小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 发热
- 脑膜炎的症状
- 脑膜炎的体征
- 脓毒症的症状
- 出现脓毒症体征
- 肺炎的症状
- 肺炎的体征
- 泌尿道感染症状
- 泌尿道感染体征
- 蜂窝织炎的症状
- 蜂窝织炎的体征
- 化脓性关节炎的症状
- 化脓性关节炎的体征
- 结膜炎的症状
- 鼻窦炎的症状
- 鼻窦炎的体征
- 中耳炎的症状
- 中耳炎的体征
- 子宫内膜炎的症状
- 子宫内膜炎的体征
- 绒毛膜羊膜炎的体征
其他诊断因素
- 新生儿感染的非特异性体征
- 老年患者感染的非特异性体征
- 腹腔内感染的症状
- 腹腔内感染的体征
- 妊娠中期流产或早产
危险因素
- 0~7 天
- 分娩期间产妇发热
- 胎膜早破（PROM）
- B族链球菌感染的早产儿
- 产妇 B族链球菌定植
- 妊娠期 B族链球菌菌尿症
- 早产（＜37 周）
- 低出生体重（＜2500g）
- 母体特异性 IgG 不足
- 患B族链球菌病的孪生同胞
- 产妇年龄＜20 岁
- 绒毛膜羊膜炎
- 年龄 60 岁以上
- 妊娠
- 经产
- 糖尿病
- 肥胖
- 晚期肝病
- 肾脏疾病
- 中心静脉导管留置
- 泌尿系统疾病
- 皮肤完整性受损或皮肤溃疡
- 神经系统疾病
- 免疫抑制
- 疗养院常住者
- 黑种人或西班牙裔种族
- 恶性肿瘤
- 产科推拿手法
- 导尿管
- HIV 感染
- 创伤
- 哮喘
- 服用胎盘胶囊
诊断性检查
首要检查
- 全血细胞计数 (FBC）
- 血清尿素氮和肌酐
- 血清电解质
- 血清葡萄糖
- 凝血功能检查
- 肝功能检查 (LFT)
- C 反应蛋白 (CRP)
- 血培养
- 脑脊液（CSF）革兰氏染色
- 脑脊液培养
- 脑脊液细胞计数和差异
- 脑脊液葡萄糖和蛋白质
- 脑脊液抗原检测
- 革兰氏染色和其他无菌体液培养
- 胸部 X 线检查
- 关节和/或骨 X 线平片
- 头颅 CT
需考虑的检查
- 超声心动图
- 磁共振成像 (MRI)
治疗流程
确诊早发型或晚发型 GBS 新生儿感染（0-89 日龄）
婴儿和儿童
成人：非妊娠
成人：妊娠期和产后
撰稿人
作者
Brendan Healy, MBChB, BSc (Hons), MRCP, FRCPath
Consultant in Microbiology and Infectious Diseases
University Hospital of Wales
Cardiff
UK
利益声明
BH has received honorarium and has been reimbursed for attending conferences from AbbVie (hepatitis C), Gilead Sciences (hepatitis C), Bristol Myers Squibb (hepatitis C), and Tillotts Pharma (fidaxomicin). BH declares that he has no competing interests in relation to the work carried out for this topic review, Group B streptococcus.
鸣谢
Dr Brendan Healy would like to gratefully acknowledge Dr Susannah Froude and Dr Harriet Hughes, previous contributors to this topic. We would also like to gratefully acknowledge Dr Benjamin D. Lorenz for his contributions to this topic.
利益声明
SF declares that she has no competing interests. HH declares that she has received funds from Gilead and Biocomposites related to conference registration, travel, accommodation, and speaker fees.
同行评议者
William A. Petri, Jr, MD, PhD, FACP
Chief and Professor of Medicine
Division of Infectious Diseases and International Health
University of Virginia Health System
Charlottesville
VA
利益声明
WAP declares that he has no competing interests.
James R. Hanley, MD, FAAP
Attending Physician
Pediatric Emergency Medicine
Ochsner Foundation Hospital
New Orleans
LA
利益声明
JRH declares that he has ownership of a limited amount of stock in various pharmaceutical companies, although no significant amounts of any company.
Kirsty Le Doare, BA, MBBS, MSc, PhD, FRCPCH
Professor of Vaccinology and Immunology
St George's, University of London
London
UK
利益声明
KLD declares that their institution has received funds for GBS vaccine clinical trials; she has not received personal funds.
鉴别诊断
- 由其他微生物引发的脓毒症
- 由其他微生物引发的心内膜炎
- 新生儿巨细胞病毒（cytomegalovirus, CMV）感染
更多 鉴别诊断指南
- B 族链球菌的检测和识别指南
- 新生儿感染：用于预防和治疗的抗生素
更多 指南患者教育信息
蜂窝织炎和丹毒
新生儿 B 族链球菌感染
更多 患者教育信息
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