围产期孕妇B族链球菌感染情况及药敏试验结果分析

Analysis on infection status and drug sensitivity of group B streptococcus in perinatal period

目的分析围产期孕妇检出B族链球菌(GBS)阳性菌株的耐药情况及妊娠不良结局发生情况,指导临床正确使用抗菌药物进行干预或治疗。方法观察2019年1—12月于曲靖市第二人民医院产科就诊的1706例围产期孕妇的GBS感染情况,对检出的GBS阳性菌株进行耐药性分析,同时记录并分析282例于本院住院围产期孕妇发生妊娠不良结局的情况。结果共检出71例GBS阳性菌株,其中分布于25~30岁年龄段的比例最高〔50.7%(36/71)〕,其次为19~24岁〔23.9%(17/71)〕和31~35岁〔15.5%(11/71)〕年龄段;71例GBS阳性菌株对青霉素、氨苄西林、万古霉素、利奈唑烷均未产生耐药,对红霉素和克林霉素耐药率均较高,分别为85.9%和78.9%;其中红霉素诱导克林霉素耐药发生率为39.3%,为诱导型耐药,对左氧氟沙星和环丙沙星的耐药率均为47.9%,对莫西沙星的敏感率为53.4%。282例本院住院孕产妇中,GBS阳性组先兆流产和胎膜早破发生率均明显高于GBS阴性组〔先兆流产:26.10%(6/23)比2.32%(6/259),胎膜早破:21.70%(5/23)比5.02%(13/259),均P<0.05〕。结论GBS感染可能会增加先兆流产和胎膜早破的发生率,临床应重视抗菌药物的正确使用,进行有效干预与治疗,改善妊娠结局。

Objective To analyze the drug resistance of group B streptococcus(GBS)positive strains in pregnant women during the perinatal period and the occurrence of adverse pregnancy outcomes,so as to guide the correct clinical use of antibiotics for intervention or treatment.Methods The GBS infection status of 1706 perinatal pregnant women who visited the obstetrics department of Qujing Second People's Hospital from January to December 2019 was observed,and the GBS positive strains were analyzed for drug resistance.At the same time,282 cases of hospitalized perinatal women in our hospital were analyzed for adverse pregnancy outcomes.Results A total of 71 strains of GBS positive strains were detected.The highest proportion of GBS positive strains was found in 25-30 years old group[50.7%(36/71)],followed by 19-24 years old[23.9%(17/71)]and 31-35 years old[15.5%(11/71)].The 71 strains of GBS positive strains were not resistant to penicillin,ampicillin,vancomycin and linezolid,the drug resistance rates to erythromycin and clindamycin were relatively high,at 85.9%and 78.9%,respectively.Among them,the incidence of clindamycin resistance induced by erythromycin was 39.3%,which was induced drug resistance.The drug resistance rates to levofloxacin and ciprofloxacin were both 47.9%,and that to moxifloxacin was 53.4%.In 282 cases of hospitalized pregnant women,the incidence of threatened abortion and premature rupture of membranes in GBS positive group was significantly higher than that in GBS negative group[26.10%(6/23)vs.2.32%(6/259),21.70%(5/23)vs.5.02%(13/259),both P<0.05].Conclusions GBS infection may increase the incidence of premature delivery and premature rupture of membranes.Clinical attention should be paid to the correct use of antibiotics,in order to effectively intervene and treat GBS infection and improve pregnancy outcomes.