围产期孕妇阴道分泌物B群链球菌感染和药物敏感性分析

Group B streptococcus infection and drug sensitivity analysis in vaginal secretions from perinatal pregnant women

目的了解围产期孕妇产前B群链球菌感染情况及药物敏感性,并通过分析为新生儿感染B群链球菌的防治提供依据。方法收集宿迁市妇产医院,如皋妇产医院,如皋广慈医院等2019年1月到2020年3月份共4750份妊娠35~37周孕妇阴道分泌物标本进行B群链球菌分离鉴定;阳性菌株用K-B法进行药敏试验。结果4750例阴道分泌物标本,检出B群链球菌225株,检出率为4.74%。药敏结果中,未检出对青霉素、万古霉素和利奈唑胺耐药的菌株,但青霉素敏感性下降,其抑菌圈在敏感折点上的占5.33%;氯霉素、左氧氟沙星、克林霉素、红霉素的耐药率分别为7.61%、57.94%、70.98%、80.44%;诱导克林霉素试验阳性率为9.43%。结论B群链球菌在围产期妇女阴道分泌物检出率达4.74%,β内酰胺类无耐药,但青霉素敏感度有下降表现。临床应重视围产期孕妇B群链球菌筛查,通过产前筛查和药物敏感试验有效的加以防治,做好预防性治疗,降低产妇及婴儿病患率。

Objective To understand the situation and drug sensitivity of antenatal group B streptococcus infection in perinatal pregnant women,and to provide basis for the prevention and treatment of group B streptococcus infection in neonates.Methods From January 2019 to March 2020,a total of 4750 samples of vaginal secretions from pregnant women at 35~37 weeks of gestation were collected from Suqian Maternity Hospital,Rugao Maternity Hospital and Rugao Guangci Hospital for the isolation and identification of group B streptococcus;The drug sensitivity test of the positive strain was carried out by K-B method.Results 225 strains of group B streptococcus were detected in 4750 samples of vaginal secretions,with a detection rate of 4.74%.Among the drug sensitivity results,no strains resistant to penicillin,vancomycin and linezolid were detected,but the sensitivity of penicillin decreased,and the inhibitory zone accounted for 5.33%at the sensitive fold point;The drug resistance rates of chloramphenicol,levofloxacin,clindamycin and erythromycin were 7.61%,57.94%,70.98%and 80.44%respectively.The positive rate of induction clindamycin test was 9.43%.Conclusion In perinatal period,the infection rate of group B streptococcus vaginal secretions reached 4.74%,and lactams showed no resistance,but the sensitivity of penicillin showed a decline.Clinical attention should be paid to the screening of group B streptococcus in perinatal pregnant women,which should be effectively prevented through prenatal screening and drug sensitivity test,and preventive treatment should be done to reduce the rate of maternal and infant patients.