Chang Fung-Wei, Lee Chun-I, Fan Hueng-Chuen, Su Her-Young, Liu Yung-Liang, Chen Cheng-Yu
Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Department of Obstetrics and Gynecology, Chung-Shan Medical University Hospital, Taichung, Taiwan, ROC.
Taiwan J Obstet Gynecol. 2017 Oct;56(5):648-651. doi: 10.1016/j.tjog.2017.08.013.
There was no national data on group B streptococcus (GBS) infections in Taiwan. Until 2012, when prenatal GBS screening was introduced to obstetric practices as a national health policy aimed at reducing neonatal GBS infections. The purpose of this study was to examine the impact of this national health policy on the incidence of maternal GBS colonization and neonatal GBS infection rate. Relatedly, the clinical characteristics of neonatal GBS infection were investigated to determine the correlations between the incidence of maternal GBS colonization and the neonatal GBS infection rate.
This population-based nationwide study used data for 2012-2013 from the National Health Insurance Research Database of Taiwan. A total of 789 newly diagnosed pregnant women with genital GBS infection were recruited.
The maternal GBS screening rate was 93.2%. The maternal colonization rate of GBS was around 8.2%, and the incidence of neonatal GBS infection was 22.6%. The data indicate that no sepsis was developed in any of the cases, while fever was found in 3 cases (3/179, 1.7%) and UTI was found in 1 case (1/179, 0.6%).
We conclude that a policy calling for universal maternal rectovaginal cultures for GBS with intrapartum antibiotic prophylaxis is a good national policy for reducing morbidity due to GBS infections in neonates in Taiwan.
台湾此前没有关于B族链球菌(GBS)感染的全国性数据。直到2012年,产前GBS筛查作为一项旨在降低新生儿GBS感染的国家卫生政策被引入产科实践。本研究的目的是检验这项国家卫生政策对孕产妇GBS定植发生率和新生儿GBS感染率的影响。相关地,对新生儿GBS感染的临床特征进行调查,以确定孕产妇GBS定植发生率与新生儿GBS感染率之间的相关性。
这项基于人群的全国性研究使用了台湾国民健康保险研究数据库2012 - 2013年的数据。共招募了789名新诊断为生殖器GBS感染的孕妇。
孕产妇GBS筛查率为93.2%。孕产妇GBS定植率约为8.2%,新生儿GBS感染发生率为22.6%。数据表明,所有病例均未发生败血症,3例(3/179,1.7%)出现发热,1例(1/179,0.6%)出现尿路感染。
我们得出结论,一项要求对孕产妇进行普遍的直肠阴道GBS培养并在分娩期进行抗生素预防的政策,是台湾一项降低新生儿GBS感染发病率的良好国家政策。