产妇定植金黄色葡萄球菌和 B 组链球菌与新生儿定植有关。
Maternal colonization with Staphylococcus aureus and Group B streptococcus is associated with colonization in newborns.
机构信息
Medical Research Council Unit The Gambia, Banjul, Gambia; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Medical Research Council Unit The Gambia, Banjul, Gambia.
出版信息
Clin Microbiol Infect. 2017 Dec;23(12):974-979. doi: 10.1016/j.cmi.2017.04.020. Epub 2017 May 3.
OBJECTIVES
Although Staphylococcus aureus and Group B streptococcus (GBS) are major causes of neonatal sepsis in sub-Saharan Africa, it is unclear how these bacteria are transmitted to the neonate.
METHODS
In a cohort of 377 Gambian women and their newborns, nasopharyngeal swabs were collected at delivery (day 0), and 3, 6, 14 and 28 days later. Breast milk samples and vaginal swabs were collected from the mother. Staphylococcus aureus and GBS were isolated using conventional microbiological methods.
RESULTS
Most women were carriers of S. aureus (264 out of 361 with all samples collected, 73.1%) at some point during follow up and many were carriers of GBS (114 out of 361, 31.6%). Carriage of S. aureus was common in all three maternal sites and GBS was common in the vaginal tract and breast milk. Among newborns, carriage of S. aureus peaked at day 6 (238 out of 377, 63.1%) and GBS at day 3 (39 out of 377, 10.3%). Neonatal carriage of S. aureus at day 6 was associated with maternal carriage in the breast milk adjusted OR 2.54; 95% CI 1.45-4.45, vaginal tract (aOR 2.55; 95% CI 1.32-4.92) and nasopharynx (aOR 2.49; 95% CI 1.56-3.97). Neonatal carriage of GBS at day 6 was associated with maternal carriage in the breast milk (aOR 3.75; 95% CI 1.32-10.65) and vaginal tract (aOR 3.42; 95% CI 1.27-9.22).
CONCLUSIONS
Maternal colonization with S. aureus or GBS is a risk factor for bacterial colonization in newborns.
目的
金黄色葡萄球菌和 B 群链球菌（GBS）是撒哈拉以南非洲地区新生儿败血症的主要病因，但这些细菌如何传播给新生儿尚不清楚。
方法
在 377 名冈比亚妇女及其新生儿的队列中，在分娩时（第 0 天）以及 3、6、14 和 28 天后采集鼻咽拭子。从母亲处采集母乳样本和阴道拭子。使用常规微生物学方法分离金黄色葡萄球菌和 GBS。
结果
大多数女性在随访期间的某个时间点携带金黄色葡萄球菌（361 个样本全部采集时，264 人，73.1%），许多女性携带 GBS（361 个样本全部采集时，114 人，31.6%）。金黄色葡萄球菌在所有三个母体部位均常见，GBS 在阴道和母乳中常见。在新生儿中，金黄色葡萄球菌的携带在第 6 天达到高峰（377 名新生儿中有 238 名，63.1%），GBS 在第 3 天达到高峰（377 名新生儿中有 39 名，10.3%）。第 6 天新生儿携带金黄色葡萄球菌与母乳中携带金黄色葡萄球菌相关，调整后的 OR 为 2.54；95%CI 为 1.45-4.45，与阴道携带相关（aOR 2.55；95%CI 为 1.32-4.92）和鼻咽携带相关（aOR 2.49；95%CI 为 1.56-3.97）。第 6 天新生儿携带 GBS 与母乳中携带 GBS（aOR 3.75；95%CI 1.32-10.65）和阴道携带 GBS 相关（aOR 3.42；95%CI 1.27-9.22）。
结论
母亲金黄色葡萄球菌或 GBS 定植是新生儿细菌定植的危险因素。
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