妊娠晚期阴道定植B族链球菌血清型别对新生儿感染的影响

Effect of vaginal colonization of group B Streptococcus serotypes on neonatal infection in late trimester of pregnancy

目的探究妊娠晚期阴道定植B族链球菌(GBS)血清型别对新生儿感染的影响。方法选取2017年1月-2019年12月南阳医学高等专科学校第一附属医院妇产科收治的妊娠晚期阴道定植B族链球菌单胎产妇共780例为研究组,发生早发型B族链球菌感染(GBS-EOD)的新生儿共28例,同时选取同时期医院收治的未发生妊娠晚期阴道定植GBS单胎产妇384例作为对照组,测定产妇及新生儿GBS血清型,并进行相关性分析。结果780株定植GBS血清标本中,血清型以Ⅲ型为主(361株,46.28%),其次为Ⅰa型(139株,17.82%),Ⅰb型为112株占14.36%,Ⅴ型有101株占12.95%;28例新生儿GBS-EOD总共发现4种血清型,按发病率高低依次为Ⅲ型50.00%(14/28),Ⅰa型28.57%(8/28),Ⅰb型14.29%(4/28),Ⅴ型7.14%(2/28)。有孕妇定植的Ⅱ、Ⅵ和NT型无患儿致病;新生儿因Ⅰa型发生GBS-EOD占5.76%(8/139),因Ⅰb型发生GBS-EOD占3.57%(4/112),因Ⅲ型发生GBS-EOD占3.88%(14/361),因Ⅴ型发生GBS-EOD占1.98%(2/101);Ia血清型与新生儿GBS-EOD的相关度最大(OR=7.984,95%CI:5.273~14.984,P=0.005),其次为Ⅲ血清型(OR=4.895,95%CI:3.072~6.631,P=0.032)。结论Ⅲ、Ⅰa、Ⅰb、Ⅴ血清型是妊娠晚期阴道定植GBS的最常见类别,Ⅲ型最为常见,相关性研究表明Ia血清型与新生儿GBS-EOD的相关度最大。

OBJECTIVE To explore the effect of vaginal colonization of group B Streptococcus serotypes on neonatal infection in the third trimester of pregnancy.METHODS A total of 780 singleton mothers with vaginal colonization of group B Streptococcus admitted to the department of Obstetrics and Gynecology of the First Affiliated Hospital of Nanyang Medical College from Jan.2017 to Dec.2019 were selected as the research group.A total of 28 newborns had early-onset Group B Streptococcus infection(GBS-EOD).At the same time,384 cases of single pregnancy women who did not undergo vaginal colonization of Streptococcus group B in the third trimester of pregnancy during the same period were selected as the control group,and the GBS serotypes of the mothers and newborns were determined,and the correlation analysis was carried out.RESULTS Among the 780 GBS serum specimens,the serotype was mainly typeⅢ(361 strains,46.28%),followed by type Ia(139,17.82%),type I B were 112 strains accounting for 14.36%,and type V were 101 strains accounting for 12.95%.A total of 4 serotypes were found in 28 neonates with GBS-EOD,of which typeⅢaccounted for 50.00%(14/28),type A a accounted for 28.57%(8/28),type I B accounted for 14.29%(4/28),and typeⅤaccounted for 7.14%(2/28),respectively,according to the incidence rate.TypesⅡ,Ⅵ,and NT colonized by pregnant women did not cause disease in children.The incidence of gbs-eod was 5.76%(8/139)for type Ia,3.57%(4/112)for typeⅠb,3.88%(14/361)for typeⅢ,and 1.98%(2/101)for typeⅤ.The correlation between gbs-eod and genotype IA was the highest(OR=7.984,95%CI:5.273-14.984,P=0.005),followed by genotypeⅢ(OR=4.895,95%CI:3.072-6.631,P=0.005).CONCLUSION SerotypesⅢ,Ⅰa,Ⅰb,andⅤwere the most common types of vaginal colonization of GBS in late trimester of pregnancy,and typeⅢwas the most common.Correlation studies showed that serotype Ia had the greatest correlation with neonatal GBS-EOD.