背景:溶胆链球菌亚种巴氏菌(SGP),牛链球菌的一种亚型,是新生儿败血症的一个罕见但重要的原因。虽然不常见,婴儿期SGP感染与发病率和死亡率增加相关。
方法:这是对SGP感染婴儿的临床过程和结局的现有文献的系统评价和荟萃分析。使用以下MeSH关键词确定研究:“溶胆链球菌,\"\"牛链球菌,\"\"新生儿\"和\"婴儿。\“数据包括围产期因素,临床表现,调查,提取并分析治疗和结局。
结果:共鉴定46篇(116例:60牛链球菌,56SGP)。这些病例主要是足月(52%),男性(57%)和通过阴道分娩出生(67%)。最常见的症状是发烧[67%(95%置信区间(CI):43%-84%)],嗜睡[66%(95%CI:32%-89%)],呼吸急促[59%(95%CI:27%-85%)]和易怒[59%(95%CI:34%-79%)]。早发性感染(生命<3天)的婴儿更容易出现呼吸道症状和菌血症(73%)。而迟发性感染主要表现为胃肠道症状。报告了在施用抗生素之前发生的四次死亡。分离出的细菌大多对青霉素敏感[95%(95%CI:78-99%)],接受青霉素衍生物治疗的病例恢复良好。
结论:SGP是新生儿败血症和脑膜炎的重要原因。青霉素衍生物是SGP的有效治疗方法,结果似乎是有利的。
BACKGROUND: Streptococcus gallolyticus subspecies pasteurianus (SGP), a subtype of Streptococcus bovis , is an uncommon but important cause of neonatal sepsis. Although uncommon, SGP infections during infancy have been associated with an increased risk of morbidity and mortality.
METHODS: This is a systematic review and meta-analysis of available literature on the clinical course and outcomes of infants with SGP infection. Studies were identified using the following MeSH keywords: \" Streptococcus gallolyticus ,\" \" Streptococcus bovis ,\" \"newborn\" and \"infant.\" Data including perinatal factors, clinical presentation, investigations, treatment and outcomes were extracted and analyzed.
RESULTS: A total of 46 articles were identified (116 cases: 60 S. bovis , 56 SGP). The cases were predominantly term (52%), male (57%) and born via vaginal delivery (67%). The most common symptom was fever [67% (95% confidence interval (CI): 43%-84%)], lethargy [66% (95% CI: 32%-89%)], tachypnea [59% (95% CI: 27%-85%)] and irritability [59% (95% CI: 34%-79%)]. Infants with early-onset infections (<3 days of life) were more likely to have respiratory symptoms and bacteremia (73%), whereas late-onset infections presented predominantly with gastrointestinal symptoms. Four mortalities were reported which occurred before antibiotic administration. Isolated bacteria were mostly penicillin-susceptible [95% (95% CI: 78-99%)] and cases treated with penicillin derivative had good recovery.
CONCLUSIONS: SGP is an important cause of neonatal sepsis and meningitis. Penicillin derivative is an effective treatment for SGP, and outcomes appear to be favorable.