Becroft D M, Farmer K, Mason G H, Morris M C, Stewart J H
Br J Obstet Gynaecol. 1976 Dec;83(12):960-6. doi: 10.1111/j.1471-0528.1976.tb00782.x.
Since 1970 there has been an increase in isolations of Group B beta-haemolytic streptococci from infants and mothers at the National Women's Hospital and the organism has become the major cause of fatal perinatal infection. Forty-three of 60 stillborn and liveborn infants with postmortem isolations of Group B streptococci had pneumonia and of these a minority also had meningitis and/or septicaemia. Amnionitis was found in 15 of 20 placentae examined from these patients and an ascending infection from the maternal genital tract, often through intact membranes, was considered likely in the majority. However, a review of the prenatal histories of 33 infants showed that only a minority had premonitory features such as prolonged rupture of membranes, prolonged labour or maternal fever. Thirteen of 26 liveborn infants had a birth weight less than 2500 g. The majority presented within one hour of birth with respiratory distress or apnoea and died within 48 hours of birth. Early diagnosis of Group B infection is possible if bacteriological and radiological evidence is sought in infants of low birth weight, with low Apgar scores and with early onset of respiratory distress syndrome or apnoea in addition to those having the more usual indications of intrauterine infection. Group B streptococci were carried vaginally in 9 per cent of women attending an antenatal clinic and this high carrier rate is considered to preclude prophylactic treatment.
自1970年以来，国家妇女医院从婴儿和母亲中分离出的B族β溶血性链球菌有所增加，该病菌已成为围产期致命感染的主要原因。在60例死产和活产且尸检分离出B族链球菌的婴儿中，有43例患有肺炎，其中少数还患有脑膜炎和/或败血症。在对这些患者检查的20个胎盘中有15个发现了羊膜炎，多数情况下认为感染是从母体生殖道上行而来，通常是通过完整的胎膜。然而，对33名婴儿的产前病史进行回顾发现，只有少数有胎膜早破、产程延长或母亲发热等先兆特征。26名活产婴儿中有13名出生体重低于2500克。大多数婴儿在出生后一小时内出现呼吸窘迫或呼吸暂停，并在出生后48小时内死亡。如果在低出生体重、阿氏评分低、呼吸窘迫综合征或呼吸暂停早发的婴儿中，除了那些有更常见宫内感染指征的婴儿外，还寻求细菌学和放射学证据，就有可能早期诊断B族感染。在参加产前检查的妇女中，9%的人阴道携带B族链球菌，这种高携带率被认为不适合进行预防性治疗。
