围产期无乳链球菌携带状况及耐药性分析

Distribution and drug resistance of Streptococcus agalactiae during perinatal period

目的探讨新疆乌鲁木齐市围产期无乳链球菌携带状况及耐药性,为临床合理使用抗菌药物提供依据。方法回顾性分析2014年1月-2016年11月围产期6 003例泌尿生殖道分泌物标本,采用法国梅里埃Vitek 2Compact全自动细菌鉴定和药敏系统检测,从中检出151株无乳链球菌,分析药敏、查阅其病历基本信息、新生儿出生状况等。结果 6 003例围产期泌尿生殖道标本中检出151株无乳链球菌,检出率为2.52%,其中≤35岁、>35岁孕产妇中无乳链球菌感染率分别为2.55%、2.26%,两者相比差异无统计学意义(P>0.05);民族中,汉族、维吾尔族、回族、哈萨克族中无乳链球菌感染率分别为2.70%、2.63%、2.18%、1.73%,相比差异无统计学意义(P>0.05);>37周感染无乳链球菌101例,且诊断胎膜早破有76例;孕1次感染无乳链球菌有90例,孕3次感染无乳链球菌有33例,且有20例曾有流产史;新生儿宫内感染中有1例感染无乳链球菌属于早发型。药敏结果中,无乳链球菌对氨苄西林、青霉素G敏感率分别为97.97%、98.63%;对红霉素、四环素、克林霉素和左氧氟沙星耐药率较高,分别为77.46%、72.85%、58.94%和54.30%。结论临床应重视在围产期对无乳链球菌的检测和耐药情况,合理使用抗生素,可有效地预防和治疗该菌的感染。

Objective To investigate the distribution and drug resistance of Streptococcus agalactiae in perinatal period in Urumchi,Xinjiang,and provide evidence for proper use of antibiotics.Methods French BioMerieux Vitek 2 Compact automatic bacterial identification and drug sensitivity system was used to detect the secretion of urogenital tract in perinatal period.The data of 6,003 perinatal cases during January 2014 and November 2016 were analyzed retrospectively.Results Among the 6,003 cases,151 strains（2.52%）of Streptococcus agalactiae were detected.The detection rate was 2.55% in women at age of ≤35 years vs 2.26%in women at age of 35 years,with no statistically significant difference（P〉0.05）.The infection rates of Streptococcus agalactiae in Han,Uygur,Hui and Kazak were 2.7%,2.63%,2.18%and 1.73% respectively,with no statistically significant differences（P〉0.05）.Among women who were pregnant over 37 weeks,there were 101 cases of Streptococcus agalactiae infection and 76 cases of premature rupture.90 Streptococcus agalactiae positive cases were found in gravida one cases,while 33 were found in gravida three cases including 20 cases with history of abortion.There was 1 case of early-onset neonatal intrauterine infection by Streptococcus agalactiae.The drug susceptibility of Streptococcus agalactiae to ampicillin（97.97%）and penicillin G（98.63%）were high,while their resistances to erythromycin（77.46%）,tetracycline（72.85%）,clindamycin（58.94%）and levofloxacin（54.30%） were high.Conclusion Clinical attention should be paid to the detection and drug resistance of Streptococcus agalactiae in perinatal period,and rational use of antibiotics can effectively prevent and treat the infection.