High Incidence of Invasive Group B Streptococcal Infections in HIV-Exposed Uninfected Infants
High Incidence of Invasive Group B Streptococcal Infections in HIV-Exposed Uninfected Infants
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DOI：
10.1542/peds.2010-0183
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发表时间：
2010-09-01
期刊：
影响因子：
8
通讯作者：
Levy, Jack
中科院分区：
文献类型：
--
作者：
Epalza, Cristina;Goetghebuer, Tessa;Levy, Jack
目的：在本中心随访的hiv暴露的未感染（HEU）婴儿中出现异常数量的B群链球菌（GBS）感染提示了本研究。本研究的目的是描述和比较艾滋病毒感染和未感染母亲所生婴儿的GBS感染的发病率和临床表现。方法：从2001 - 2008年出生的新生儿数据库和微生物学实验室记录中确定所有侵袭性GBS感染病例。回顾了所有GBS感染婴儿的病历。结果：在本中心分娩的322名hiv感染母亲中，有5名（1.55%）婴儿发生GBS侵袭性感染。在同一时期，由未感染艾滋病毒的母亲所生的20158名婴儿中，GBS感染的发生率为16例（0.08%）。一名HEU婴儿在首次发作治疗完成后28天出现复发性感染。迟发性感染在HEU婴儿中更为常见（6例中有5例，对照人群中16例中有2例）。HEU婴儿的疾病也更严重，6例HEU婴儿中有5例败血症或败血症休克，而对照组为16例中的10例，大多数HEU婴儿在感染开始时出现白细胞减少。结论：HEU婴儿的GBS感染发生率明显高于未感染hiv的母亲所生的婴儿。HEU婴儿的这些GBS败血症发作大多是晚发的，并且比对照人群更严重，这表明HEU婴儿对GBS感染的易感性增加。儿科2010;126: e631-e638
OBJECTIVES: The occurrence of an unusual number of group B streptococcal (GBS) infections in HIV-exposed uninfected (HEU) infants who were followed in our center prompted this study. The objective of this study was to describe and compare the incidence and clinical presentation of GBS infections in infants who were born to HIV-infected and -uninfected mothers.METHODS: All cases of invasive GBS infections in infants who were born between 2001 and 2008 were identified from the database of HEU infants and from the microbiology laboratory records. The medical charts of all infants with GBS infection were reviewed.RESULTS: GBS invasive infections were described for 5 (1.55%) infants who were born to 322 HIV-infected mothers who delivered in our center. The incidence of GBS infections during the same period was 16 (0.08%) of 20 158 infants who were born to HIV-uninfected mothers. One HEU infant presented a recurrent infection 28 days after completion of treatment for the first episode. Late-onset infection was more frequent in HEU infants (5 of 6 vs 2 of 16 episodes in the control population). The diseases were also more severe in HEU infants with 5 of 6 sepsis or sepsis shock in HEU infants versus 10 of 16 in control subjects, and most HEU infants had leukopenia at onset of infection.CONCLUSIONS: The incidence of GBS infection was significantly higher in HEU infants than in infants who were born to HIV-uninfected mothers. These episodes of GBS sepsis in HEU infants were mostly of late onset and more severe than in the control population, suggesting an increased susceptibility of HEU infants to GBS infection. Pediatrics 2010;126:e631-e638