Boyer K M
Rush Medical College, Chicago, Illinois, USA.
Curr Opin Pediatr. 1995 Feb;7(1):13-8. doi: 10.1097/00008480-199502000-00004.
Group B streptococci remain a leading cause of life-threatening neonatal infection worldwide. The current estimate of incidence in the United States is 1.8 cases per 1000 live births, with a case-fatality ratio of 10% to 20%. Advances in understanding of the pathogenesis of septic shock and meningitis are yielding new approaches to the treatment of these serious infections. Selective intrapartum chemoprophylaxis with ampicillin has been shown to be both effective and cost effective and is gaining more widespread acceptance as a preventive measure. Conjugate vaccines consisting of type-specific group B streptococci capsular polysaccharides coupled to tetanus toxoid or protein membrane antigens of group B streptococci have been shown to prevent neonatal infection in a mouse model of maternal immunization. Such vaccines are now in trials of safety and immunogenicity in humans.
B族链球菌仍是全球危及新生儿生命感染的主要原因。目前美国的发病率估计为每1000例活产中有1.8例，病死率为10%至20%。对脓毒症休克和脑膜炎发病机制认识的进展为这些严重感染的治疗带来了新方法。已证明用氨苄青霉素进行选择性产时化学预防既有效又具成本效益，并且作为一种预防措施正获得更广泛的认可。由B族链球菌特定型荚膜多糖与破伤风类毒素或B族链球菌蛋白膜抗原偶联而成的结合疫苗已在母体免疫的小鼠模型中显示可预防新生儿感染。此类疫苗目前正在进行人体安全性和免疫原性试验。
