预防早发型 B 群链球菌败血症：基于临床危险因素的筛查还是基于培养的筛查？
Preventing early-onset group B streptococcal sepsis: clinical risk factor-based screening or culture-based screening?
机构信息
Department of Neonatology, National University Health System, Singapore.
Department of Laboratory Medicine, National University Health System, Singapore.
出版信息
Singapore Med J. 2021 Jan;62(1):34-38. doi: 10.11622/smedj.2019155. Epub 2019 Dec 2.
INTRODUCTION
Two strategies are available for prevention of early-onset group B streptococcal (GBS) sepsis - clinical risk factor-based screening and routine culture-based screening of pregnant women for GBS colonisation. In our hospital, we switched from the former to the latter approach in 2014.
METHODS
We compared the incidence of early-onset GBS sepsis during 2001-2015 between infants born to pregnant women who were screened for GBS colonisation and those born to women who were not screened.
RESULTS
Among 41,143 live births, there were nine cases of early-onset GBS sepsis. All infants with GBS sepsis were born to pregnant women who were not screened for GBS colonisation. The incidence of early-onset GBS sepsis among infants of women who were not screened was 0.41 per 1,000 live births (95% confidence interval [CI] 0.19-0.77) when compared to infants of women who were screened, for whom the sepsis incidence was zero per 1,000 live births (95% CI 0-0.19; p = 0.005).
CONCLUSION
Our data suggests that routine culture-based screening of pregnant women for GBS colonisation is a better preventive strategy for early-onset GBS sepsis in neonates when compared to clinical risk factor-based screening.
引言
有两种策略可用于预防早发型 B 组链球菌（GBS）败血症 - 基于临床危险因素的筛查和对孕妇进行 GBS 定植的常规培养筛查。在我们医院，我们于 2014 年从前者转为后者方法。
方法
我们比较了 2001 年至 2015 年期间在接受 GBS 定植筛查的孕妇所分娩的婴儿与未接受筛查的孕妇所分娩的婴儿中早发型 GBS 败血症的发生率。
结果
在 41,143 例活产中，有 9 例早发型 GBS 败血症。所有患有 GBS 败血症的婴儿均出生于未接受 GBS 定植筛查的孕妇。与接受筛查的孕妇相比，未接受筛查的孕妇所分娩的婴儿中早发型 GBS 败血症的发生率为每 1,000 例活产 0.41 例（95%置信区间 [CI] 0.19-0.77），而接受筛查的孕妇的败血症发生率为每 1,000 例活产 0 例（95%CI 0-0.19；p = 0.005）。
结论
与基于临床危险因素的筛查相比，对孕妇进行 GBS 定植的常规培养筛查是预防新生儿早发型 GBS 败血症的更好策略。
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