与晚发型侵袭性 B 组链球菌病相关的临床危险因素：系统评价和荟萃分析。

Clinical Risk Factors Associated With Late-Onset Invasive Group B Streptococcal Disease: Systematic Review and Meta-Analyses.

机构信息

Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, United Kingdom.

Center for Early Brain Development, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

出版信息

Clin Infect Dis. 2022 Sep 30;75(7):1255-1264. doi: 10.1093/cid/ciac206.

BACKGROUND

Group B streptococcal (GBS) infection remains one of the most significant causes of late-onset sepsis and meningitis (LOGBS) among young infants. However, transmission routes and risk factors for LOGBS are not yet fully understood.

METHODS

We conducted systematic reviews on clinical risk factors previously reported in the literature (prematurity, low birth weight [<2500 g], antenatal colonization, multiple-gestation pregnancy, maternal age <20 years, male infant sex, intrapartum fever, prolonged rupture of membranes) and meta-analyses to determine pooled estimates of risk.

RESULTS

We included 27 articles, reporting 5315 cases. Prematurity (odds ratio [OR] 5.66; 95% confidence interval [CI]: 4.43-7.22), low birth weight (OR 6.73; 95% CI: 4.68-9.67), maternal colonization (2.67; [2.07-3.45]), and multiple-gestation pregnancies (OR 8.01; 95% CI: 5.19-12.38) were associated with an increased risk of LOGBS.

CONCLUSIONS

Prematurity/low birth weight and maternal colonization are major risk factors for LOGBS. Future GBS vaccine studies should try to establish the optimal time for vaccination during pregnancy to protect preterm infants.

背景

B 群链球菌（GBS）感染仍然是导致婴幼儿迟发性败血症和脑膜炎（LOGBS）的最主要原因之一。然而，LOGBS 的传播途径和危险因素尚未完全清楚。

方法

我们对文献中先前报道的临床危险因素（早产、低出生体重[<2500 克]、产前定植、多胎妊娠、产妇年龄<20 岁、男婴、产时发热、胎膜早破时间延长）进行了系统评价和荟萃分析，以确定风险的汇总估计值。

结果

我们纳入了 27 篇文章，报告了 5315 例病例。早产（比值比[OR]5.66；95%置信区间[CI]：4.43-7.22）、低出生体重（OR 6.73；95% CI：4.68-9.67）、产妇定植（2.67；[2.07-3.45]）和多胎妊娠（OR 8.01；95% CI：5.19-12.38）与 LOGBS 风险增加相关。