新生儿B族链球菌感染流行病学和预防策略近十年来的研究进展

郭孟杨; 高薇; 袁林; 姚开虎

doi:10.7499/j.issn.1008-8830.2211140

PDF(573 KB)

HTML

中国当代儿科杂志 ›› 2023, Vol. 25 ›› Issue (5) : 534-540. DOI: 10.7499/j.issn.1008-8830.2211140

综述

新生儿B族链球菌感染流行病学和预防策略近十年来的研究进展

郭孟杨, 高薇, 袁林, 姚开虎

作者信息 +

Recent research on the epidemiology and preventive strategies of neonatal group B Streptococcus infection in the latest decade

GUO Meng-Yang, GAO Wei, YUAN Lin, YAO Kai-Hu

Author information +

文章历史 +

摘要

孕妇筛查结合产时抗生素预防是目前预防新生儿B族链球菌（group B Streptococcus，GBS）感染的主要策略，推广使用这一策略有效降低了新生儿GBS早发型疾病的发病率，但GBS感染的疾病负担仍很严重。产时抗生素预防策略存在引起抗生素耐药性、不能有效预防GBS晚发型疾病等局限，研发和评估其他预防策略至关重要，同时还需要密切关注如何评估孕妇青霉素过敏，以及母亲GBS筛查阴性的新生儿GBS感染的预防等问题。近年来，GBS疫苗及其免疫学相关研究取得了一些进展，应用特异性疫苗有望进一步减少新生儿GBS感染。

Abstract

Currently, the main strategy for preventing neonatal group B Streptococcus (GBS) infection is prenatal screening combined with intrapartum antibiotic prophylaxis, which has effectively reduced the incidence of neonatal GBS early-onset disease. However, the burden of GBS infection is still significant. The intrapartum antibiotic prophylaxis strategy has limitations such as inducing antibiotic resistance and inability to effectively prevent GBS late-onset disease. It is crucial to develop and evaluate other prevention strategies, while paying close attention to assessing penicillin allergy in pregnant women and how to prevent GBS infection in neonates with negative maternal GBS screening. In recent years, there has been some progress in GBS vaccines and related immunological research, and the use of specific vaccines is expected to significantly reduce GBS infection in neonates.

导出引用

郭孟杨, 高薇, 袁林, 姚开虎. 新生儿B族链球菌感染流行病学和预防策略近十年来的研究进展[J]. 中国当代儿科杂志. 2023, 25(5): 534-540 https://doi.org/10.7499/j.issn.1008-8830.2211140

GUO Meng-Yang, GAO Wei, YUAN Lin, YAO Kai-Hu. Recent research on the epidemiology and preventive strategies of neonatal group B Streptococcus infection in the latest decade[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(5): 534-540 https://doi.org/10.7499/j.issn.1008-8830.2211140

