新生儿GBS感染的影响因素及预防对策  

Influencing Factors and Preventive Countermeasures of GBS Infection in Newborns

作　　者：刘大伟[1] 高艳[1] LIU Dawei;GAO Yan(Department of Neonatology,Lianyungang Matemal and Child Health Hospital,Lianyungang 222000,China)

机构地区：[1]连云港市妇幼保健院新生儿科,江苏连云港222000

出　　处：《中国医药指南》2023年第19期49-52,共4页Guide of China Medicine

摘　　要：目的探讨新生儿B族链球菌(GBS)感染的相关影响因素及预防对策。方法选取2019年3月至2021年9月我院收治的新生儿GBS感染患儿共98例作为研究对象,根据患儿的发病时间将其分为早发组(63例)与迟发组(35例),其中早发组患儿在7 d内发病,迟发组患儿在7 d之后发病。分析对比两组GBS患儿并发肺炎、脑膜炎以及败血症的发生率,采用Logistic回归分析新生儿GBS感染的相关影响因素,药敏测试GBS对青霉素、万古霉素以及红霉素药物的耐药性及敏感性,观察两组患儿使用药物治疗后的恢复情况。结果两组GBS患儿并发脑膜炎、败血症、败血症合并脑膜炎以及败血症合并肺炎脑膜炎的发生率对比无明显差异(P>0.05),早发组患儿并发肺炎、败血症合并肺炎的发生率明显高于迟发组(P<0.05);通过对两组新生儿GBS感染影响因素行Logistic回归分析得出,新生儿发生胎膜早破、阴道分娩是导致GBS感染的主要影响因素;GBS耐药性及敏感性分析显示,GBS对青霉素以及万古霉素的敏感性较高,对红霉素等药物的耐药性较高;两组GBS患儿通过药物治疗后恢复情况良好,脑脊液生化指标理想。结论经阴道分娩以及胎膜早破是导致新生儿GBS感染的主要影响因素,患儿临床表现主要为肺炎、败血症等症状,通过对治疗药物的药敏性测试发现,青霉素药物治疗敏感性最高,可结合患儿具体病情以及临床治疗方式进行对症治疗。Objective To investigate the influencing factors and preventive countermeasures related to GBS(group B streptococcus)infection in neonates.Methods A total of 98 cases of neonatal GBS infection admitted to our hospital from March 2019 to September 2021 were selected as study subjects,and they were divided into early-onset group(63 cases)and late-onset group(35 cases)according to the onset time of the children,in which the children in the early-onset group had onset within 7 days and the children in the late-onset group had onset after 7 days.The incidence of pneumonia,meningitis and sepsis in the two groups of children with GBS was analyzed and the factors associated with GBS infection in neonates were analyzed by Logistic regression,and the resistance and sensitivity of GBS to penicillin,vancomycin and erythromycin were tested by drug sensitivity.Results There was no significant difference in the incidence of concurrent meningitis,sepsis,sepsis combined with meningitis and sepsis combined with pneumonia meningitis in the two groups of GBS children(P>0.05),and the incidence of concurrent pneumonia and sepsis combined with pneumonia in the early-onset group were significantly higher than that in the late-onset group(P<0.05);by logistic regression analysis of the influencing factors of GBS infection in the two groups of neonates,it was concluded that the Logistic regression analysis of the factors affecting GBS infection in the two groups of neonates showed that premature rupture of membranes and vaginal delivery were the main factors influencing GBS infection;GBS resistance and sensitivity analysis showed that GBS was more sensitive to penicillin as well as vancomycin and more resistant to erythromycin and other drugs;the two groups of children with GBS recovered well after drug treatment and the biochemical index of cerebrospinal fluid was satisfactory.Conclusion Transthoracic delirery and premature rupture of membranes are the main influencing factors of GBS infection in neonates,and the clinical manifestations o

关 键 词：新生儿 GBS感染 影响因素 预防对策 

分 类 号：R722.13[医药卫生—儿科]