早发性B组链球菌病(GBS EOD)风险新生儿的管理:比利时新的儿科指南

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Acta Clinica Belgica Pub Date : 2014-10-01 Epub Date: 2014-07-24 DOI:10.1179/2295333714Y.0000000054
L Mahieu, J-P Langhendries, V Cossey, C De Praeter, P Lepage, P Melin
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引用次数: 9

摘要

尽管在妊娠晚期和产时进行了B群链球菌(GBS)筛查和抗微生物预防,但新生儿早发性败血症仍然是新生儿发病率和死亡率的常见来源,尤其是早产儿。新生儿早发型脓毒症的鉴定通常基于围产期危险因素。临床症状是特异性的,实验室检查不敏感。因此,许多临床医生会过度治疗高危婴儿。不适当的抗生素治疗增加了迟发性败血症、坏死性小肠结肠炎、死亡率的风险,并延长了住院时间和费用。2003年,比利时卫生委员会公布了预防围产期GBS感染的指导方针。本报告介绍了比利时儿科管理指南,该指南已得到比利时和佛兰德新生儿和儿科学会的认可。2014年指南中最重要的变化如下:腰椎穿刺的建议;澄清正常脊髓液参数和血液中性粒细胞指标校正胎龄出生后进行诊断检测的具体时间;无症状新生儿无诊断检测指征,除非有其他危险因素;根据孕产妇和新生儿危险因素修订的新生儿管理算法;早产儿指的是35周以下的婴儿,而不是37周。这些指导方针是在最佳证据的基础上制定的,在证据不足的情况下是根据专家意见制定的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of the neonate at risk for early-onset Group B streptococcal disease (GBS EOD): new paediatric guidelines in Belgium.

Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial prophylaxis, early-onset sepsis in neonates remains a common source of neonatal morbidity and mortality especially in preterm neonates. The identification of neonates with early-onset sepsis is usually based on perinatal risk factors. Clinical signs are aspecific and laboratory tests are not sensitive. Therefore, many clinicians will overtreat at-risk infants. Inappropriate treatment with antibiotics increases the risk for late-onset sepsis, necrotizing enterocolitis, mortality, and prolongs hospitalisation and costs. In 2003, the Belgian Health Council published guidelines for the prevention of perinatal GBS infections. This report presents the Belgian paediatric management guidelines, which have been endorsed by the Belgian and Flemish societies of neonatology and paediatrics. The most imported changes in the 2014 guidelines are the following: recommendations for a lumbar puncture; clarification of normal spinal fluid parameters and blood neutrophil indices corrected for gestation age; specific timing for diagnostic testing after birth; no indication for diagnostic testing in asymptomatic newborns unless additional risk factors; a revised algorithm for management of neonates according to maternal and neonatal risk factors; and premature infants described as those below 35 weeks instead of 37 weeks. The guidelines were made on the basis of the best evidence and on expert opinion when inadequate evidence exists.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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