妊娠晚期B群链球菌定植情况、抗菌药物敏感性及妊娠结局分析

Analysis of colonization of Group B Streptococcus, antimicrobial susceptibility and pregnancy outcome in the third trimester of pregnancy

目的分析妊娠晚期B群链球菌(GBS)定植情况、抗菌药物敏感性及其妊娠结局。方法回顾性分析2020年1月—9月安徽医科大学第二附属医院孕35~37周自愿行阴道联合直肠GBS筛查的500名孕妇的病历资料。分析妊娠GBS定植情况、GBS阳性标本抗菌药物敏感性。按照GBS筛查结果,将其分为GBS阴性组与GBS阳性组,比较两组妊娠结局。结果500名孕妇中GBS阳性共检出56名,定植率为11.20%;其中阴道阳性标本41份,定植率为8.20%;直肠阳性标本32份,定植率为6.40%。GBS对克林霉素、红霉素、四环素具有较高的耐药性,对头孢呋辛、利奈唑胺、万古霉素、氨苄西林、青霉素的敏感性均较高。GBS阳性组产前发热、异常孕产史占比高于GBS阴性组,差异均有统计学意义(均P<0.05)。GBS阳性组胎膜早破、产褥期感染、产前发势、产后出血、新生儿败血症、新生儿肺炎占比高于GBS阴性组,差异均有统计学意义(均P<0.05)。结论在妊娠晚期GBS总体定植率较低,综合直肠检测可使GBS检出率增加。GBS阳性患者具有较高的胎膜早破、产褥期感染、产后出血、新生儿败血症、新生儿肺炎等不良妊娠结局;GBS对头孢呋辛、利奈唑胺、万古霉素、氨苄西林、青霉素的敏感性均较高。

Objective To analyze the colonization and antimicrobial susceptibility of Group B Streptococcus(GBS)in the third trimester of pregnancy and its pregnancy outcome.Methods The medical records of 500 pregnant women who voluntarily underwent vaginal combined rectal GBS screening in the Second Affiliated Hospital of Anhui Medical University from January to September 2020 were retrospectively analyzed.The colonization of GBS and the antimicrobial susceptibility of GBS positive samples were analyzed.According to the results of GBS screening,they were divided into GBS negative group and GBS positive group,and the pregnancy outcome of two groups was compared.Results A total of 56 pregnant women with GBS positive were detected among 500 pregnant women,and the colonization rate was 11.20%;among which 41 were positive vaginal specimens,the colonization rate was 8.20%;there were 32 positive rectal specimens,the colonization rate was 6.40%.GBS had high resistance to Clindamycin,Erythromycin and Tetracycline,and high sensitivity to Cefuroxime,Linezolid,Vancomycin,Ampicillin and Penicillin.The proportion of prenatal fever,abnormal pregnancy history of GBS positive group were higher than those of GBS negative group,and the differences were statistically significant(all P<0.05).The proportions of premature rupture of membranes,puerperium infection,postpartum hemorrhage,neonatal septicemia and neonatal pneumonia in GBS positive group were higher than those in GBS negative group,and the differences were statistically significant(all P<0.05).Conclusion The overall colonization rate of GBS is low in the third trimester of pregnancy,and the detection rate of GBS can be increased by comprehensive rectal examination.GBS positive patients have higher adverse pregnancy outcomes such as premature rupture of membranes,puerperal infection,Prenatal fever postpartum hemorrhage,neonatal septicemia,and neonatal pneumonia.GBS has high sensitivity to Cefuroxime,Linezolid,Vancomycin,Ampicillin and Penicillin.