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中国内地孕妇和患病婴儿中 B 组链球菌感染的流行病学。

Epidemiology of group B streptococcal infection in pregnant women and diseased infants in mainland China.

机构信息

Department of Neonatology, Xiamen Maternal and Child Care Hospital, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China.

Department of Neonatology, Xiamen Maternal and Child Care Hospital, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China.

出版信息

Pediatr Neonatol. 2019 Oct;60(5):487-495. doi: 10.1016/j.pedneo.2019.07.001. Epub 2019 Jul 26.

Abstract

Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and an important cause of maternal disease in many countries; however, no accurate population-based epidemiological data on GBS is yet available in mainland China. In this systematic literature review, we obtained published data regarding the maternal GBS colonization rate, incidence of invasive GBS disease in infants, clinical screening, and the associated GBS typing and clinical outcomes in China. The maternal GBS colonization rate in mainland China ranged from 3.7 to 14.52%, and the incidence of invasive GBS disease in infants was 0.55-1.79 per 1000 live births, with a case fatality risk ranging from 6.45 to 7.1%. Serotype III was the dominant serotype that was observed in GBS isolates. GBS detection and identification has become more commonplace, due to the availability of polymerase chain reaction and DNA microarray technologies. Immunizing pregnant women against GBS is an emerging approach through which newborns are protected from GBS. The available data suggest that five GBS serotypes (Ia, Ib, II, III, and V) account for the majority of the cases of GBS disease in mainland China. Furthermore, conjugate vaccines comprising some or all of these serotypes are of potential value in the prevention of GBS infection.

摘要

B 群链球菌(GBS)是新生儿败血症的主要病因,也是许多国家产妇疾病的重要病因;然而,中国大陆尚无关于 GBS 的准确基于人群的流行病学数据。在本系统文献综述中,我们获取了关于中国的产妇 GBS 定植率、婴儿侵袭性 GBS 病的发病率、临床筛查以及相关 GBS 分型和临床结局的已发表数据。中国大陆的产妇 GBS 定植率为 3.7%至 14.52%,婴儿侵袭性 GBS 病的发病率为每 1000 例活产儿 0.55-1.79 例,病死率风险为 6.45%-7.1%。III 型是 GBS 分离株中观察到的主要血清型。由于聚合酶链反应和 DNA 微阵列技术的应用,GBS 的检测和鉴定变得更加普遍。通过对孕妇进行 GBS 免疫接种,可以保护新生儿免受 GBS 的侵害。现有数据表明,在中国内地,五种 GBS 血清型(Ia、Ib、II、III 和 V)占 GBS 病的大多数。此外,包含这些血清型中的一些或全部的结合疫苗在预防 GBS 感染方面具有潜在价值。

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