围产期孕妇生殖道分泌物无乳链球菌的分布及耐药分析

Analysis of distribution and drug resistance of Streptococcus agalactiae in reproductive tract secretions of perinatal pregnant women

目的分析围产期孕妇生殖道分泌物中无乳链球菌的分布情况及耐药性,为临床预防和合理使用抗生素提供依据。方法对2016年1月-2019年12月本院产科围产期孕妇送检的24244例宫颈分泌物进行细菌培养鉴定和药敏试验,对分离出的无乳链球菌进行药敏分析。结果从24244例围产期孕妇宫颈分泌物中分离细菌764例,阳性率为3.15%,其中革兰氏阳性菌占81.6%,主要以无乳链球菌(73.0%)为主;革兰氏性阴性菌占18.4%,主要以大肠埃希菌(14.0%)、肺炎克雷伯菌(1.4%)、产气肠杆菌(1.0%)为主。无乳链球菌对青霉素、头孢唑啉、头孢呋辛、氨苄西林、万古霉素、替考拉宁、利奈唑胺敏感率是100%,对克林霉素、四环素的耐药率在80%以上。结论本地区围产期孕妇生殖道中主要是以无乳链球菌为主。针对无乳链球菌的预防用药可以首选青霉素,对于青霉素过敏者及其他细菌感染可根据药敏结果选用合适抗生素。围产期宫颈分泌物细菌培养对于临床医师及时进行抗感染控制,减少母婴传播有重要意义。

Objective To analyze the colonization and drug resistance of Streptococcus agalactiae in the genital tract secretions of pregnant women during perinatal period,and to provide the basis for clinical prevention and rational use of antibiotics.Methods A total of 24244 cases of cervical secretions submitted by perinatal pregnant women in our hospital were identified by bacterial culture and drug sensitivity test from January 2016 to December 2019,and drug sensitivity tests was conducted on the isolated streptococcus agalactiae.Results 764 cases of bacteria were isolated from the cervical secretions of 24244 perinatal pregnant women,with a positive rate of 3.15%,of which 81.6%were Gram-positive bacteria and Streptococcus agalactiae(73.0%)were the main bacteria.Gram-negative bacteria accounted for 18.4%,and the main bacteria were Escherichia coli(14.0%),Klebsiella pneumoniae(1.4%)and Enterobacter pneumoniae(1.0%).The sensitivity rate of Streptococcus agalactiae to penicillin、cefazolinwas、cefuroxiome、Ampicillin、Vancomycin、teicoplanin and Linezolid were 100%;The resistance rate of Clindamycin and Tetracyclnie were above 80%.Conclusions Streptococcus agalactiae were mainly found in the reproductive tract of perinatal pregnant women in this area.Penicillin can be the first choice of prophylactic drugs for Streptococcus agalactiae,and appropriate antibiotics can be selected for people allergic to penicillin and other bacterial infections according to the results of drug sensitivity.Bacterial culture of cervical secretions during perinatal period is of great significance for clinicians to carry out antiinfection control in time and reduce mother-to-child transmission.