85. Tổng quan luận điểm điều trị nhiễm liên cầu khuẩn nhóm B ở trẻ sơ sinh
Nội dung chính của bài viết
Tóm tắt
Đánh giá hiệu quả điều trị nhiễm liên cầu khuẩn nhóm B ở trẻ sơ sinh. Nghiên cứu tổng quan bao gồm các nghiên cứu có kết quả điều trị liên cầu khuẩn nhóm B ở trẻ sơ sinh trên thế giới từ cơ sở dữ liệu thông tin điện tử Pubmed. Chúng tôi đã tìm được 16 bài báo phù hợp với các tiêu chuẩn lựa chọn liên quan đến 6770 bệnh nhân với các tiêu chuẩn về kết quả điều trị, tỷ lệ tử vong và các biến chứng, di chứng sau nhiễm, tỷ lệ kháng kháng sinh và các phương pháp điều trị liên cầu khuẩn nhóm B ở trẻ sơ sinh. Tỷ lệ tử vong dao động 4,7 - 14,3%, di chứng thần kinh 8,3 - 40%, và suy hô hấp là biến chứng thường gặp nhất (3 - 64%). Kháng sinh hàng đầu là Penicillin và Ampicillin với tỷ lệ nhạy cảm đạt 100%; trong khi kháng Erythromycin và Clindamycin cao (20,8 - 92,5%). Nhiễm liên cầu khuẩn nhóm B ở trẻ sơ sinh gây bệnh cảnh nặng và nhiều biến chứng, đặc biệt ở trẻ non tháng. Nhận diện sớm kết hợp điều trị kháng sinh phù hợp và hỗ trợ tích cực là chìa khóa cải thiện tiên lượng.
Chi tiết bài viết
Từ khóa
Liên cầu khuẩn nhóm B, nhiễm trùng sơ sinh, điều trị, di chứng thần kinh, kháng kháng sinh
Tài liệu tham khảo
1. Boyer KM, Gadzala CA, Kelly PD, Burd LI, Gotoff SP. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. II. Predictive value of prenatal cultures. J Infect Dis. 1983;148(5):802-809. doi:10.1093/infdis/148.5.802
2. Jennings HJ, Katzenellenbogen E, Lugowski C, Kasper DL. Structure of native polysaccharide antigens of type Ia and type Ib group B Streptococcus. Biochemistry. 1983;22(5):1258-1264. doi:10.1021/bi00274a042
3. Wessels MR, Benedí WJ, Jennings HJ, Michon F, DiFabio JL, Kasper DL. Isolation and characterization of type IV group B Streptococcus capsular polysaccharide. Infect Immun. 1989;57(4):1089-1094. doi:10.1128/iai.57.4.1089-1094.1989
