Lim C T, Thong M K, Parasakthi N, Ngeow Y F
Department of Paediatrics, Faculty of Medicine, University Malaya, Malaysia.
Ann Acad Med Singap. 1997 Jul;26(4):421-5.
Between January 1984 and December 1994, 30 cases of early neonatal group B streptococcus (GBS) septicaemia were managed in the Neonatal Unit, University Hospital, Kuala Lumpur. Two neonates were outborn and 28 were inborn, giving an average annual incidence of neonatal GBS septicaemia of 0.4/1000 livebirths among inborn babies. In a separate survey over a three-month period, GBS genital carriage rate among 196 parturients was found to be 9.7%. Of the infants with GBS septicaemia, the mean gestational age was 37.5 +/- 3.8 weeks and the mean birthweight was 2540 +/- 716 g. Twelve (40%) were preterm infants and 14 (47%) were low birthweight infants. Male and female infants were almost equally affected. Prolonged rupture of membranes and maternal pyrexia accounted for only 5 (17%) and 3 (10%) of the cases respectively. Twenty-four (80%) neonates had onset of symptoms within 6 hours of life and respiratory symptoms were observed in 24 (80%) of the cases, while meningitis was uncommon. Six (20%) neonates died. Preterm and low birthweight infants had higher mortality than their term counterparts: 42% versus 6% and 36% versus 6% respectively. Of those who died, 4 (67%) required respiratory support right from birth and the mean time of onset of symptoms was 4 hours (range 0 to 21 hours) and the duration of survival was only 28.8 hours (range 12 to 38 hours). As the incidence of neonatal GBS septicaemia was low, mass screening and chemoprophylaxis for GBS were not recommended. All the GBS isolates were sensitive to penicillin and ampicillin, thus one of these antibiotics should be included in the antimicrobial therapy of septic neonates.
1984年1月至1994年12月期间，吉隆坡大学医院新生儿病房共收治了30例早发型新生儿B族链球菌（GBS）败血症病例。其中2例为院外出生，28例为院内出生，院内出生婴儿中新生儿GBS败血症的年平均发病率为0.4/1000活产儿。在一项为期三个月的单独调查中，发现196名产妇的GBS生殖道携带率为9.7%。患有GBS败血症的婴儿，平均胎龄为37.5±3.8周，平均出生体重为2540±716克。12例（40%）为早产儿，14例（47%）为低出生体重儿。男婴和女婴受影响程度几乎相同。胎膜早破和产妇发热分别仅占病例的5例（17%）和3例（10%）。24例（80%）新生儿在出生后6小时内出现症状，24例（80%）病例出现呼吸道症状，而脑膜炎并不常见。6例（20%）新生儿死亡。早产儿和低出生体重儿的死亡率高于足月儿：分别为42%对6%和36%对6%。在死亡病例中，4例（67%）从出生起就需要呼吸支持，症状出现的平均时间为4小时（范围0至21小时），存活时间仅为28.8小时（范围12至38小时）。由于新生儿GBS败血症的发病率较低，不建议对GBS进行大规模筛查和化学预防。所有GBS分离株均对青霉素和氨苄西林敏感，因此这些抗生素之一应纳入败血症新生儿的抗菌治疗中。
