未足月胎膜早破胎膜细菌培养及药敏结果分析

Analysis on results of fetal membrane bacterial culture and drug susceptibility test in preterm premature rupture of membranes

目的分析未足月胎膜早破孕妇胎膜细菌培养及药敏结果,为未足月胎膜早破相关的绒毛膜羊膜炎的治疗提供科学依据。方法对2011年6月至2013年9月在该院产科分娩的124例妊娠28-37周的胎膜早破孕妇胎膜的细菌培养及药敏结果进行回顾性分析。结果在未足月胎膜早破中,胎膜细菌培养阳性率为25.00%（31/124）,临床绒毛膜羊膜炎发生率为2.42%（3/124）,其中临床绒毛膜羊膜炎细菌培养均为阳性。31例胎膜细菌培养阳性的孕妇中,大肠埃希菌为16例,占51.61%（16/31）,其余菌种均为1-2例,且发生临床绒毛膜羊膜炎的孕妇均为大肠埃希菌阳性。大肠埃希菌对庆大霉素、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、丁胺卡那、头孢西丁、左氧氟沙星敏感。结论未足月胎膜早破的孕妇中,绒毛膜羊膜炎的主要致病菌为大肠埃希菌,应合理应用抗菌药物降低母婴感染。

Objective To analyze the results of fetal membrane bacterial culture and drug susceptibility test in preterm premature rupture of membranes（PPROM）in order to provide the scientific basis for treating PPROM related chorioamnionitis.Methods The results of fetal membrane bacterial culture and drug susceptibility test in 124 cases of PPROM（28-37 weeks pregnancy）in the obstetric department of our hospital from June 2011 to September 2013 were retrospectively analyzed.Results Among 124 cases of PPROM,the positive rate of fetal membrane bacterial culture was 25.00%（31/124）,the occurrence rate of clinical chorioamnionitis was 2.42%（3/124）,the bacterial culture in chorioamnionitis was positve.In 31 pregnant women with positive fetal membrane bacterial culture,16 cases were Escherichia coli（E.coli）,accounting for 51.61%（16/31）,1-2cases were other bacterial species.Moreover E.coli was positive in pregnant women with clinical chorioamnionitis.E.coli was sensitive to gentamicin,imipenem,piperacillin/tazobactam,cefoperazone/sulbactam,amikacin,cefoxitin and levofloxacin.Conclusion E.coli is the main pathogenic bacterium in pregnant women of PPROM.Antibacterial drugs should be rationally used for reducing the infection of mother and newborn.