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CLC number: R722.1

On-line Access: 2018-12-03

Received: 2018-04-29

Revision Accepted: 2018-09-09

Crosschecked: 2018-11-21

Cited: 0

Clicked: 646

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Zhen Wang

https://orcid.org/0000-0002-7307-7485

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Journal of Zhejiang University SCIENCE B 2018 Vol.19 No.12 P.973-978

http://doi.org/10.1631/jzus.B1800165


Risk factors and drug resistance in early-onset neonatal group B streptococcal disease


Author(s):  Ying-wei Wang, Yao-qiang Du, Xiao-lin Miao, Guang-yong Ye, Yi-yun Wang, Ai-bo Xu, Yun-zhong Jing, Yu Tong, Kai Xu, Mei-qin Zheng, Dong Chen, Zhen Wang

Affiliation(s):  Department of Laboratory Medicine, Tiantai People’s Hospital, Taizhou 317200, China; more

Corresponding email(s):   chendong_wz@126.com, wangzhen@hmc.edu.cn

Key Words:  Neonate, Group B streptococcus, Risk factor, Drug-resistance


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Ying-wei Wang, Yao-qiang Du, Xiao-lin Miao, Guang-yong Ye, Yi-yun Wang, Ai-bo Xu, Yun-zhong Jing, Yu Tong, Kai Xu, Mei-qin Zheng, Dong Chen, Zhen Wang. Risk factors and drug resistance in early-onset neonatal group B streptococcal disease[J]. Journal of Zhejiang University Science B, 2018, 19(12): 973-978.

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volume="19",
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pages="973-978",
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publisher="Zhejiang University Press & Springer",
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Abstract: 
In recent years, group B streptococcus (GBS) has become an important pathogen that causes infections in many neonatal organs, including the brain, lung, and eye (Ballard et al., 2016). A series of studies performed on GBS infections in western countries have revealed that GBS is one of the primary pathogens implicated in perinatal infection, and GBS infections are a major cause of neonatal morbidity and mortality in the United States (Decheva et al., 2013). In China, GBS is mainly found by screens for adult urogenital tract and perinatal infections, and neonatal GBS infections have been rarely reported. The incidence rate of early-onset neonatal GBS disease is thought to be lower in China than in western countries; however, this data is controversial since it also reflects the clinical interest in GBS (Dabrowska-Szponar and Galinski, 2001).

新生儿早发型无乳链球菌感染的风险因素及耐药分析

目的:新生儿早发型无乳链球菌(GBS)是一种可致婴儿脑、肺和眼部发生感染甚至死亡的细菌.筛查其感染风险因素并建立概率预测模型有助于疾病的预防和控制,进一步分析GBS菌株的耐药类型和耐药基因,为疾病的临床诊断和治疗提供指导意见.
创新点:首次归类了新生儿感染GBS的众多因素,按照孕妇、分娩过程、胎儿因素分为三类,统计筛选出重要风险因素并建立Logistic回归的概率预测模型,并通过聚合酶链式反应(PCR)筛查到了相关耐药基因.
方法:收集2007年1月至2015年12月,浙江大学医学院附属妇产科医院、温州医科大学附属眼视光医院和温州市人民医院的实验组135例早发型GBS感染和对照组234例无感染的新生儿及其母亲的临床资料和标本,进行数据统计分析并构建概率预测模型,采用传统的药敏实验对所有GBS阳性标本进行耐药分析,同时PCR筛查耐药基因并测定序列.
结论:这9年间新生儿早发型GBS感染率呈上升趋势.孕妇泌尿系统感染、胎膜早破、胎龄这三项因素与感染GBS的结局存在显著关联,由此得出的Logistic回归模型可用于预测感染GBS的概率.135株GBS对克林霉素、红霉素、四环素的耐药菌株比例分别为51.11%、80.00%、91.11%,同时未发现对万古霉素、青霉素、呋喃妥因、力奈唑胺的耐药性.PCR筛查发现aac6ant6-Iaph3-IIITEM四个耐药基因,其中aph3-III仅存在于耐药株中,而测序发现aac6基因在非耐药株中相比耐药株存在一个缺失突变.临床上尽早对患者分离的GBS药敏试验,有助于合理用药和有效治疗.

关键词:新生儿;无乳链球菌;风险因素;耐药性

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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[17]List of electronic supplementary materials

[18]Table S1 PCR primers in this study

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