参考文献

1 Anon. Prevention of group B streptococcal early-onset disease in newborns: ACOG committee opinion, number 797[J]. Obstet Gynecol, 2020, 135(2): e51-e72. PMID: 31977795. DOI: 10.1097/AOG.0000000000003668.
2 Russell NJ, Seale AC, O'Sullivan C, et al. Risk of early-onset neonatal group B streptococcal disease with maternal colonization worldwide: systematic review and meta-analyses[J]. Clin Infect Dis, 2017, 65(suppl_2): S152-S159. PMID: 29117325. PMCID: PMC5850448. DOI: 10.1093/cid/cix655.
3 Public Health England. Group B streptococcal infections: guidance, data and analysis[EB/OL]. (2020-06-26)[2022-11-07]. https://www.gov.uk/guidance/group-b-streptococcal-infections.
4 Centers for Disease Control and Prevention. Group B strep home[EB/OL]. (2022-10-18)[2022-11-05]. https://www.cdc.gov/groupbstrep/clinicians/index.html.
5 中华医学会围产医学分会, 中华医学会妇产科学分会产科学组. 预防围产期B族链球菌病(中国)专家共识[J]. 中华围产医学杂志, 2021, 24(8): 561-566. DOI: 10.3760/cma.j.cn113903-20210716-00638.
6 World Health Organization. Urgent need for vaccine to prevent deadly group B Streptococcus[EB/OL]. (2021-11-02)[2022-11-04]. https://www.who.int/news/item/02-11-2021-urgent-need-for-vaccine-to-prevent-deadly-group-b-streptococcus.
7 Gon?alves BP, Procter SR, Paul P, et al. Group B Streptococcus infection during pregnancy and infancy: estimates of regional and global burden[J]. Lancet Glob Health, 2022, 10(6): e807-e819. PMID: 35490693. PMCID: PMC9090904. DOI: 10.1016/S2214-109X(22)00093-6.
8 GOV.UK. Laboratory surveillance of pyogenic and non-pyogenic streptococcal bacteraemia in England: 2020 update[EB/OL]. (2021-11-23)[2022-07-28]. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1036011/hpr1921_strptcccl-BSI_2020.pdf.
9 Nanduri SA, Petit S, Smelser C, et al. Epidemiology of invasive early-onset and late-onset group B streptococcal disease in the United States, 2006 to 2015: multistate laboratory and population-based surveillance[J]. JAMA Pediatr, 2019, 173(3): 224-233. PMID: 30640366. PMCID: PMC6439883. DOI: 10.1001/jamapediatrics.2018.4826.
10 Cho CY, Tang YH, Chen YH, et al. Group B streptococcal infection in neonates and colonization in pregnant women: an epidemiological retrospective analysis[J]. J Microbiol Immunol Infect, 2019, 52(2): 265-272. PMID: 28882582. DOI: 10.1016/j.jmii.2017.08.004.
11 Zhu Y, Huang J, Lin XZ, et al. Group B Streptococcus colonization in late pregnancy and invasive infection in neonates in China: a population-based 3-year study[J]. Neonatology, 2019, 115(4): 301-309. PMID: 30808831. DOI: 10.1159/000494133.
12 Huang J, Lin XZ, Zhu Y, et al. Epidemiology of group B streptococcal infection in pregnant women and diseased infants in mainland China[J]. Pediatr Neonatol, 2019, 60(5): 487-495. PMID: 31445795. DOI: 10.1016/j.pedneo.2019.07.001.
13 Ding Y, Wang Y, Hsia Y, et al. Systematic review and meta-analyses of incidence for group B Streptococcus disease in infants and antimicrobial resistance, China[J]. Emerg Infect Dis, 2020, 26(11): 2651-2659. PMID: 33079042. PMCID: PMC7588546. DOI: 10.3201/eid2611.181414.
14 Furfaro LL, Chang BJ, Payne MS. Perinatal Streptococcus agalactiae epidemiology and surveillance targets[J]. Clin Microbiol Rev, 2018, 31(4): e00049-18. PMID: 30111577. PMCID: PMC6148196. DOI: 10.1128/CMR.00049-18.
15 祝垚, 高磊, 黄仲玲, 等. 新生儿B族链球菌感染现状的多中心前瞻性研究[J]. 中国当代儿科杂志, 2021, 23(9): 889-895. PMID: 34535202. PMCID: PMC8480158. DOI: 10.7499/j.issn.1008-8830.2105018.
16 Miselli F, Creti R, Lugli L, et al. Group B Streptococcus late-onset neonatal disease: an update in management and prevention[J]. Pediatr Infect Dis J, 2022, 41(6): e263-e266. PMID: 35446809. DOI: 10.1097/INF.0000000000003517.
17 Le Doare K, O'Driscoll M, Turner K, et al. Intrapartum antibiotic chemoprophylaxis policies for the prevention of group B streptococcal disease worldwide: systematic review[J]. Clin Infect Dis, 2017, 65(suppl_2): S143-S151. PMID: 29117324. PMCID: PMC5850619. DOI: 10.1093/cid/cix654.
18 Hughes RG, Brocklehurst P, Steer PJ, et al. Prevention of early-onset neonatal group B streptococcal disease: green-top guideline No. 36[J]. BJOG, 2017, 124(12): e280-e305. PMID: 28901693. DOI: 10.1111/1471-0528.14821.
19 Queensland Government . Queensland clinical guideline: early onset group B streptococcal disease[EB/OL]. (2022-08-08)[2022-11-04]. https://www.health.qld.gov.au/__data/assets/pdf_file/0026/626732/g-gbs.pdf.
