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B族链球菌的高定植率和抗菌药物耐药性凸显了即使在实施产时抗生素预防指南后仍需进行疫苗接种的必要性。

High rates of colonization and antimicrobial resistance of group B streptococcus highlight the need for vaccination even after implementation of guidelines for intrapartum antibiotic prophylaxis.

作者信息

Wang Ching-Hui, Kung Wan-Ju, Lee Chien-Hung, Lee Cheng-Fa, Kao Chia-Ling, Chen Hui-Chi, Hsu Ting-Wen, Lin Ching-Chiang

机构信息

Department of Laboratory Medicine, Fooyin University Hospital, Pingtung, Taiwan.

Department of Public Health and Environmental Medicine Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Vaccine. 2022 Jan 21;40(2):282-287. doi: 10.1016/j.vaccine.2021.11.069. Epub 2021 Dec 2.

Abstract

INTRODUCTION

It is estimated that about 11-35% of pregnant women are colonized with Group B streptococcus. Intrapartum antibiotic prophylaxis (IAP) is the primary intervention to decrease the risk of infecting babies born to GBS colonized mothers.

METHODS

A total of 5,996 pregnant women, who received the Taiwanese universal GBS screening program from 2012 to 2020, were included in this study that investigated GBS colonization, antimicrobial resistance rates and their neonatal incidence of invasive GBS infection.

RESULTS

The average GBS colonization rate was 18.5%. Older age groups had higher colonization rates than younger age groups. Compared to Taiwanese, immigrant women from Indonesia had a greater positive rate. GBS isolated from Vietnamese women had significant greater resistance to clindamycin relative to Taiwanese women. Rates of resistance to erythromycin increase from 35.5% to 45.5% over the 9 years of measurements. The incidence of invasive GBS disease was about 0.6/1,000 (4/6,204) live births during the study.

CONCLUSIONS

Although relatively low incidence of invasive GBS diseases was observed after implementation of IAP, the colonization of GBS remains high and antimicrobial resistance of GBS is increasing. An effective GBS vaccine holds promise to be a solution for these issues.

摘要

引言

据估计,约11%-35%的孕妇感染B族链球菌。产时抗生素预防(IAP)是降低感染B族链球菌的母亲所生婴儿感染风险的主要干预措施。

方法

本研究纳入了2012年至2020年接受台湾地区B族链球菌普遍筛查项目的5996名孕妇,调查B族链球菌定植情况、抗菌药物耐药率及其新生儿侵袭性B族链球菌感染发生率。

结果

B族链球菌平均定植率为18.5%。年龄较大的组比年龄较小的组有更高的定植率。与台湾女性相比,来自印度尼西亚的移民女性阳性率更高。从越南女性中分离出的B族链球菌对克林霉素的耐药性相对于台湾女性显著更高。在9年的测量期间,对红霉素的耐药率从35.5%升至45.5%。在研究期间,侵袭性B族链球菌病的发生率约为0.6/1000(4/6204)活产儿。

结论

尽管实施IAP后侵袭性B族链球菌病的发病率相对较低,但B族链球菌的定植率仍然很高,且B族链球菌的抗菌药物耐药性正在增加。一种有效的B族链球菌疫苗有望解决这些问题。

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