胎膜早破早产儿B族链球菌感染的发生率及转归

Incidence and Outcome of Group B Streptococcus Infection in Premature Infants with Premature Rupture of Membranes

目的:探讨B族链球菌(GBS)感染在胎膜早破早产儿中的发生率及其与早产儿转归的关系。方法:选取2018年3月至2019年2月于南京中医药大学沭阳附属医院产科出生的120例早产儿,分为胎膜早破组和无胎膜早破组各60例,采用PCR法检测鼻咽拭子B族链球菌抗原,抽取静脉血进行血培养及药敏试验,记录PCR法及血培养结果、主要就诊症状、治疗情况及合并症等。结果:胎膜早破组和无胎膜早破组血培养GBS阳性率分别为10.00%和1.67%,PCR检测GBS阳性率分别为21.67%、5.00%,差异均有统计学意义(P<0.05)。PCR检测GBS阳性组胎儿宫内生长受限、胎儿窘迫、新生儿窒息和化脓性脑膜炎发生率高于GBS阴性组,但差异均无统计学意义(P>0.05);GBS阳性组新生儿肺炎、败血症发生率均高于GBS阴性组,差异均有统计学意义(P<0.05)。PCR、血培养两种检测方法阳性率分别为13.33%和5.83%(P<0.05)。结论:胎膜早破组胎儿宫内生长受限、胎儿窘迫、新生儿窒息、肺炎、败血症、化脓性脑膜炎发生率高于无胎膜早破组。与血培养检测B族链球菌比较,采用PCR法检测鼻咽拭子B族链球菌抗原可提高检测阳性率。

Objective:To probe into the incidences of group B Streptococcus(GBS)infection in preterm infants with premature rupture of membranes and its correlation with prognosis of preterm infants.Methods:A total of 120 premature infants delivered in Shuyang Affiliated Hospital of Nanjing University of Chinese Medicine from Mar.2018 to Feb.2019 were extracted to be divided into the premature rupture of membranes group and no premature rupture of membranes group,with 60 cases in each group.PCR was used to detect group B streptococcus antigens in nasopharyngeal swabs.Venous blood was collected for blood culture and drug sensitivity test.The results of PCR and blood culture,main symptoms,treatment and complications were recorded.Results:The positive rate of GBS in blood culture was respectively 10.00%and 1.67%in the premature rupture of membranes group and no premature rupture of membranes group,and the positive rate of GBS by PCR was respectively 21.67%and 5.00%,with statistically significant differences(P<0.05).The incidence of fetal growth restriction,fetal distress,neonatal asphyxia and purulent meningitis detected by PCR in the GBS positive group was higher than that in the GBS negative group,but the differences were not statistically significant(P>0.05).The incidence of neonatal pneumonia and sepsis in the GBS positive group was higher than that in the GBS negative group,and the differences were statistically significant(P<0.05).The positive rates of PCR and blood culture were respectively 13.33%and 5.83%(P<0.05).Conclusion:The incidence of fetal growth restriction,fetal distress,neonatal asphyxia,pneumonia,sepsis and purulent meningitis in the premature rupture of membranes group was higher than that of the no premature rupture of membranes group.Compared with the detection of GBS by blood culture,the detection of GBS antigen from nasopharyngeal swabs by PCR can increase the positive rate.