新生儿早发型GBS败血症1例并文献复习

目的介绍新生儿早发型B族溶血链球菌（GBS）败血症的临床表现、治疗及预防方法。方法报道1例血培养及脑脊液培养均为阳性的早发型GBS败血症患儿的，临床表现、实验室检查及治疗经过，并进行文献复习。结果该病例为一例以化脓性脑膜炎为主要表现的早发型GBS败血症，先后经积极1周青霉素及4周万古霉素抗感染治疗，治愈出院，随访预后良好。结论GBS是新生儿早发型败血症重要的致病菌，青霉素是治疗的首选药物，必要时也可使用万古霉素抗感染治疗，建议对孕妇开展产前GBS筛查并进行预防性治疗，尤其应对高危新生儿进行监测以减少早发型GBS败血症的发生和远期严重后遗症。免疫预防和疫苗预防有望成为更有效的预防策略。

A case report of early-onset group B streptococcal sepsis and literature review

Objective To introduce the clinic manifestations, treatment and prophylaxis of early-onset neonatal group B streptococcal （GBS） sepsis. Methods Early-onset GBS sepsis in one case was reported with positive results both in blood culture and cerebrospinal culture. Its clinical manifestations, laboratory examinations, and process of treatment were reported and corresponding literatures were reviewed. Results The major clinic manifestation of the case was purulent meningitis. After one-week penicillin and four-week vaneomycin treatment, the case was cured and discharged with good prognosis at follow-up. Conclusion GBS is the important pathogen of early-onset neonatal sepsis, and penicillin is the first choice for the treatment. Vaneomycin can be used if necessary. GBS screening for pregnancy and preventive treatment is recommended, and high-risk neonates should be monitored to reduce the incidence of early-onset GBS sepsis and avoid serious sequela. Immunity regulation and vaccines may be more efficacious strategy in future.