妊娠妇女与新生儿沙眼衣原体感染的基因型研究

Genotypes of Chlamydia trachomatis infection in pregnant women and neonates

目的探究妇女与新生儿沙眼衣原体(Chlamydia trachomatis,CT)感染情况及其基因型分布。方法选取2015年1月-2019年1月河南大学淮河医院妇产科就诊的(门诊及住院)患者为研究对象,包括:孕妇(包括流产者)3 289例(孕妇组)、非孕生殖道感染患者4 224例(非孕生殖道感染组)、不孕症患者16 086例(不孕组)及2 915例新生儿。采集子宫分泌物和新生儿的呼吸道分泌物或胃液,进行CT筛查,并提取CT DNA进行细胞培养,PCR扩增后进行基因分型。结果孕妇组中共有205例感染CT,CT感染率为6.23%(205/3 289);不孕组共300例CT感染,感染率为7.10%(300/4 224);非孕生殖道感染组共1 657例CT感染,感染率为10.30%(1 657/16 086)。三组CT感染率差异有统计学意义(P<0.05),而感染CT各基因型相比,差异不具有统计学意义(χ^2=3.153,P=0.533)。2 915例新生儿,阴道分娩中有168例CT感染,剖宫产分娩未出现CT感染。其中30例患儿及其母亲感染CT基因型进行一致性分析,16例新生儿和其母亲CT基因型一致,另外14例新生儿比其母亲缺少1~2个基因型。结论对孕妇实施CT检测,可尽早干预,降低并发症发生率,减少新生儿CT感染的可能性,具有一定的临床优势,值得临床应用推广。

OBJECTIVE To explore the genotypes of Chlamydia trachomatis infection in pregnant women and neonates. METHODS The patients who were treated in the department of gynecology and obstetrics(outpatients and hospitalized patients) of Huaihe Hospital, Henan University from Jan 2015 to Jan 2019 were recruited as the study objects, 3 289 pregnant women(including miscarriage patients) were assigned as the pregnancy group, 4 224 non-pregnancy patients with genital tract infection were assigned as the non-pregnancy genital tract infection group, 16 086 infertility patients were set as the infertility group, and 2 915 neonates were also included.The cervical secretions of the women and the respiratory secretions or gastric juice of the neonates were collected, the C.trachomatis screening was carried out, DNA was extracted for cell culture, and PCR amplification was performed for genotyping. RESULTS There were 205(6.23%)(205/3 289) cases of C. trachomatis infection in the pregnancy group, 300(7.10%)(300/4 224) cases in the infertility group and 1 657(10.30%)(1 657/16 086)cases in the non-pregnancy genital tract infection group, and there was significant difference in the incidence of C.trachomatis infection among the three groups(P<0.05), however, there was no significant difference among the women with the various genotypes of C. trachomatis infection(χ^2=3.153,P=0.533).Of the 2 915 neonates, 168 had C. trachomatis infection among the neonates who were born via vaginal delivery, and none of the neonates had C. trachomatis infection among the neonates who were born through cesarean section.The gene identity analysis of the C. trachomatis infection in 30 neonates and their mothers showed that 16 neonates and their mothers had consistent genotypes, and 14 neonates lacked 1-2 genotypes as compared with their mothers. CONCLUSION It is an effective way to carry out the screening test of C. trachomatis and take interventions as early as possible so as to reduce the incidence of complications and prevent the neonates from being infected with C. trachomatis, which is worthy to be promoted in the hospital.