- 期刊
Group B Streptococcus Infection in Infancy: 21-Year Experience
嬰兒期B型鏈球菌感染：二十一年經驗
摘要
有關於B型鏈球菌感染的臨床症狀作臨床回顧分析，收集從1980到2000年期間的個案。在25個受到B型鏈球菌感染的嬰兒中，其中9個(36%)嬰兒是早期發病，12個(48%)爲晚期發病，4個(16%)在3個月大以後才發病，在早期發病的嬰兒中有89%在出生後一天內發病，其中有33%爲早産兒。 在B型鏈球菌感染的臨床症狀以發燒表現佔75%、活動力差25%、呼吸窘迫25%、嗜睡20%、燥動不安20%。在腦膜炎感染的嬰兒中31%有癲癇表現。 早期發病比晚期發病的嬰兒産生較高比例的肺炎(66%)及致死率(33.3%)，在晚期發病的嬰兒較多以腦膜炎症狀表現(77%)，及有較高的後遺症(40%)，在8個分離出的B型鏈球菌菌株對penicillin，ampicillin，cefotaxime，vancomycin具敏感性，在分離出的B型鏈球菌菌株中若具有較高最低限度抑制濃度(MIC)，則有較高比例嚴重的神經性後遺症，菌株對erythromycin及clindamycin的敏感必分別爲62%及75%。從血液及腦脊髓液分離出的菌株中大部份爲第三型B型鏈球菌。
並列摘要
In this hospital-based review, clinical presentations associated with Group B streptococcus (GBS) infections in children occurring between January 1980 and March 2000 were analyzed. Among the 25 infants with invasive group B streptococcal infections, 9 (36%) were early onset diseases (EOD), 12 (48%) were late onset diseases (LOD), and 4 (16%) occurred beyond the third month of life. Eight of the nine (89%) EOD cases manifested during the first day of life and three (33%) were premature births. Common presentations in GBS infection were fever (75%), poor activity (25%), respiratory distress (25%), lethargy (20%), and irritability (20%). Seizure occurred in 31% of infants with meningitis. Pneumonia (66%) and case-fatality rate (33.3%) were significantly higher in EOD than in LOD. Meningitis was the major manifestation (77%) of LOD and had severe sequelae in 40% of cases. Eight strains were assayed for antibiotic sensitivity and they were all susceptible to penicillin, ampicillin, cefotaxime, and vancomycin. The susceptibilities to erythromycin and clindamycin were 62% and 75%, respectively. Most of the strains from blood or cerebrospinal fluid were type Ⅲ.