胎膜早破孕妇宫颈分泌物病原菌分布及耐药分析

Distribution and Drug Resistance of Pathogens Causing Premature Ruptureof Membrane

目的了解胎膜早破孕妇宫颈分泌物中细菌学分布及药物耐药情况。方法对本院2013至2014年572例胎膜早破孕妇宫颈分泌物细菌培养及耐药结果进行回顾性分析。结果 572例宫颈分泌物标本中分离出212例阳性标本,培养阳性率为37.1%。212株病原菌中,革兰阳性菌占62.3%(132株),以表皮葡萄球菌及金黄色葡萄球菌为主,对万古霉素、利奈唑胺和替考拉宁均无耐药菌株;其次为革兰阴性菌,占26.4%(56株),以大肠埃希菌为主,其对哌拉西林/他唑巴坦、亚胺培南、第四代头孢类抗菌素(头孢吡肟)、阿米卡星、氨曲南及左氧氟沙星的耐药率较低;真菌占11.3%(24株),以白色念珠菌为主。结论为预防和治疗胎膜早破,应根据细菌培养及耐药结果合理应用抗生素。

Objective To investigate the bacterial distribution characteristic and antibiotic resistance of pathogens isolated from cervical secretion of premature rupture of the membrane cases. Methods 572 cases of pregnant women with premature rupture of membranes in our hospital were retrospectively analyzed by the results of bacterial culture and drug resistance of cervical secretion. Results A total of 212 pathogenic bacteria strains were found positive among 572 cervical secretion, accounting for 37.1%. Among 212 strains of pathogens, gram- positive bacteria accounted for 62.3% （132 strains） , Staphylococcus epidermidis and Staphylococcus aureus were the main bacteria, and there were no resistant strains to vancomycin, linezolid and teicoplanin. Gram negative bacteria accounted for 26.4% （ 56 strains）. Escherichia coli was the main bacteria, and showed low resistance to the piperacillin / tazobactam, imipenem, fourth generation cephalosporin （cefepime） , Amikacin, aztreonam and levofloxacin. Fungi accounted for 11.3% （24 strains）. Candida albieans was the main bacteria. Conclusion For the prevention and treatment of premature rupture of membranes, rational use of antibiotics should be based on the results of bacterial culture and resistance.