4. Schrag S, Gorwitz R, Fultz-Butts K. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep. 2002;51(RR-11):1-22.
5. Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective. Accessed April 22, 2024. https://www.cdc.gov/mmwr/preview/mmwrhtml/00043277.htm
6. Joubrel C, Tazi A, Six A, et al. Group B streptococcus neonatal invasive infections, France 2007-2012. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2015;21(10):910-916. doi:10.1016/j.cmi.2015.05.039
7. Dong Y, Jiang SY, Zhou Q, Cao Y. Group B Streptococcus causes severe sepsis in term neonates: 8 years experience of a major Chinese neonatal unit. World J Pediatr WJP. 2017;13(4):314-320. doi:10.1007/s12519-017-0034-5
8. Molecular characteristics of group B Streptococcus isolates from infants in southern mainland China | BMC Infectious Diseases | Full Text. Accessed July 10, 2025. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4434-0
9. Lo CW, Liu HC, Lee CC, et al. Serotype distribution and clinical correlation of Streptococcus agalactiae causing invasive disease in infants and children in Taiwan. J Microbiol Immunol Infect Wei Mian Yu Gan Ran Za Zhi. 2019;52(4):578-584. doi:10.1016/j.jmii.2017.09.002
10. Kao Y, Tsai MH, Lai MY, et al. Emerging serotype III sequence type 17 group B streptococcus invasive infection in infants: the clinical characteristics and impacts on outcomes. BMC Infect Dis. 2019;19(1):538. doi:10.1186/s12879-019-4177-y
11. Kang HM, Lee HJ, Lee H, et al. Genotype Characterization of Group B Streptococcus Isolated From Infants With Invasive Diseases in South Korea. Pediatr Infect Dis J. 2017;36(10):e242-e247. doi:10.1097/INF.0000000000001531
12. Wang P, Ma Z, Tong J, et al. Serotype distribution, antimicrobial resistance, and molecular characterization of invasive group B Streptococcus isolates recovered from Chinese neonates. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2015;37:115-118. doi:10.1016/j.ijid.2015.06.019
13. Andersen M, Smith B, Murra M, Nielsen SY, Slotved HC, Henriksen TB. Invasive group B Streptococcus strains and clinical characteristics in Danish infants from 1999 to 2009. Front Microbiol. 2022;13:1001953. doi:10.3389/fmicb.2022.1001953
14. Ding Y, Wang Y, Hsia Y, Russell N, Heath PT. Systematic Review and Meta-Analyses of Incidence for Group B Streptococcus Disease in Infants and Antimicrobial Resistance, China. Emerg Infect Dis. 2020;26(11):2651-2659. doi:10.3201/eid2611.181414
15. Andersen M, Murra M, Nielsen SY. Invasive group B Streptococcus strains and clinical characteristics in Danish infants from 1999 to 2009. Front Microbiol. 2022;13:1001953. doi:10.3389/fmicb.2022.1001953
16. Etiological serotype and genotype distributions and clinical characteristics of group B streptococcus-inducing invasive disease among infants in South China | BMC Pediatrics | Full Text. Accessed July 10, 2025. https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02048-2
17. Mynarek M, Bjellmo S, Lydersen S, Afset JE, Andersen GL, Vik T. Incidence of invasive Group B Streptococcal infection and the risk of infant death and cerebral palsy: a Norwegian Cohort Study. Pediatr Res. 2021;89(6):1541-1548. doi:10.1038/s41390-020-1092-2
18. Creti R, Imperi M, Berardi A, et al. Invasive Group B Streptococcal Disease in Neonates and Infants, Italy, Years 2015-2019. Microorganisms. 2021;9(12):2579. doi:10.3390/microorganisms9122579
19. Clinical and Laboratory Features of Group B Streptococcus Meningitis in Infants and Newborns: Study of 848 Cases in France, 2001–2014 | Clinical Infectious Diseases | Oxford Academic. Accessed July 10, 2025. https://academic.oup.com/cid/article/66/6/857/4554470
20. Nanduri SA, Petit S, Smelser C, et al. Epidemiology of Invasive Early-Onset and Late-Onset Group B Streptococcal Disease in the United States, 2006 to 2015: Multistate Laboratory and Population-Based Surveillance. JAMA Pediatr. 2019;173(3):224-233. doi:10.1001/jamapediatrics.2018.4826
2. Jennings HJ, Katzenellenbogen E, Lugowski C, Kasper DL. Structure of native polysaccharide antigens of type Ia and type Ib group B Streptococcus. Biochemistry. 1983;22(5):1258-1264. doi:10.1021/bi00274a042
3. Wessels MR, Benedí WJ, Jennings HJ, Michon F, DiFabio JL, Kasper DL. Isolation and characterization of type IV group B Streptococcus capsular polysaccharide. Infect Immun. 1989;57(4):1089-1094. doi:10.1128/iai.57.4.1089-1094.1989
