围产期孕妇无乳链球菌感染情况及耐药分析

Analysis on the Infection and Drug Resistance of Streptococcus Lactobacillus in Perinatal Pregnant Women

目的观察围产期孕妇阴道分泌物中无乳链球菌(GBS)感染情况,并对其实施药敏实验,判断其的耐药。方法将2018年1月至2021年1月台山市人民医院接门诊部及住院病房接诊的所有围产期孕妇进行无乳链球菌检查,依据患者的年龄阶段,将其分为4个组,<20周岁为A组,20~28周岁为B组,29~38周岁为C组,>38周岁为D组,其中A组有77人,B组有1950人,C组有284人,D组有35人,合计2346人,对所有患者均采集其阴道及肛门分泌物进行培养,依据溶血、细菌形态、CAMP、触酶实验的结果对患者进行诊断。然后将将确诊患者的分泌物采用梅里埃ATB自动细菌鉴定及药敏分析系统进行鉴定和药物敏感分析。结果A组患者有2例确诊,感染率为1.50%;B组患者有215例确诊,感染率为11.03%;C组患者有40例确诊,感染率为4.62%;D组患者有1例确诊,感染率为2.86%;所有患者中共确诊258例,感染率为11.00%。258例GBS确诊患者的GBS毒株对于青霉素的敏反应为100.00%,对于万古霉素的药敏反应为100.00%,对于氯霉素的药敏反应为80.23%,对于头孢噻肟的药敏反应为100.00%,对于左氧氟沙星的药敏反应为73.26%,对于红霉素的药敏反应为67.44%,对于四环素的药敏反应为74.81%;其中左氧氟沙星、红霉素存在中介情况,分别为2.71%、0.78%;其中氯霉素、左氧氟沙星、红霉素以及四环素存在耐药性,其耐药率分别为19.77%、24.03%、31.78%、25.19%。结论无乳链球菌当下尚未发现其对青霉素、万古霉素以及头孢噻肟的耐药情况,但是其他抗菌药物的存在一定的耐药性,故需要加强对其的培养检测,关注其耐药趋势,为临床用药提供理论指导,20~28周岁产妇属于无乳链球菌的易感人群。

Objective To observe the infection of streptococcus lactis(GBS)in vaginal discharge of pregnant women in perinatal period,and carry out drug sensitivity test to judge its drug resistance.Methods All perinatal pregnant women in outpatient department and inpatient ward of Taishan People’s Hospital from January 2018 to January 2021 were examined for streptococcus lactis,and depending on the patient’s age,they were divided into four groups,<20 years old as A group,20-28 years of age as B group,29-38 as C group,>38 as D group.Among them A group of 77,B group of 1950 people,C group had 284 people,D group has 35 people,with a total of 2346 people.All patients were cultured with vaginal and anal secretions,according to the results of hemolysis,bacterial morphology and CAMP,thixozyme test,the patients were diagnosed.After that,the secretions of the confirmed patients were identified by Meriere ATB automatic bacterial identification and drug sensitivity analysis system.Results In A group,two patients were diagnosed,the infection rate is 1.50 per cent;B group had 215 confirmed cases,the infection rate was 11.03 per cent;C group had 40 confirmed cases,the infection rate is 4.62 per cent;A patient in D group was diagnosed,the infection rate was 2.86 per cent;A total of 258 patients were diagnosed,the infection rate was 11.00.The sensitive response of GBS strains to penicillin was 100.00%in 258 GBS confirmed patients,the susceptibility to vancomycin was 100.00%,the drug sensitivity of chloramphenicol was 80.23%,the drug sensitivity of cefotaxime was 100.00%,the drug sensitivity of ofloxacin was 73.26%,the susceptibility to erythromycin was 67.44%,the drug sensitivity of tetracycline was 74.81%;Among them levofloxacin,erythromycin exist intermediary situation,2.71%and 0.78%respectively;Among them,chloramphenicol,levofloxacin,erythromycin and tetracycline are resistant,the drug resistance rates were 19.77%,24.03%,31.78%and 25.19%,respectively.Conclusion Streptococcus lactis has not found its resistance to penicillin,vancomycin and cefotaxime,but other antimicrobial agents have certain drug resistance,so it is necessary to strengthen the culture and detection of Streptococcus lactis,pay attention to its drug resistance trend,and provide theoretical guidance for clinical drug use.