FQ-PCR法与细菌培养法检测妊娠晚期B族链球菌感染的效能比较及细菌耐药性分析

Comparison of FQ-PCR and bacterial culture in detecting group B streptococcus in late pregnancy and analysis of drug resistance

目的探讨荧光定量聚合酶链反应(FQ-PCR)法与细菌培养法在妊娠晚期B族链球菌(GBS)感染检测中的应用价值,并分析妊娠晚期GBS的耐药情况。方法选取961例孕妇,于孕35~37周时采集孕妇阴道下段1/3处及肛周分泌物,同时行FQ-PCR法与细菌培养法检测GBS,比较2种方法的检验效能,并根据细菌培养的药敏结果对GBS的耐药情况进行分析。结果 2种检测方法总体GBS检出率为10.7%(103/961),其中FQ-PCR法检出率显著高于细菌培养法(P<0.05)。以FQ-PCR法联合细菌培养法为金标准,FQ-PCR法检测的灵敏度优于细菌培养法(P<0.05)。33株GBS菌株对青霉素G、替加环素、利奈唑胺、氨苄西林、万古霉素、喹奴普汀-达福普汀、克林霉素、呋喃妥因、环丙沙星、莫西沙星、左旋氧氟沙星、氯洁霉素及四环素等13种抗菌药物的耐药率分别为0.0%、0.0%、0.0%、0.0%、0.0%、0.0%、24.3%、12.1%、30.3%、33.3%、39.4%、54.5%、63.7%。结论 FQ-PCR检测方法快速、准确、敏感,可用于GBS的产前筛查,妊娠晚期孕妇感染GBS对青霉素G、替加环素、利奈唑胺敏感率高。

Objective To compare fluorescence quantitative polymerase chain reaction （FQ- PCR） and bacte rial culture in detection of group B streptococcus （GBS） in late pregnancy and to analyze the d rug re sistance of GBS clinical is olates. Methods A total of 961 pregnant women who received antenatal ca re and delive red in Wenzhou People ’s Hos pital from Feb rua ry 2016 to J anua ry 2017 we re enrolled in the stud y. The s amples were collected from the lower third of the vagina and perianal secretion from women with 35- 37 weeks of gestation, the GBS was tested by FQ- PCR and bacte rial culture. The detection rate of GBS by two methods was compa red and drug resistance of GBS is olates was analyzed. Results The ove rall GBS detection rate by two methods was 10.7% （103/961）.The detection rate by FQ- PCR wa s hig he r than that of culture method （P〈0.05）.The FQ- PCR combined with bacte rial culture was the gold standard, and the sensitivity of FQ- PCR was better than that of bacte rial culture （P〈0.05）. The resistance rates of 33 strains of GBS to 13 antibiotics （penicillin G, tigecycline, linezolid, ampicillin, vancomycin,quinup ristin- Dafoe,clindamycin, nitrofurantoin, ciprofloxacin, moxifloxacin, levofloxacin, clindamycin and tetracycline ）we re 0.0%,0.0%, 0.0%, 0.0%, 0.0%, 0.0%, 24.3%, 12.1%, 30.3%, 33.3%, 39.4%, 54.5% and 63.7%, respectively. Conclusion FQ- PCR is arapid, accurate and sensitive method for GBS detection in late pregnant women. GBS strains a revery sensitive to penicillin G,tegafur and linezolid