孕妇携带B群链球菌的临床分离及其药物敏感性分析

Clinical Separation and Drug Sensitivity Analysis of Pregnant Women Carryiny Group B Streptococcus

目的探讨无乳链球菌的临床分离及药物敏感性,为B群链球菌感染的临床诊治提供参考。方法采集2015年1月至2017年12月期间,来该院就诊的孕期在35-37周孕妇的阴道拭子和肛周拭子,进行B群链球菌的分离及鉴定,并对分离菌株进行药敏试验。结果28090份标本中GBS共计分离菌株2753株,阳性率9.80%(2753/28090);其中,肛周拭子GBS阳性率为9.82%(1379/14045);阴道拭子GBS阳性率为9.78%(1373/14045);经统计学分析,肛周拭子和阴道拭子GBS检出率无统计学差异(P<0.05)。同一孕妇肛周拭子和阴道拭子同时检出GBS的概率为38.13%。药敏结果显示GBS对青霉素、万古霉素、替加环素、利奈唑胺、氨苄西林的耐药率为0%;对左氧氟沙星、莫西沙星和环丙沙星保持中等水平耐药,耐药率率分别是29%、29%、31%;红霉素、克林霉素、四环素的耐药率为71%、82%和86%。结论本地区孕妇携带GBS阳性率9.80%,对红霉素、克林霉素和四环素的耐药率较高,临床应积极开展GBS的常规检测并重视抗菌药物的合理应用。

Objective To explore the clinical isolation and drug sensitivity of Streptococcus agalactiae,and to provide reference for the clinical diagnosis and treatment of group B streptococcal infection.Methods During the period from January 2015 to December 2017,we collected vaginal swabs and perianal swabs from 35-37 weeks pregnant women in our hospital for the isolation and identification of group B streptococci.Sensitivity test.Results Among the 28 090 specimens,2 753 strains were isolated from GBS,the positive rate was 9.80%(2 753/28 090).Among them,the positive rate of GBS in the perianal swab was 9.82%(1 379/14 045);the positive rate of GBS in the vaginal swab was 9.78%(1373)./14 045);Statistical analysis showed that there was no significant difference in the rate of GBS between perianal swabs and vaginal swabs ( P <0.05).The probability of simultaneous detection of GBS in the same pregnant woman′s perianal swab and vaginal swab was 38.13%.Drug susceptibility results showed that GBS resistance to penicillin,vancomycin,tigecycline,linezolid,ampicillin was 0%;moderate resistance to levofloxacin,moxifloxacin and ciprofloxacin,resistance The rate rates were 29%,29%,and 31%,respectively;the resistance rates of erythromycin,clindamycin,and tetracycline were 71%,82%,and 86%.Conclusion The positive rate of GBS in pregnant women in this region is 9.80%,and the resistance rate to erythromycin,clindamycin and tetracycline is high.The clinical examination of GBS should be carried out actively and the rational application of antibiotics should be emphasized.