Burden of Invasive Group B Streptococcus Disease and Early Neurological Sequelae in South African Infants
Burden of Invasive Group B Streptococcus Disease and Early Neurological Sequelae in South African Infants
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DOI：
10.1371/journal.pone.0123014
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发表时间：
2015-04-07
期刊：
影响因子：
3.7
通讯作者：
Madhi, Shabir A.
中科院分区：
文献类型：
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作者：
Dangor, Ziyaad;Lala, Sanjay G.;Madhi, Shabir A.
简介 B 族链球菌 (GBS) 是新生儿败血症和脑膜炎的主要原因。我们的目的是评估孕妇中 HIV 感染率高 (29.5%) 的婴儿患侵袭性早发型（出生后 0-6 天，EOD）和晚发型（7-89 天，LOD）GBS 疾病以及随后的神经系统后遗症的负担。方法在约翰内斯堡的三家二级三级公立医院进行了病例对照研究。 2012 年 11 月至 2014 年 2 月期间，通过实验室监测发现了小于 3 个月大的婴儿的侵袭性病例。对存活病例和 3 个月大和 6 个月大的对照进行了神经发育筛查。结果我们在 12 个月内发现了 122 例侵袭性 GBS 疾病病例。尽管 HIV 暴露婴儿和未暴露 HIV 婴儿的 EOD 发生率（每 1,000 个活产婴儿）相似（1.13 比 1.46；p = 0.487），但 HIV 暴露婴儿的 LOD 风险高出 4.67 倍（95% CI：2.24-9.74）（2.27 比 0.49；p = 0.487）。
IntroductionGroup B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis. We aimed to evaluate the burden of invasive early-onset (0-6 days of life, EOD) and late-onset (7-89 days, LOD) GBS disease and subsequent neurological sequelae in infants from a setting with a high prevalence (29.5%) of HIV among pregnant women.MethodsA case-control study was undertaken at three secondary-tertiary care public hospitals in Johannesburg. Invasive cases in infants < 3 months age were identified by surveillance of laboratories from November 2012 to February 2014. Neurodevelopmental screening was done in surviving cases and controls at 3 and 6 months of age.ResultsWe identified 122 cases of invasive GBS disease over a 12 month period. Although the incidence (per 1,000 live births) of EOD was similar between HIV-exposed and HIV-unexposed infants (1.13 vs. 1.46; p = 0.487), there was a 4.67-fold (95% CI: 2.24-9.74) greater risk for LOD in HIV-exposed infants (2.27 vs. 0.49; p