产科B群链球菌:尚未解决的问题

V. Radzinsky, O. Doronina, A. Olenev, O. V. Stetsyuk
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引用次数: 0

摘要

几十年来,在新生儿感染的所有可能病原体中,B群链球菌一直处于领先地位。败血症、脑膜炎和肺炎是与B组链球菌相关的新生儿感染最常见的临床表现。在这篇综述中,我们的目标是分析文献,这些文献证明了一种在全球范围内预防B组链球菌母婴垂直传播的方法。在撰写这篇综述时,研究了PubMed数据库中外国和国内作者的科学出版物。这篇综述考虑了用于产前抗生素预防的药物选择,以及它们的药效学和药代动力学特征。该分析详细说明了B组链球菌对抗菌药物耐药性增长的问题。乳铁蛋白在最低抑制浓度为500μg/ml时具有抗菌活性。该综述还反映了口服含有嗜酸乳杆菌、唾液乳杆菌、鼠李糖乳杆菌GR-1和罗伊氏乳杆菌RC-14的益生菌的保护和治疗效果。分析表明,青霉素G和氨苄青霉素对B群链球菌的杀菌作用最为明显。同时,β-内酰胺青霉素最常见的副作用包括过敏反应,可能发展为过敏性休克。鉴于此,一线储备组的抗生素包括头孢唑林、克林霉素和万古霉素。同时,重要的是要考虑到克林霉素治疗浓度的降低和母体和胎儿血液中α-1-酸糖蛋白的变化、万古霉素的肾毒性作用以及头孢唑林与青霉素组抗生素的交叉过敏反应。在更详细地研究乳铁蛋白和益生菌的作用的基础上,开发预防胎儿和新生儿围产期感染的新策略是解决B群链球菌问题的一个有希望的方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Group B streptococcus in obstetrics: unsolved problems
For several decades, among all possible pathogens of neonatal infections, group B streptococcus has been one of the leading positions. Sepsis, meningitis, and pneumonia are among the most common clinical manifestations of neonatal infection associated with group B streptococcus. In this review, our goal was to analyze the literature demonstrating a worldwide approach to the prevention of vertical transmission of group B streptococcus from mother to child. When writing the review, scientific publications of foreign and domestic authors from the PubMed database were studied. The review considers the drugs of choice for intranatal antibiotic prophylaxis, and their pharmacodynamic, and pharmacokinetic features. The analysis details the problem of the growth of resistance of group B streptococcus to antibacterial drugs. The antimicrobial activity of lactoferrin was noted at a minimum inhibitory concentration of 500 μg/ml. The presented review also reflects the protective and therapeutic effects of oral intake of probiotics containing Lactobacillus acidophilus, Lactobacillus salivarius, Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14 . Based on the analysis, it can be concluded that penicillin G and ampicillin have the most pronounced bactericidal effect against group B streptococcus. At the same time, the most common side effects of β-lactam penicillins include an allergic reaction with the possible development of anaphylactic shock. Given this, the antibiotics of the first-line reserve group include cefazolin, clindamycin, and vancomycin. At the same time, it is important to take into account the decrease in the therapeutic concentration of clindamycin with a change in the alpha-1-acid glycoprotein in the blood of the mother and fetus, the nephrotoxic effect of vancomycin and the cross-a llergic reaction of cefazolin with antibiotics of the penicillin group. A promising direction in solving the problem of group B streptococcus is the development of new strategies for the prevention of perinatal infection of the fetus and newborn based on a more detailed study of the effects of lactoferrin and probiotics.
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CiteScore
0.50
自引率
0.00%
发文量
43
审稿时长
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