Yanni Marianne, Stark Michael, Francis Laura, Francis Joshua R, McMillan Mark, Baird Rob, Heath Paul T, Gordon Alex, Riccardione James, Wilson Angela, Lee Rebecca, Chooi Kathrina, Quinn Olivia-Paris, Marshall Helen S
From the Department of Paediatrics, Women's and Children's Health Network, Adelaide, South Australia, Australia.
Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Pediatr Infect Dis J. 2023 May 1;42(5):429-435. doi: 10.1097/INF.0000000000003881. Epub 2023 Mar 16.
To determine maternal and neonatal risk factors for, and incidence of, neonatal early-onset group B streptococcus (EOGBS) and late-onset (LOGBS) infection in South Australia (SA) and the Northern Territory (NT).
A case-control study with 2:1 matched controls to cases. The study included tertiary hospitals in South Australia and the Northern Territory, Australia. Retrospective data were collected from a 16-year epoch (2000-2015).
Of a total of 188 clinically suspected or confirmed cases, 139 were confirmed, of which 56.1% (n = 78) were EOGBS and 43.9% (n = 61) were LOGBS. The incidence of clinically suspected and confirmed cases of EOGBS was 0.26/1000 live births in SA and 0.73/1000 live births in the NT, and the incidence of confirmed cases was 0.19/1000 for SA and 0.36/1000 for the NT. The incidence of clinically suspected or confirmed LOGBS was 0.18/1000 live births in SA and 0.16/1000 for the NT. The majority of infants with GBS presented with sepsis, pneumonia, or meningitis. Developmental delay was the most commonly recorded long-term complication at 1 year old. Risk factors for EOGBS included maternal GBS carriage, previous fetal death, identifying as Aboriginal and/or Torres Strait Islander, and maternal fever in labor/chorioamnionitis.
GBS remains a leading cause of neonatal morbidity and mortality. Adding previous fetal death to GBS screening guidelines would improve GBS prevention. The introduction of maternal GBS vaccination programs should be guided by country-specific disease epidemiology.
确定南澳大利亚州（SA）和北领地（NT）新生儿早发型B族链球菌（EOGBS）及晚发型（LOGBS）感染的孕产妇和新生儿风险因素以及发病率。
一项病例对照研究，病例与对照按2:1匹配。该研究纳入了澳大利亚南澳大利亚州和北领地的三级医院。回顾性收集了16年（2000 - 2015年）的数据。
在总共188例临床疑似或确诊病例中，139例得到确诊，其中56.1%（n = 78）为EOGBS，43.9%（n = 61）为LOGBS。SA地区EOGBS临床疑似及确诊病例的发病率为0.26/1000活产儿，NT地区为0.73/1000活产儿；确诊病例发病率SA地区为0.19/1000，NT地区为0.36/1000。SA地区临床疑似或确诊LOGBS的发病率为0.18/1000活产儿，NT地区为0.16/1000活产儿。大多数感染GBS的婴儿表现为败血症、肺炎或脑膜炎。发育迟缓是1岁时最常记录到 的长期并发症。EOGBS的风险因素包括孕产妇GBS携带、既往死胎、原住民和/或托雷斯海峡岛民身份以及分娩时产妇发热/绒毛膜羊膜炎。
GBS仍然是新生儿发病和死亡的主要原因。将既往死胎纳入GBS筛查指南将改善GBS的预防。孕产妇GBS疫苗接种计划的引入应以特定国家的疾病流行病学为指导。
