孕妇孕晚期 GBS定植及新生儿早发型 GBS感染趋势

摘要

Objective To observe the perinatal group B streptococcus ( GBS) colonization and subsequent vertical transmission rate and to evaluate trend of neonatal early-onset group B streptococcal disease ( EOD) .Methods Vaginal GBS screening was performed among 3 487 pregnant women delivering in Affiliated Suzhou Maternal and Neonatal Medical Health Center of Nanjing Medical College .Culturing screening strategies recommended by CDC were used to evaluate the colonization rate of perinatal GBS .Vertical transmission screening was conducted among 1 018 mother and newborn samples .Neonatal outcomes were followed , and the vertical transmission rate and the incidence rate of EOD in neonates were recorded .Results In culture screening group, there were 142 of 3 487cases found with GBS, and the vaginal GBS colonization rate was 4.07%.In vertical transmission screening group , 52 of 1 018 matched samples were found with GBS and 4 neonates were positive with vertical transmission rate of 7.69%.Among 1 062 recruited neonates, one case developed EOD with incidence of 0.94‰(1/1 062).Conclusion Although GBS colonization rate is low , the vertical transmission rate and incidence of EOD in neonates are relatively high .It is necessary to promote the implementation of GBS prenatal screening in China with health support .%目的：观察孕晚期B族链球菌（ GBS）的定植情况以及母婴垂直传播率，评估新生儿早发型GBS疾病（ EOD）的发病趋势。方法选择2014年1月至2015年3月在南京医学院附属苏州母子医疗保健中心住院分娩的3487例孕妇进行阴道GBS筛查，根据美国疾病控制中心（ CDC）推荐的培养筛查策略评估孕妇孕晚期GBS的定植率；对1018对孕妇－新生儿配对病例进行垂直传播筛查，追踪新生儿结局，统计母婴垂直传播率及新生儿EOD的发病率。结果在培养筛查组，3487例孕妇标本中有142例GBS培养阳性，孕妇阴道GBS定植率为4．07％；在母婴垂直传播筛查组，1018对配对标本中，有52例孕妇GBS培养阳性，其分娩新生儿有4例阳性，垂直传播率为7．69％。在1062例纳入研究的新生儿中有1例发生EOD，其发病率为0．94‰（1／1062）。结论虽然孕妇孕晚期GBS定植率低，但其垂直传播率及新生儿EOD发病率均较高。有必要于有条件的地区进一步推行GBS产前筛查和相关治疗。