孕晚期妇女B族链球菌带菌情况分析

Analysis of group B Streptococcus in the third trimester of pregnancy

目的:检测孕晚期妇女B族链球菌(group B Streptococcus,GBS)的带菌情况及其耐药情况。方法:选取在南通大学附属妇幼保健院产科门诊进行产前检查的孕34~38周的孕妇2210例为研究对象。采集阴道内1/3处分泌物进行细菌培养与实时荧光聚合酶链反应(real time fluorescent polymerase chain reaction,RT-PCR),观察2种方法的检测效果。再将GBS阳性者进行白带分析检测及耐药情况分析,同时选取GBS阴性患者作为对照。结果:2210例受检孕妇经细菌培养GBS阳性为8.28%,RT-PCR检测阳性为10.18%,RT-PCR检出率高于细菌培养。白带分析结果发现,GBS阳性与阴性标本中pH、白细胞酯酶、过氧化氢和唾液酸苷酶差异有统计学意义,而β葡萄糖醛酸酶和乙酰氨基葡萄糖苷酶差异无统计学意义。GBS对氨苄西林、利奈唑胺、青霉素G、奎奴普丁/达福普汀、替加环素、万古霉素的敏感率高(均为100.00%)。随访发现曾有患GBS阳性的患者,新生儿疾病患病率明显高于GBS阴性患者。结论:孕晚期GBS感染可提高不良妊娠结局的发生风险,导致新生儿疾病的增加,临床应注意筛查。

Objective:To detect the carrier and drug resistance of group B Streptococcus(GBS)in the third trimester of pregnancy.Methods:A total of 2210 pregnant women aged 34-38 weeks who underwent prenatal examination in the Obstetrical Department of Maternal and Child Health Hospital Affiliated to Nantong University were selected as the study subjects.Vaginal discharge from one third of vagina were collected for bacterial culture and real time fluorescent polymerase chain reaction(RT-PCR)to observe the detection effect of the two methods.Then,the GBS positive patients were tested for leucorrhea and drug resistance were analyzed,and the GBS negative patients were selected as the control group.Results:The positive rate of bacterial culture and RT-PCR in 2210 pregnant women was 8.28%and 10.18%respectively.The detection rate of RT-PCR was higher than that of bacterial culture.Leucorrhea analysis revealed differences in pH,leucocyte esterase,hydrogen peroxide and sialidase between positive and negative samples,while no significant differences were found betweenβ-glucuronase and acetylglucosidase.In comparison of drug resistance,GBS showed the highest sensitivity to Ampicillin,Linezolid,Penicillin G,Quinuptin/Dafoptin,Tegacycline and Vancomycin at 100.00%,providing a clinical treatment method.During follow up,we found that there had been GBS positive patients,and the morbidity of neonatal diseases were significantly higher than that of GBS negative patients.Conclusion:GBS infection in the third trimester of pregnancy can increase the risk of adverse pregnancy outcomes and lead to increased neonatal diseases.