Abstract：
To determine maternal and neonatal risk factors for, and incidence of, neonatal early-onset group B streptococcus (EOGBS) and late-onset (LOGBS) infection in South Australia (SA) and the Northern Territory (NT).
A case-control study with 2:1 matched controls to cases. The study included tertiary hospitals in South Australia and the Northern Territory, Australia. Retrospective data were collected from a 16-year epoch (2000-2015).
Of a total of 188 clinically suspected or confirmed cases, 139 were confirmed, of which 56.1% (n = 78) were EOGBS and 43.9% (n = 61) were LOGBS. The incidence of clinically suspected and confirmed cases of EOGBS was 0.26/1000 live births in SA and 0.73/1000 live births in the NT, and the incidence of confirmed cases was 0.19/1000 for SA and 0.36/1000 for the NT. The incidence of clinically suspected or confirmed LOGBS was 0.18/1000 live births in SA and 0.16/1000 for the NT. The majority of infants with GBS presented with sepsis, pneumonia, or meningitis. Developmental delay was the most commonly recorded long-term complication at 1 year old. Risk factors for EOGBS included maternal GBS carriage, previous fetal death, identifying as Aboriginal and/or Torres Strait Islander, and maternal fever in labor/chorioamnionitis.
GBS remains a leading cause of neonatal morbidity and mortality. Adding previous fetal death to GBS screening guidelines would improve GBS prevention. The introduction of maternal GBS vaccination programs should be guided by country-specific disease epidemiology.
A case-control study with 2:1 matched controls to cases. The study included tertiary hospitals in South Australia and the Northern Territory, Australia. Retrospective data were collected from a 16-year epoch (2000-2015).
Of a total of 188 clinically suspected or confirmed cases, 139 were confirmed, of which 56.1% (n = 78) were EOGBS and 43.9% (n = 61) were LOGBS. The incidence of clinically suspected and confirmed cases of EOGBS was 0.26/1000 live births in SA and 0.73/1000 live births in the NT, and the incidence of confirmed cases was 0.19/1000 for SA and 0.36/1000 for the NT. The incidence of clinically suspected or confirmed LOGBS was 0.18/1000 live births in SA and 0.16/1000 for the NT. The majority of infants with GBS presented with sepsis, pneumonia, or meningitis. Developmental delay was the most commonly recorded long-term complication at 1 year old. Risk factors for EOGBS included maternal GBS carriage, previous fetal death, identifying as Aboriginal and/or Torres Strait Islander, and maternal fever in labor/chorioamnionitis.
GBS remains a leading cause of neonatal morbidity and mortality. Adding previous fetal death to GBS screening guidelines would improve GBS prevention. The introduction of maternal GBS vaccination programs should be guided by country-specific disease epidemiology.
摘要：
背景：为了确定孕产妇和新生儿的危险因素，和发病率，南澳大利亚（SA）和北领地（NT）的新生儿早发性B组链球菌（EOGBS）和晚发性（LOGBS）感染。
方法：病例对照研究，对照与病例2：1匹配。该研究包括南澳大利亚和北领地的三级医院，澳大利亚。回顾性数据收集自16年（2000-2015年）。
结果：总共188例临床怀疑或确诊病例，139被确认，其中56.1%(n=78)为EOGBS，43.9%(n=61)为LOGBS。临床怀疑和确诊的EOGBS病例的发生率在SA中为0.26/1000活产，在NT中为0.73/1000活产，SA的确诊病例发生率为0.19/1000，NT为0.36/1000。临床怀疑或确认的LOGBS的发生率在SA中为0.18/1000活产，在NT中为0.16/1000。大多数GBS婴儿出现败血症，肺炎,或者脑膜炎.发育延迟是1岁时最常见的长期并发症。EOGBS的危险因素包括孕产妇GBS携带，先前的胎儿死亡，确认为原住民和/或托雷斯海峡岛民，和产妇在分娩时发烧/绒毛膜羊膜炎。
结论：GBS仍然是新生儿发病和死亡的主要原因。将先前的胎儿死亡添加到GBS筛查指南中将改善GBS的预防。孕产妇GBS疫苗接种计划的引入应以特定国家的疾病流行病学为指导。
方法：病例对照研究，对照与病例2：1匹配。该研究包括南澳大利亚和北领地的三级医院，澳大利亚。回顾性数据收集自16年（2000-2015年）。
结果：总共188例临床怀疑或确诊病例，139被确认，其中56.1%(n=78)为EOGBS，43.9%(n=61)为LOGBS。临床怀疑和确诊的EOGBS病例的发生率在SA中为0.26/1000活产，在NT中为0.73/1000活产，SA的确诊病例发生率为0.19/1000，NT为0.36/1000。临床怀疑或确认的LOGBS的发生率在SA中为0.18/1000活产，在NT中为0.16/1000。大多数GBS婴儿出现败血症，肺炎,或者脑膜炎.发育延迟是1岁时最常见的长期并发症。EOGBS的危险因素包括孕产妇GBS携带，先前的胎儿死亡，确认为原住民和/或托雷斯海峡岛民，和产妇在分娩时发烧/绒毛膜羊膜炎。
结论：GBS仍然是新生儿发病和死亡的主要原因。将先前的胎儿死亡添加到GBS筛查指南中将改善GBS的预防。孕产妇GBS疫苗接种计划的引入应以特定国家的疾病流行病学为指导。
