Research progress in late-onset group B Streptococcus infection in infants and its prevention
LI Yibai,1, CUI Ruiji2, GAO Shan2, HU Jiajin3, GUO Xiaoying,4
1.The First Hospital of China Medical University, Shenyang 110122, China
2.Department of Neonatology, Shenyang Maternity and Child Health Hospital, Liaoning Province, Shenyang 110114, China
3.Key Laboratory of Obesity and Glucose, Lipid Associated Metabolic Diseases of Liaoning Province/Health Sciences Institute, China Medical University, Shenyang 110122, China
4.School of Public Health, China Medical University, Shenyang 110122, China
B族链球菌（group B Streptococcus，GBS）是革兰阳性链球菌家族的主要成员，在新生儿和小婴儿感染谱中占有重要地位。出生<7 d的新生儿发生的GBS感染被称为GBS早发型病（GBS early-onset disease，GBS-EOD），7~89 d的新生儿和婴儿发生的GBS感染被称为GBS晚发型病（GBS late-onset disease，GBS-LOD）。随着产时抗生素的预防性使用，新生儿GBS-EOD发生率大幅下降，然而GBS-LOD却没有获得很好的预防控制效果，给临床诊疗和护理带来压力和挑战。虽然GBS传播引发新生儿和婴儿患病的具体机制还没有被完全阐明，但研究已发现母体GBS定植、产妇的特征（如年龄、体质量和种族）、早产、多胞胎中有GBS感染，以及暴露于人类免疫缺陷病毒环境等是导致GBS-LOD的危险因素。接种疫苗、调节肠道微生态、补充乳铁蛋白作为预防母婴GBS感染的措施在不断发展完善中。此外，加强孕产妇保健和健康教育、强化看护者的手卫生意识、做好环境和设备的消毒工作、实施隔离等常规感染控制策略在预防GBS-LOD中也发挥了重要作用。该文综述了婴儿GBS-LOD的流行病学特征、传播方式、危险因素及预防措施，以期帮助临床医护人员提高对疾病的认识和临床实践能力。
关键词：婴儿
;
晚发型
;
B族链球菌
;
感染
;
预防
Abstract
Group B Streptococcus (GBS) is a major member of the Gram-positive Streptococcus family, which occupies a dominant position in the infection spectrum of newborns and young infants. GBS infections occurring 0‒6 days after birth are called GBS early-onset disease (GBS-EOD), and those occurring 7‒89 days are called GBS late-onset disease (GBS-LOD). With the use of intrapartum antibiotic prophylaxis, the incidence of neonatal GBS-EOD has declined without a notable impact on GBS-LOD, which brings great pressure and challenge to clinical diagnosis and nursing work. However, the specific mechanisms by which GBS transmission triggers illness in newborns and young infants are not fully elucidated. Some factors, such as maternal GBS colonization, maternal characteristics (age, weight and ethnicity), preterm birth, GBS infection in multiple births, and exposure to human immunodeficiency virus, have been identified as risk factors for GBS-LOD. To prevent maternal and infant GBS infection, some measures, such as vaccination of pregnant women, gut microbiota regulation and lactoferrin supplementation, are developing. In addition, strengthening maternal health care and health education, along with some other conventional infection control strategies (including enhancing hand hygiene awareness among caregivers and making good disinfection of the environment and equipment) is also effective in the prevention of GBS-LOD. This review elaborates the prevalence, transmission, risk factors and prevention of GBS-LOD in infants, aiming to improve the understanding and clinical practice ability of the medical staff.
Keywords：infant
;
late-onset
;
group B Streptococcus (GBS)
;
infection
;
prevention
LI Yibai, CUI Ruiji, GAO Shan, HU Jiajin, GUO Xiaoying. Research progress in late-onset group B Streptococcus infection in infants and its prevention. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2024, 44(8): 1044-1049 doi:10.3969/j.issn.1674-8115.2024.08.014
B族链球菌（group B Streptococcus，GBS）又称为无乳链球菌，是革兰阳性链球菌家族的主要成员，在新生儿和小婴儿感染谱中占有重要地位。根据GBS感染的发病时间，通常将出生<7 d的新生儿发生的GBS感染称为早发型GBS病（GBS early-onset disease，GBS-EOD），而将出生7~89 d的新生儿和小婴儿发生的GBS感染称为晚发型GBS病（GBS late-onset disease，GBS-LOD）。近些年，随着产时抗生素的预防性使用，GBS-EOD得到有效控制，但这一措施对GBS-LOD的预防控制效果不理想［1］，给临床诊疗和护理工作带来压力和挑战。随着儿童感染性疾病研究的不断深入，婴儿期GBS-LOD越来越引起人们的重视。本文从GBS-LOD在婴儿中的流行病学特征、传播方式、危险因素及预防策略4个方面进行综述，旨在为GBS-LOD的综合管理和制订相关公共卫生干预策略提供依据。
LI Yibai and CUI Ruiji contributed to the conceptualization of the paper and drafted the initial manuscript. HU Jiajin and GUO Xiaoying provided guidance on the writing. LI Yibai, GAO Shan and GUO Xiaoying were responsible for reviewing and revising the paper. All the authors have read the last version of paper and consented for submission.
利益冲突声明
所有作者声明不存在利益冲突。
COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
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