先兆流产孕妇宫颈分泌物的细菌菌种分布、耐药性及对妊娠结局的影响

Distribution and drug resistance of bacteria in cervical secretions of pregnant women with threatened abortion and its influence on pregnancy outcome

目的探讨先兆流产孕妇宫颈分泌物的细菌菌种分布、耐药性及对妊娠结局的影响。方法对200例在我院就诊的先兆流产孕妇的宫颈分泌物培养细菌菌种分布及耐药性进行回顾性分析。根据检查结果分为检测出致病菌孕妇与未检测出致病菌孕妇,将检测出致病菌的孕妇归为观察组,未检测出致病菌的孕妇归为对照组,并追踪孕妇的妊娠结局,比较两组妊娠结局的差别。结果 200例先兆流产孕妇中,82例培养出致病菌共97株,感染率达41.00%(82/200),其中细菌52株、真菌45株;最常见的细菌为大肠埃希菌、金黄色葡萄球菌、阴沟肠杆菌、表皮葡萄球菌及屎肠球菌,最常见的真菌为白假丝酵母菌、光滑假丝酵母菌与克柔假丝酵母菌;细菌对万古霉素、阿米卡星与亚胺培南的耐药率较低,真菌对两性霉素B与5-氟胞嘧啶的耐药率较低;观察组不良妊娠结局发生率明显少于对照组(χ2=5.35,P<0.05)。结论先兆流产孕妇宫颈分泌物致病菌感染率较高,感染的致病菌对多种常用抗生素耐药率较高,一旦感染会增加不良妊娠结局的发生率,因此应对先兆流产孕妇宫颈分泌物进行致病菌培养及耐药性分析,合理选择抗生素治疗。

Objective To discuss the distribution and drug resistance of bacteria in cervical secretions of pregnant women with threatened abortion and its influence on pregnancy outcome.Methods The distribution and drug resistance of pathogenic bacteria in cervical secretions of 200 pregnant women with threatened abortion were analyzed retrospectively.The pregnant women with positive results of pathogen detection were divided into observation group while those with negative results into control group.The pregnancy outcomes were tracked and compared between the two groups.Results Ninety-seven strains of pathogenic bacteria were cultured from 82 cases of threatened abortion,including 52 strains of bacteria and 45 strains of fungi,with the infection rate at 41.00%（82/200）.Most of the bacteria were Escherichia coli,Staphylococcus aureus,Enterobacter cloacae,Staphylococcus epidermidis and Enterococcus faecium which showed lower resistance to Vancomycin,Amikacin and Imipenem,while the most common fungi were Candida albicans,Candida glabrata and Candida krusei,which had lower resistance to Amphoteric enzyme B and 5-flucytosine.The occurrence rate of adverse pregnancy outcome in observation group was much lower than that in control group（χ2=5.35,P〈0.05）.Conclusion The cervical secretions of pregnant women with threatened abortion have high infection rate of pathogens with high drug resistance to many commonly used antibiotics.,which may increase the occurrence rate of adverse pregnancy outcomes.Pathogenic bacteria culture and drug resistance analysis should be performed on cervical secretions of pregnant women with threatened abortion to guide reasonable treatment with antibiotics.