Synchronous Recurrence of Group B Streptococcal Late-Onset Sepsis in Twins
Synchronous Recurrence of Group B Streptococcal Late-Onset Sepsis in Twins
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DOI：
10.1542/peds.2013-0426
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发表时间：
2014-05-01
期刊：
影响因子：
8
通讯作者：
Henneke, Philipp
中科院分区：
文献类型：
--
作者：
Elling, Roland;Hufnagel, Markus;Henneke, Philipp
B 族链球菌 (GBS) 仍然是工业化国家新生儿败血症和脑膜炎的主要原因。尽管产时预防性使用抗生素已导致早发性败血症的发生率显着下降，但晚发性败血症的发病率却保持不变。迟发性脓毒症是否通常源于婴儿皮肤粘膜 GBS 定植，或者是否由急性外源性 GBS 感染引起，仍存在争议。在这里，我们报道了一对双胞胎，他们都以惊人的平行方式两次患上 GBS 败血症，这两个病例都源自单个高毒力 GBS 克隆。综合考虑，两例病例均表现为宫颈软组织感染、发作的同步性以及母乳中 GBS DNA 的检测，都强烈表明潜伏期短的肠内传播方式。
Group B Streptococcus (GBS) remains the leading cause of neonatal sepsis and meningitis in industrialized countries. Whereas the use of intrapartum antibiotic prophylaxis has led to a significant decline in early-onset sepsis, the incidence of late-onset sepsis has remained unchanged. Whether late-onset sepsis usually originates from established mucocutaneous GBS colonization of the infant or whether it results from an acute exogenous GBS infection remains controversial. Here we report on twins who both twice developed GBS sepsis in a strikingly parallel fashion, with both instances originating from a single hypervirulent GBS clone. Factored together, the presentation as cervical soft tissue infection in both cases, the synchronicity of the episodes, and the detection of GBS DNA in breast milk all strongly suggest an enteral mode of transmission with a short incubation period.