3种方法检测围产期孕妇阴道分泌物B群链球菌的效果分析

Effect analysis of three methods for detection of group B streptococcus in vaginal secretion of perinatal pregnant women

目的分析一般细菌培养法、B群链球菌(GBS)显色培养法和实时荧光聚合酶链反应(PCR)在围产期孕妇GBS检测中的应用效果。方法收集2019年1-8月自愿就诊于曲靖市第二人民医院妇产科的围产期孕妇送检的1 088份阴道分泌物标本,同时采用一般细菌培养法、GBS显色培养法和实时荧光PCR检测GBS,比较3种方法的阳性率和检测时长;以一般细菌培养法为参考标准,计算其余两种方法的敏感度、特异度和准确度。结果 1 088份围产期孕妇阴道分泌物标本中,一般细菌培养法检出阳性55份,阳性率为5.06%;GBS显色法检出阳性62份,阳性率为5.70%;实时荧光PCR检出阳性78份,阳性率为7.17%。实时荧光PCR阳性率明显高于一般细菌培养法〔7.17%(78/1 088)比5.06%(55/1088)〕,差异有统计学意义(P<0.05),其余方法比较差异均无统计学意义(均P>0.05)。以一般细菌培养法为参考标准,GBS显色培养法的敏感度、特异度、准确度分别为100%、99.3%、99.4%,实时荧光PCR分别为96.4%、97.6%、97.5%,差异无统计学意义(P>0.05)。一般细菌培养法和GBS显色培养法所需时长为24~36 h,实时荧光PCR耗时4~6 h。结论实时荧光PCR筛查GBS阳性率最高且耗时短,适合于为临床提供准确、快速的诊断依据,GBS显色培养法适合于基层医院进行GBS的常规筛查和防治。

Objective To analyze the application effects of general bacterial culture method,group B streptococcus(GBS)chromogenic culture method and real-time fluorescent polymerase chain reaction(PCR)on detection of GBS in vaginal secretion of perinatal pregnant women.Methods The 1088 vaginal secretion specimens sent by perinatal pregnant women who voluntarily consulted in the obstetrics and gynecology department of Qujing Second People's Hospital from January to August,2019 for the purpose of methodology evaluation were collected.The general bacterial culture method,GBS chromogenic culture method and real-time fluorescent PCR were used to detect GBS,and the positive rates and detection time of three methods were compared.Taking the general bacterial culture method as reference standard,the sensitivity,specificity and accuracy of the other two methods were calculated.Results Among the 1088 specimens of vaginal secretion of perinatal pregnant women,55 cases were positive by general bacterial culture method,the positive rate was 5.06%,62 cases were positive by GBS colorimetric method,the positive rate was 5.70%,and 78 cases were positive by real-time fluorescent PCR,the positive rate was 7.17%.The positive rate by real-time fluorescent PCR was significantly higher than that by general bacterial culture method[7.17%(78/1088)vs.5.06%(55/1088)],with significant difference(P<0.05),and the rest had no significant difference(P>0.05);Using the general bacterial culture method as a reference standard,the sensitivity,specificity,and accuracy of the GBS chromogenic culture method were 100%,99.3%,and 99.4%,and those of the real-time fluorescent PCR were 96.4%,97.6%,and 97.5%,respectively,without significant difference(P>0.05).The time required by general bacterial culture method and GBS chromogenic culture method was 24-36 h,while the time required by real-time fluorescent PCR was 4-6 h.Conclusions The real-time fluorescent PCR has the highest positive rate and takes a short time to screen GBS,which is suitable for providing accurate and rapid diagnostic evidence for clinical use.The GBS colorimetric culture method is suitable for the routine screening and prevention of GBS in primary hospitals.