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儿科 B 群链球菌(GBS)感染的临床特征和治疗策略:系统评价。

Clinical Characteristics and Treatment Strategies for Group B Streptococcus (GBS) Infection in Pediatrics: A Systematic Review.

机构信息

Department of Clinical Pharmacy, Northern Border University, Rafhaa 73213, Saudi Arabia.

Department of Clinical Pharmacy, Shaqra University, Al-Dawadimi 17472, Saudi Arabia.

出版信息

Medicina (Kaunas). 2023 Jul 9;59(7):1279. doi: 10.3390/medicina59071279.

Abstract

: Group B streptococcus (GBS) is the leading cause of infections in neonates with high fatality rates. GBS is caused by the streptococcus bacterium known as streptococcus agalactiae, which is highly contagious and can be transmitted from pregnant women to infants. GBS infection can occur as an early onset or late-onset infection and has different treatment strategies. Antibiotics are effective in treating GBS infections at early stages. The aim of this systematic review was to summarize the clinical characteristics and treatment strategies for GBS, with a focus on antibiotics. : The findings of this review were reported in accordance with the PRISMA 2020 guidelines and a flow diagram of the study selection process, a summary of the included studies, a description of the study characteristics, a summary of the results, a discussion of the implications of the findings, and a conclusion are included. Overall, the authors followed a rigorous methodology to ensure that this review is comprehensive and inclusive of relevant studies on GBS infection and its treatment. : Overall, 940 studies were reviewed and only the most relevant 22 studies were included in the systematic review. This review describes the characteristics of patients in different studies related to early onset GBS disease and presents various treatment strategies and outcomes for GBS infection in pediatrics. The studies suggest that preventive measures, risk-based intrapartum antibiotic prophylaxis, and maternal vaccination can significantly reduce the burden of GBS disease, but late-onset GBS disease remains a concern, and more strategies are required to decrease its rate. Improvement is needed in the management of the risk factors of GBS. A conjugate vaccine with a serotype (Ia, Ib, II, III, and V) has been proven effective in the prevention of GBS in neonates. Moreover, penicillin is an important core antibiotic for treating early onset GBS (EOD). : This systematic review summarizes the treatment comparison for GBS infections in neonates, with a primary focus on antibiotics. IAP (intrapartum antibiotic prophylaxis) according to guidelines, antenatal screening, and the development of a conjugate vaccine may be effective and could lower the incidence of the disease.

摘要

: 乙型链球菌(GBS)是导致新生儿感染的主要原因,死亡率很高。GBS 由一种名为无乳链球菌的链球菌引起,具有高度传染性,可以由孕妇传播给婴儿。GBS 感染可表现为早发型或晚发型感染,治疗策略也不同。抗生素在早期治疗 GBS 感染方面非常有效。本系统评价的目的是总结 GBS 的临床特征和治疗策略,重点是抗生素。 : 本综述的研究结果按照 PRISMA 2020 指南和研究选择过程的流程图、纳入研究的总结、研究特征的描述、结果的总结、对研究结果的讨论以及结论进行报告。总体而言,作者采用了严格的方法学,以确保本综述全面且包含了关于 GBS 感染及其治疗的相关研究。 : 总体而言,共评价了 940 项研究,仅纳入了 22 项最相关的研究进行系统评价。本综述描述了不同研究中与早发型 GBS 疾病相关的患者特征,并提出了儿科 GBS 感染的各种治疗策略和结果。研究表明,预防措施、基于风险的分娩时抗生素预防和母亲疫苗接种可以显著降低 GBS 疾病的负担,但晚发型 GBS 疾病仍然是一个问题,需要更多的策略来降低其发生率。需要改善 GBS 危险因素的管理。一种包含(Ia、Ib、II、III 和 V 型)血清型的结合疫苗已被证明可有效预防新生儿 GBS。此外,青霉素是治疗早发型 GBS(EOD)的重要核心抗生素。 : 本系统评价总结了新生儿 GBS 感染的治疗比较,重点是抗生素。根据指南进行 IAP(分娩时抗生素预防)、产前筛查和开发结合疫苗可能是有效的,可以降低疾病的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f23/10383037/9c33d5546320/medicina-59-01279-g001.jpg

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