孕晚期孕妇无乳链球菌感染转归情况及对新生儿的影响

The outcome of streptococcus agalactiae infection in pregnant women in late pregnancy and its effect on newborns

目的探讨孕晚期孕妇无乳链球菌感染转归及对新生儿的影响。方法选取2015年11月~2016年11月在我院登记建档的孕妇共800例,采集孕晚期孕妇生殖道标本并针对性进行无乳链球菌培养及药物治疗,探讨孕晚期妇女无乳链球菌的感染转归情况,并根据培养结果分为观察组与对照组,其中观察组为无乳链球菌培养阳性,对照组为无乳链球菌培养阴性,监测及比较两组新生儿无乳链球菌感染情况。结果 800例建档孕晚期孕妇共检测出48例无乳链球菌培养阳性,阳性率达6.00%;无乳链球菌药敏试验耐药性较高的三种抗生素依次为四环素56.25%、阿奇霉素45.83%、红霉素33.34%,对阿莫西林、头孢呋辛、头孢曲松耐药性依次降低,亚胺培南、利奈唑胺、万古霉素三种抗生素未发现耐药;观察组新生儿无乳链球菌感染率明显高于对照组(P<0.05)。结论孕晚期孕妇无乳链球菌培养阳性率增高,母婴垂直传播是围生期新生儿感染首要途径,必须及时根据微生物室药敏进行联合抗感染治疗,微生物室药敏结果是临床合理使用抗生素的客观依据,有效控制GBS的传播,明显降低围生期新生儿的死亡率及致残率。

Objective To investigate the outcome of streptococcus agalactiae infection in pregnant women in the late pregnancy and its effect on newborns. Methods A total of 800 pregnant women who registered files in our hospital from November 2015 to November 2016 were selected. The pregnant women＇s reproductive tract specimens were collected and were targeted for streptococcus agalactiae culture and drug therapy. The infection outcome of streptococcus agalac- tiae women in late pregnancy was explored. The patients were divided into observation group and control group accord- ing to the culture results, the observation group was positive for streptococcus agalaetiae, and the control group was neg- ative for streptococcus agalactia. The neonatal streptococcus agalactiae infection between two groups was monitored and compared. Results A total of 48 cases of streptococcus agalactia culture positive were detected in 800 pregnant women with files, and the positive rate was 6.00%. The three antibiotics with high drug resistance in streptococcus agalactia susceptibility test were tetracycline（56.25%）, azithromyein（45.83%） and erythromyein （33.34%）. The drug resistance of streptococcus agalactia to amoxicillin, cefuroxime and ceftriaxone decreased in descending order; and the antibiotics including imipenem, linezolid, vancomycin did not find resistance. The infection rate of neonatal streptococcus agalaetiae in the observation group was significantly higher than that in the control group（P〈0.05）. Conclusion The positive rate of streptococcus agalaetia culture in pregnant women in the late pregnancy is higher, and the vertical transmission of maternal and infant is the primary route of perinatal neonatal infection. It must be treated by joint anti-infective treatment according to timely antimicrobial susceptibility in microbiological room. Microbial room drug susceptibility results are the objective basis for rational use of antibiotics, which effectively controls the spread of GBS, and significantly reduces perinatal neonatal mortality and morbidity.