20 中国细菌耐药监测网. CHINET中国细菌耐药监测结果(CHINET 2021)[EB/OL]. (2022-02-11)[2022-11-09]. http://www.chinets.com/Data/AntibioticDrugFast.
21 Jones S, Newton P, Payne M, et al. Epidemiology, antimicrobial resistance, and virulence determinants of group B Streptococcus in an Australian setting[J]. Front Microbiol, 2022, 13: 839079. PMID: 35774462. PMCID: PMC9238357. DOI: 10.3389/fmicb.2022.839079.
22 Park C, Nichols M, Schrag SJ. Two cases of invasive vancomycin-resistant group B Streptococcus infection[J]. N Engl J Med, 2014, 370(9): 885-886. PMID: 24571775. DOI: 10.1056/NEJMc1308504.
23 Mudzana R, Mavenyengwa RT, Gudza-Mugabe M. Analysis of virulence factors and antibiotic resistance genes in group B Streptococcus from clinical samples[J]. BMC Infect Dis, 2021, 21(1): 125. PMID: 33509097. PMCID: PMC7844887. DOI: 10.1186/s12879-021-05820-6.
24 Metcalf BJ, Chochua S, Gertz RE, et al. Short-read whole genome sequencing for determination of antimicrobial resistance mechanisms and capsular serotypes of current invasive Streptococcus agalactiae recovered in the USA[J]. Clin Microbiol Infect, 2017, 23(8): 574.e7-574.e14. PMID: 28257899. DOI: 10.1016/j.cmi.2017.02.021.
25 黄晓林, 严静静. 孕期B族链球菌感染对胎膜早破和新生儿影响及药敏分析[J]. 中国计划生育学杂志, 2021, 29(5): 1041-1045. DOI: 10.3969/j.issn.1004-8189.2021.05.046.
26 Huang J, Li S, Li L, et al. Alarming regional differences in prevalence and antimicrobial susceptibility of group B streptococci in pregnant women: a systematic review and meta-analysis[J]. J Glob Antimicrob Resist, 2016, 7: 169-177. PMID: 27837713. DOI: 10.1016/j.jgar.2016.08.010.
27 European Committee on Antimicrobial Susceptibility Testing. Clinical breakpoints - breakpoints and guidance[EB/OL]. (2022-01-01)[2022-11-10]. https://www.eucast.org/clinical_breakpoints.
28 Berardi A, Rossi C, Lugli L, et al. Group B Streptococcus late-onset disease: 2003-2010[J]. Pediatrics, 2013, 131(2): e361-e368. PMID: 23296441. DOI: 10.1542/peds.2012-1231.
29 Davanzo R, De Cunto A, Travan L, et al. To feed or not to feed? Case presentation and best practice guidance for human milk feeding and group B Streptococcus in developed countries[J]. J Hum Lact, 2013, 29(4): 452-457. PMID: 23507961. DOI: 10.1177/0890334413480427.
30 Ching NS, Buttery JP, Lai E, et al. Breastfeeding and risk of late-onset group B streptococcal disease[J]. Pediatrics, 2021, 148(3): e2020049561. PMID: 34385351. DOI: 10.1542/peds.2020-049561.
31 Berardi A, Trevisani V, Di Caprio A, et al. Understanding factors in group B Streptococcus late-onset disease[J]. Infect Drug Resist, 2021, 14: 3207-3218. PMID: 34429620. PMCID: PMC8380284. DOI: 10.2147/IDR.S291511.
32 Collin SM, Lamb P, Jauneikaite E, et al. Hospital clusters of invasive Group B streptococcal disease: a systematic review[J]. J Infect, 2019, 79(6): 521-527. PMID: 31733233. DOI: 10.1016/j.jinf.2019.11.008.
33 Cress BF, Englaender JA, He W, et al. Masquerading microbial pathogens: capsular polysaccharides mimic host-tissue molecules[J]. FEMS Microbiol Rev, 2014, 38(4): 660-697. PMID: 24372337. PMCID: PMC4120193. DOI: 10.1111/1574-6976.12056.
34 Absalon J, Segall N, Block SL, et al. Safety and immunogenicity of a novel hexavalent group B Streptococcus conjugate vaccine in healthy, non-pregnant adults: a phase 1/2, randomised, placebo-controlled, observer-blinded, dose-escalation trial[J]. Lancet Infect Dis, 2021, 21(2): 263-274. PMID: 32891191. PMCID: PMC9760110. DOI: 10.1016/S1473-3099(20)30478-3.
35 Fischer P, Pawlowski A, Cao D, et al. Safety and immunogenicity of a prototype recombinant alpha-like protein subunit vaccine (GBS-NN) against group B Streptococcus in a randomised placebo-controlled double-blind phase 1 trial in healthy adult women[J]. Vaccine, 2021, 39(32): 4489-4499. PMID: 34215454. DOI: 10.1016/j.vaccine.2021.06.046.
36 World Health Organization. Defeating meningitis by 2030: a global road map[EB/OL]. (2021-06-24)[2023-04-19]. https://www.who.int/publications/i/item/9789240025516.
37 Puopolo KM, Lynfield R, Cummings JJ.American Academy of Pediatrics, Committee on Fetus and Newborn, Committee on Infectious Diseases. Management of Infants at Risk for Group B Streptococcal Disease[J]. Pediatrics, 2019, 144(4): e20192350. PMID: 31570651. DOI: 10.1542/peds.2019-2350.