth Hospital , Hong Kong SAR , China.
b Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong SAR , China.
J Matern Fetal Neonatal Med. 2018 Apr;31(7):881-887. doi: 10.1080/14767058.2017.1300649. Epub 2017 Mar 21.
To determine the prevalence of maternal colonization with group B streptococcus (GBS), and early onset GBS disease (EOGBSD) after implementation of universal screening.
This was a three-year retrospective cohort study on universal antenatal rectovaginal culture-based screening and intrapartum antimicrobial prophylaxis (IAP) to colonized women in the public sector in Hong Kong. Routinely collected data including maternal colonization and EOGBSD were retrieved.
Of 113,989 GBS screening performed, 21.8% were positive. The colonization rate was higher in the public hospitals (higher risk) than in the Maternal and Child Health Centers (lower risk) (23.7% vs 18.1%, p < .001), while their false negative rates were not greater than expected. Majority of eligible women opted for screening, and colonized women received IAP. There were 29 cases of EOGBSD with clinical signs and a positive blood or cerebrospinal fluid culture. Compared to clinical risk-based screening, EOGBSD incidence decreased after universal screening (1 vs 0.24 per 1000 births, p < .001). Although EOGBSD occurred at a higher rate in preterm than term infants, 86.7% occurred in the latter, and were associated with a false negative screening result (41.3%), lack of screening (20.7%) or unavailability of a colonization result at labour (13.8%).
Maternal GBS colonization rate was higher than previously reported, and varied with different risk populations. EOGBSD reduced after universal screening.
确定实施普遍筛查后B族链球菌（GBS）的孕产妇定植率以及早发型GBS疾病（EOGBSD）的发生率。
这是一项为期三年的回顾性队列研究，针对香港公共部门基于直肠阴道培养的普遍产前筛查以及对定植妇女进行的产时抗菌药物预防（IAP）。检索常规收集的数据，包括孕产妇定植情况和EOGBSD。
在进行的113,989次GBS筛查中，21.8%呈阳性。公立医院（高风险）的定植率高于母婴健康中心（低风险）（23.7%对18.1%，p<0.001），而其假阴性率不高于预期。大多数符合条件的妇女选择了筛查，定植妇女接受了IAP。有29例EOGBSD病例具有临床体征且血液或脑脊液培养呈阳性。与基于临床风险的筛查相比，普遍筛查后EOGBSD的发生率有所下降（每1000例出生中1例对0.24例，p<0.001）。尽管早产婴儿的EOGBSD发生率高于足月儿，但86.7%发生在足月儿中，并且与假阴性筛查结果（41.3%）、未进行筛查（20.7%）或分娩时无法获得定植结果（13.8%）有关。
孕产妇GBS定植率高于先前报道，且因不同风险人群而异。普遍筛查后EOGBSD有所减少。
