婴幼儿B族链球菌致败血症的危险因素和围生期临床特征

【目的】探讨婴幼儿B族链球菌（GBS）导致败血症的危险因素和围生期临床特征。【方法】对2013年5月至2015年5月本院收治的34例GBS患儿的临床资料进行回顾分析，并和同期收治的30例非GBS革兰阳性菌败血症患儿的临床资料进行对比。【结果】早发型GBS败血症首发症状以呼吸系统症状为主，晚发型GBS败血症以高热或低体温为主要症状；晚发型GBS败血症与晚发型非GBS革兰阳性菌败血症患儿在抽搐、气促等症状方法差异具有统计学意义（P〈0．05）；GBS治疗以青霉素为首选药物，对青霉素、氨苄青霉素、美洛培南、头孢曲松、万古霉素具有高度敏感性，在治疗上多采用二联治疗。【结论】早发型GBS败血症起病早，病症凶险，致死率高，晚发型败血症起病隐匿，早期缺乏特异性表现，同时并发症多，易诱发脑膜炎。对于32～37孕周的孕妇应提前进行直肠和阴道GBS细菌培养，对疑似GBS败血症患儿应使用抗生素进行预防，可有效降低GBS败血症的感染率。

Risk Factors of Infants Group B Streptococcus (GBS) for Septicemia and its Perinatal Clinical Features

Objective]To investigate the risk factors of infants Group B streptococcus (GBS) for septice‐mia and its perinatal clinical features .Methods]The clinical data of 34 children with GBS in our hospital from May 2013 to May 2015 were analyzed retrospectively and compared with that of 30 cases of children with non GBS gram positive bacterial sepsis at the same period .Results]The first symptom of early onset GBS sepsis occurred mainly in respiratory systems ,while that of late onset GBS sepsis were with high fever or low body temperature .The difference of symptoms of late‐onset GBS sepsis and late‐onset non GBS sepsis like convul‐sions and shortness of breath had statistical significance ( P < 0 .05) .Penicillin was considered as the preferred drug for GBS treatment .GBS is highly sensitive to penicillin ,ampicillin ,ceftriaxone ,meropenem and vanco‐mycin ,thus duplex treatment is usually used for the therapy .Conclusion] Early onset GBS sepsis invaded ear‐ly with dangerous symptoms had high death rate .Late onset sepsis conceals at early stage with less specificity and many complications ,which is easy to cause meningitis .For pregnant women with 32 ~ 37 weeks of gesta‐tion ,the bacteria culture of rectum and vagina GBS should be carried out in advance .The use of antibiotics for prevention of suspected GBS sepsis in children can effectively reduce the infection rate of GBS sepsis .