北京地区孕晚期妇女定植B族链球菌耐药状况与血清型分布情况分析

Antibiotic resistance and serotype distribution of group B Streptococci in pregnant women in Beijing

目的了解北京地区孕产妇携带无乳链球菌的分子流行病学特征与无乳链球菌对常用抗菌药物的耐药菌谱特别是大环内酯类抗生素的耐药情况。方法收集2016年7月-2017年6月在民航总医院及北京华府妇儿医院就诊的接受产前检查的孕晚期妇女阴道/直肠拭子所培养出的无乳链球菌,又称为B族链球菌(group B Streptococcus,GBS)菌株,共96株。采用PCR方法来测定无乳链球菌血清型,进行抗生素药敏实验,并检测相关耐药基因。结果最常见的血清型为Ⅲ型(40株,41.7%),Ia型(13株,13.5%),V型(18株,18.8%)。所有无乳链球菌菌株均对青霉素、氨苄西林、万古霉素、头孢噻肟敏感。71%(68株)无乳链球菌对于红霉素耐药,69%(66株)对于克林霉素耐药。红霉素耐药主要与erm B基因相关,有81.4%红霉素耐药菌株携带该基因。结论北京地区的GBS菌株的分子流行病学特征与世界其他国家的报道相似,但有其自身特点:(1)血清Ⅲ型为最多见的血清型;(2)克林霉素与红霉素耐药极高;(3)未见青霉素类与万古霉素耐药的菌株。

Objective To investigate the molecular epidemiological characteristics of group B Streptococci（GBS） isolated from pregnant women in Beijing,and the antibiotic profiles of the microorganism. Methods A total of 96 GBS isolates were collected from vaginal/rectal swabs in pregnant women admitted to Civil Aviation General Hospital and Bejing Huafu Women Children＇s Hospital from July 2016 to June2017. PCR methods were used to analyze the serotypes and antibiotic genes. Antibiotic susceptibility tests were performed on common antibiotics against GBS. Results The most common serotypes were III（40 strains,41. 7%）,Ia（13 strains,13. 5%）,and V（18 strains,18. 8%） respectively. And all strains were sensitive to penicillin,ampicillin,vancomycin and cefotaxime. However,71%（68 strains）GBS were resistant to erythromycin,69%（66 strains） were resistant to clindamycin. The erythromycin resistance was mainly associated with the erm B gene; 81. 4% of the erythromycin resistant strains carried the gene. Conclusion The GBS strains in Beijing area have similar molecular epidemiological features to other countries around the world,but having its own characteristics.