Neonatal respiratory distress related to colonization wi

大约25%的育龄妇女在直肠或阴道中携带GBS。他们的新生儿中有一半在出生时获得GBS;据说98%没有症状。B族链球菌（GBS）细胞壁磷脂引起实验动物肺动脉高压。当暴露于青霉素时，变形链球菌立即释放磷脂。我们假设新生儿定植GBS接受细菌磷脂导致肺动脉高压和呼吸窘迫，特别是在新生儿的青霉素治疗的母亲。对1,610名妊娠32周以上、无早发性疾病的殖民新生儿的数据分析显示，8.8%的新生儿在出生后48小时内出现呼吸窘迫症状。在分娩过程中使用青霉素可以增强这种效果。我们的研究结果支持新生儿呼吸窘迫与无症状GBS定植和分娩过程中使用青霉素的相关性。正在进行一项前瞻性研究，以将血清细菌磷脂水平与GBS定植母亲的新生儿呼吸窘迫的发生以及分娩期间使用青霉素对呼吸窘迫发生的影响联系起来。正在与NICHD的alfred Yergey博士合作开发用于测量母亲和新生儿生物样本中细菌磷脂的测定法。

About 25% of women of childbearing age carry GBS in their rectum or vagina. Half of their newborns acquire GBS at birth; 98% are said to be asymptomatic. Phospholipids from group B streptococcal (GBS) cell wall cause pulmonary hypertension in experimental animals. When exposed to penicillin, Streptococcus mutans release phospholipids immediately. We hypothesize that newborns colonized with GBS receive bacterial phospholipids leading to pulmonary hypertension and respiratory distress, especially in newborns of penicillin-treated mothers. Analysis of data from 1,610 colonized newborns of >32 weeks gestation without early-onset disease showed that 8.8% had signs of respiratory distress within 48 hours after birth. This effect was enhanced by penicillin use during labor. Our findings support the association of neonatal respiratory distress with asymptomatic GBS colonization and with penicillin use during labor. A prospective study to relate the levels of serum bacterial phospholipids to the occurrence of respiratory distress in newborns of mothers colonized by GBS, and the effects of penicillin use during labor on the occurrence of respiratory distress is underway. Assay to measure bacterial phospholipids in biological specimens in mothers and newborns are being developed in collaboration with Dr. alfred Yergey at NICHD.