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妊娠期李斯特菌病:一项回顾性队列研究。

Listeriosis during pregnancy: a retrospective cohort study.

机构信息

Department of Clinical Laboratory, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, China.

Neonatal Intensive Care Unit, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, China.

出版信息

BMC Pregnancy Childbirth. 2022 Mar 28;22(1):261. doi: 10.1186/s12884-022-04613-2.

Abstract

BACKGROUND

Pregnancy-associated listeriosis is a severe infectious disease and potentially leads to fetal/neonatal fatal, while limited information on pregnancy-associated listeriosis is available in China. This study aimed to reveal the clinical characteristics and outcomes of pregnancy-associated listeriosis cases and provide references for treating and managing this disease.

METHODS

We performed a retrospective study on maternal and neonatal patients with pregnancy-associated listeriosis. The clinical characteristics of pregnancy-associated listeriosis were studied, and the outcome determinants of neonatal listeriosis were explored.

RESULTS

14 cases of pregnancy-associated listeriosis were identified. The incidence of pregnancy-associated listeriosis in our hospital was 16.69/100,000 births. All of the 14 maternal patients eventually recovered after delivery shortly with no sequelae. None of the 12 mothers who delivered in this hospital received antepartum first-line empirical treatment. Among the 14 neonatal cases, 1 was late-onset listeriosis and 13 were early-onset cases; 11 survived and 3 died. Fatality rates were significantly higher in outborn neonates (P = 0.005). Besides, higher mortality rates were observed in neonates with lower birth weight (P = 0.038), gestational age < 28 weeks (P = 0.056), and Apgar score (5 min) < 5 (P = 0.056), with marginally significant differences.

CONCLUSIONS

Pregnancy-associated listeriosis would bring disastrous effects to the neonatal cases, especially to the outborn, low birth weight, and low gestational age of neonates. Timely detection and treatment should be taken seriously for the key neonates. How to early detect L. monocytogenes infected cases, especially in the prenatal stage, remains a serious challenge.

摘要

背景

妊娠李斯特菌病是一种严重的传染病,可能导致胎儿/新生儿死亡,而中国关于妊娠李斯特菌病的信息有限。本研究旨在揭示妊娠李斯特菌病病例的临床特征和结局,为治疗和管理该病提供参考。

方法

我们对母婴李斯特菌病患者进行了回顾性研究。研究了妊娠李斯特菌病的临床特征,并探讨了新生儿李斯特菌病结局的决定因素。

结果

共发现 14 例妊娠李斯特菌病。我院妊娠李斯特菌病的发病率为 16.69/10 万分娩。所有 14 例产妇均在分娩后短期内痊愈,无后遗症。在我院分娩的 12 位母亲中,均未接受产前一线经验性治疗。14 例新生儿中,1 例为晚发型李斯特菌病,13 例为早发型;11 例存活,3 例死亡。外源性新生儿的病死率显著更高(P=0.005)。此外,出生体重较低(P=0.038)、胎龄<28 周(P=0.056)和 Apgar 评分(5 分钟)<5(P=0.056)的新生儿死亡率更高,差异有统计学意义。

结论

妊娠李斯特菌病会给新生儿病例带来灾难性影响,特别是对早产儿、低出生体重儿和低胎龄儿。对于重点新生儿,应认真采取及时检测和治疗。如何早期检测李斯特菌感染病例,特别是在产前阶段,仍然是一个严峻的挑战。

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