2017—2018年北京大兴区人民医院产科B族链球菌的分布及耐药性分析

Analysis on distribution and drug resistance of group B streptococcus in Department of Obstetrics of People’s Hospital of Beijing Daxing District from 2017 to 2018

目的探讨2017-2018年北京大兴区人民医院产科B族链球菌的分布及耐药性。方法选取2017年1月-2018年12月产科就诊的围产期孕妇396例,对产科B族链球菌的分布及耐药性进行分析。结果 396例围产期孕妇中B族链球菌携带者105例,带菌率为26.5%。2017、2018年围产期孕妇中B族链球菌的带菌率分别为24.7%、28.0%。<30岁、≥30岁孕妇中B族链球菌的带菌率分别为20.8%、40.7%,两组比较差异具有统计学意义(P<0.05)。105例B族链球菌携带者中21例(20.0%)具有定植临床表现,291例B族链球菌阴性孕妇中19例(6.5%)具有定植临床表现,二者差异具有统计学意义(P<0.05)。B族链球菌对头孢西丁、头孢哌酮舒巴坦、青霉素G、万古霉素、美罗培南、头孢呋辛、哌拉西林舒巴坦的敏感率为100.0%,对头孢他啶的敏感率较高,为92.4%,对克林霉素、左旋氧氟沙星、红霉素的耐药率较高,分别为9.5%、12.4%、29.5%。B族链球菌阳性孕妇胎膜早破、宫内感染、早产儿、胎儿窘迫、新生儿感染的发生率显著高于B族链球菌阴性孕妇(P<0.05)。结论 2017-2018年北京市大兴区人民医院围产期孕妇中B族链球菌带菌率处于较高水平,且高龄孕妇更容易感染,B族链球菌有一定的耐药性,应定期分析病原菌的耐药性,指导医生合理使用抗菌药物。

Objective To investigate the distribution and drug resistance of group B streptococcus in Department of Obstetrics of People’s Hospital of Beijing Daxing District from 2017 to 2018. Methods From January 2017 to December 2018, 396 cases of perinatal pregnant women were enrolled in the study. The distribution and drug resistance of group B streptococcus in Department of Obstetrics of People’s Hospital of Beijing Daxing District from 2017 to 2018 were analyzed. Results There were 105 cases(26.5%) of pregnant women carrying group B streptococcus in 396 cases of perinatal pregnant women. The carrier rate of group B streptococcus of perinatal pregnant women in 2017 and 2018 were 24.7% and 28.0%. The carrier rate of pregnant women under 30 years old and ≥ 30 years old were 20.8% and40.7%, respectively, and there were differences between two groups(P < 0.05). 21 Cases(20.0%) of 105 cases group B streptococcal carriers had colonized clinical manifestations. Among 291 pregnant women with negative group B streptococcus, 19 cases(6.5%) had colonization clinical manifestations, and the difference between them was significant(P < 0.05). The susceptibility rates of group B streptococcus against cefoxitin, cefoperazone sulbactam, penicillin G, vancomycin, meropenem, cefuroxime, and piperacillin sulbactam were 100.0%. And the susceptibility rate against ceftazidime was 92.4%. Group B streptococcus was resistant to clindamycin, levofloxacin, and erythromycin with the drug resistance rate of 9.5%, 12.4%, and 29.5%, respectively. The incidence of premature rupture of membranes, intrauterine infection, premature infants, fetal distress, and neonatal infection in group B streptococcus positive pregnant women was significantly higher than that in group B streptococcus negative pregnant women(P < 0.05). Conclusion From 2017 to 2018, group B streptococcal infection rate is high in perinatal pregnant women in People’s Hospital of Beijing Daxing District, and the older pregnant women are more susceptible to infection. Group B streptococcus has some drug resistance, therefore, the drug resistance of pathogens should be analyzed regularly to guide doctors to use antibiotics rationally.