全球外科部位和非侵入性细菌感染中的 B 群链球菌：系统评价和荟萃分析。

Group B Streptococcus in surgical site and non-invasive bacterial infections worldwide: A systematic review and meta-analysis.

机构信息

Healthcare-Associated Infection and Antimicrobial Resistance (HCAI & AMR) Division, National Infection Service, Public Health England, London, UK.

出版信息

Int J Infect Dis. 2019 Jun;83:116-129. doi: 10.1016/j.ijid.2019.04.017. Epub 2019 Apr 24.

DOI:10.1016/j.ijid.2019.04.017

PMID:31028879

Abstract

OBJECTIVES

The epidemiology of disease caused by group B Streptococcus (GBS; Streptococcus agalactiae) outside pregnancy and the neonatal period is poorly characterized. The aim of this study was to quantify the role of GBS as a cause of surgical site and non-invasive infections at all ages.

METHODS

A systematic review (PROSPERO CRD42017068914) and meta-analysis of GBS as a proportion (%) of bacterial isolates from surgical site infection (SSI), skin/soft tissue infection (SSTI), urinary tract infection (UTI), and respiratory tract infection (RTI) was conducted.

RESULTS

Seventy-four studies and data sources were included, covering 67 countries. In orthopaedic surgery, GBS accounted for 0.37% (95% confidence interval (CI) 0.08-1.68%), 0.87% (95% CI 0.33-2.28%), and 1.46% (95% CI 0.49-4.29%) of superficial, deep, and organ/space SSI, respectively. GBS played a more significant role as a cause of post-caesarean section SSI, detected in 2.92% (95% CI 1.51-5.55%), 1.93% (95% CI 0.97-3.81%), and 9.69% (95% CI 6.72-13.8%) of superficial, deep, and organ/space SSI. Of the SSTI isolates, 1.89% (95% CI 1.16-3.05%) were GBS. The prevalence of GBS in community and hospital UTI isolates was 1.61% (1.13-2.30%) and 0.73% (0.43-1.23%), respectively. GBS was uncommonly associated with RTI, accounting for 0.35% (95% CI 0.19-0.63%) of community and 0.27% (95% CI 0.15-0.48%) of hospital RTI isolates.

CONCLUSIONS

GBS is implicated in a small proportion of surgical site and non-invasive infections, but a substantial proportion of invasive SSI post-caesarean section.

摘要

目的

B 群链球菌（GBS；无乳链球菌）引起的妊娠和新生儿期以外疾病的流行病学特征尚未明确。本研究旨在定量评估 GBS 在各年龄段作为手术部位和非侵入性感染病因的作用。

方法

对 GBS 作为手术部位感染（SSI）、皮肤/软组织感染（SSTI）、尿路感染（UTI）和呼吸道感染（RTI）细菌分离物比例（%）的系统评价（PROSPERO CRD42017068914）和荟萃分析。

结果

共纳入 74 项研究和数据源，涵盖 67 个国家。在矫形外科手术中，GBS 分别占浅表性、深部和器官/腔隙 SSI 的 0.37%（95%置信区间（CI）0.08-1.68%）、0.87%（95% CI 0.33-2.28%）和 1.46%（95% CI 0.49-4.29%），而作为剖宫产术后 SSI 的病因，GBS 的作用更为显著，分别为 2.92%（95% CI 1.51-5.55%）、1.93%（95% CI 0.97-3.81%）和 9.69%（95% CI 6.72-13.8%）。在 SSTI 分离株中，1.89%（95% CI 1.16-3.05%）为 GBS。社区和医院 UTI 分离株中 GBS 的患病率分别为 1.61%（1.13-2.30%）和 0.73%（0.43-1.23%）。GBS 与 RTI 的相关性较低，占社区获得性 RTI 分离株的 0.35%（95% CI 0.19-0.63%）和医院获得性 RTI 分离株的 0.27%（95% CI 0.15-0.48%）。