徐州地区妊娠晚期妇女感染B群链球菌的筛检情况及药物敏感性分析

Screening for group B Streptococcal infection in late pregnant women in Xuzhou area and its drug sensitivity analysis

目的对比荧光定量聚合酶链反应(PCR)技术和细菌培养法在徐州地区妊娠晚期妇女B群链球菌(GBS)定植筛查中的应用,并了解GBS的耐药情况。方法采集本地区妊娠晚期妇女的阴道拭子和肛门拭子,同时进行荧光PCR检测和细菌培养法检测,比较分析两种方法的各项性能指标。对细菌培养法阳性者做药敏试验。结果484例标本中,荧光PCR技术检测GBS阳性53例,阳性率11.0%,灵敏度为100.0%;细菌培养法检测GBS阳性31例,阳性率6.4%,灵敏度59.6%。两组之间阳性率和灵敏度比较差异均有统计学意义(P<0.05)。药敏结果显示青霉素、头孢曲松、万古霉素的敏感率是100.0%;红霉素、克林霉素、左氧氟沙星的耐药率为71.0%、64.5%和58.1%。结论徐州地区妊娠晚期妇女GBS的定植率不低,PCR是一种更为快速的具有较高特异性和敏感度的方法。临床应积极开展GBS的常规检测。本地区GBS对红霉素和克林霉素耐药率较高,临床应重视抗菌药物的合理应用,避免更多GBS耐药株的出现。

Objective To compare the colonization rates of group B streptococcus （GBS） detected by using fluorescent PCR and bacterial culture in late pregnant women in Xuzhou area and analyze the drug resistance of GBS .Methods The fluorescence PCR assay and bacterial culture assay for GBS were both performed for the late‐pregnant women′s vaginal swabs and anal swabs samples which were collected in this area .The diagnostic efficiency were compared between the two methods .Then the drug sensitivity test were performed for stains isolated for the bacteria culture .Results Among the 484 spcimens ,53 cases were positive detected by u‐sing fluorescent PCR ,and the positive rate was 11 .0% ,the sensitivity was 100 .0% .31 cases were detected positive by using bacte‐rial culture ,and the positive rate was 6 .4% ,the sensitivity was 59 .6% .There were statistically significant differences between the positive rate and the sensitivity of the two groups（P〈0 .05） .The drug sensitivity test showed that the sensitive rates were 100 .0%to penicillin ,ceftriaxone ,vancomycin .The resistance rates to erythromycin ,clindamycin ,levofloxacin were 71 .0% ,64 .5% and 58 .1% ,respectively .Conclusion The screening rate of GBS in late pregnant women is not low in Xuzhou area .PCR is a more rap‐id ,specificific and sensitive method .Routine detection of GBS should carried out by using the method of fluorescent PCR .Resistance rate of GBS to erythromycin and clindamycin were high in Xuzhou area .More attention should be paid to the rational use of antibi‐otics to prevent drug‐resistant producing in strains of GBS .