4. Schrag S, Gorwitz R, Fultz-Butts K. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep. 2002;51(RR-11):1-22.
5. Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective. Accessed April 22, 2024. https://www.cdc.gov/mmwr/preview/mmwrhtml/00043277.htm
6. Joubrel C, Tazi A, Six A, et al. Group B streptococcus neonatal invasive infections, France 2007-2012. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2015;21(10):910-916. doi:10.1016/j.cmi.2015.05.039
7. Dong Y, Jiang SY, Zhou Q, Cao Y. Group B Streptococcus causes severe sepsis in term neonates: 8 years experience of a major Chinese neonatal unit. World J Pediatr WJP. 2017;13(4):314-320. doi:10.1007/s12519-017-0034-5
8. Molecular characteristics of group B Streptococcus isolates from infants in southern mainland China | BMC Infectious Diseases | Full Text. Accessed July 10, 2025. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4434-0
9. Lo CW, Liu HC, Lee CC, et al. Serotype distribution and clinical correlation of Streptococcus agalactiae causing invasive disease in infants and children in Taiwan. J Microbiol Immunol Infect Wei Mian Yu Gan Ran Za Zhi. 2019;52(4):578-584. doi:10.1016/j.jmii.2017.09.002
10. Kao Y, Tsai MH, Lai MY, et al. Emerging serotype III sequence type 17 group B streptococcus invasive infection in infants: the clinical characteristics and impacts on outcomes. BMC Infect Dis. 2019;19(1):538. doi:10.1186/s12879-019-4177-y
11. Kang HM, Lee HJ, Lee H, et al. Genotype Characterization of Group B Streptococcus Isolated From Infants With Invasive Diseases in South Korea. Pediatr Infect Dis J. 2017;36(10):e242-e247. doi:10.1097/INF.0000000000001531
12. Wang P, Ma Z, Tong J, et al. Serotype distribution, antimicrobial resistance, and molecular characterization of invasive group B Streptococcus isolates recovered from Chinese neonates. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2015;37:115-118. doi:10.1016/j.ijid.2015.06.019
13. Andersen M, Smith B, Murra M, Nielsen SY, Slotved HC, Henriksen TB. Invasive group B Streptococcus strains and clinical characteristics in Danish infants from 1999 to 2009. Front Microbiol. 2022;13:1001953. doi:10.3389/fmicb.2022.1001953
14. Ding Y, Wang Y, Hsia Y, Russell N, Heath PT. Systematic Review and Meta-Analyses of Incidence for Group B Streptococcus Disease in Infants and Antimicrobial Resistance, China. Emerg Infect Dis. 2020;26(11):2651-2659. doi:10.3201/eid2611.181414
15. Andersen M, Murra M, Nielsen SY. Invasive group B Streptococcus strains and clinical characteristics in Danish infants from 1999 to 2009. Front Microbiol. 2022;13:1001953. doi:10.3389/fmicb.2022.1001953
16. Etiological serotype and genotype distributions and clinical characteristics of group B streptococcus-inducing invasive disease among infants in South China | BMC Pediatrics | Full Text. Accessed July 10, 2025. https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02048-2
17. Mynarek M, Bjellmo S, Lydersen S, Afset JE, Andersen GL, Vik T. Incidence of invasive Group B Streptococcal infection and the risk of infant death and cerebral palsy: a Norwegian Cohort Study. Pediatr Res. 2021;89(6):1541-1548. doi:10.1038/s41390-020-1092-2
18. Creti R, Imperi M, Berardi A, et al. Invasive Group B Streptococcal Disease in Neonates and Infants, Italy, Years 2015-2019. Microorganisms. 2021;9(12):2579. doi:10.3390/microorganisms9122579
19. Clinical and Laboratory Features of Group B Streptococcus Meningitis in Infants and Newborns: Study of 848 Cases in France, 2001–2014 | Clinical Infectious Diseases | Oxford Academic. Accessed July 10, 2025. https://academic.oup.com/cid/article/66/6/857/4554470
20. Nanduri SA, Petit S, Smelser C, et al. Epidemiology of Invasive Early-Onset and Late-Onset Group B Streptococcal Disease in the United States, 2006 to 2015: Multistate Laboratory and Population-Based Surveillance. JAMA Pediatr. 2019;173(3):224-233. doi:10.1001/jamapediatrics.2018.4826