妊娠晚期妇女B族链球菌检出情况与药敏分析

Detection and drug sensitivity analysis of group B Streptococcus in women of the third trimester

目的分析本地妊娠晚期妇女B族链球菌(group B Streptococcus,GBS)的定植率与药敏情况,以指导临床制定合适的筛查与预防策略。方法通过回顾性的研究,以山东省妇幼保健院2019年1月至2020年12月进行孕晚期B组链球菌筛选的孕妇为研究对象,共纳入6 345名孕妇,分别取肛门拭子和阴道拭子进行培养、鉴定及药敏试验,统计分析B族链球菌带菌与药敏状况。结果本地区妊娠晚期妇女B族链球菌阳性率7.2%,低于发达国家报道的14%~30%,与中国其他地区的定植率也存在一定的差异;阴道拭子检出率是3.9%,直肠拭子检出率是5.5%,两者较综合检出率低,差异有统计学意义(P<0.05);31~35岁组带菌率最高7.70%,与其他各年龄比较差异均无统计学意义(P>0.05);本地区B族链球菌对青霉素、阿莫西林、利奈唑胺、美罗培南、头孢吡肟、头孢噻肟和万古霉素的敏感率为100%,对红霉素、克林霉素、氯霉素、四环素和左氧氟沙星的敏感率分别是21%、32.5%、89.5%、70.2%、31.5%。结论不同地区孕产期妇女B族链球菌带菌率存在差异,各年龄组之间无明显差异,同时送检阴道和直肠拭子可以提高检出率,青霉素仍可作为预防B族链球菌感染的首选药物,对青霉素过敏者建议进行药敏试验。

Objective To analyze the carrying rate and drug sensitivity of group B Streptococcus(GBS)in local women in the third trimester of pregnancy,so as to guide the clinical development of appropriate screening and prevention strategies.Methods By retrospective study,pregnant women screened for GBS in the third trimester in Shandong Maternal and Child Health Care Hospital from January 2019 to December 2020 were selected as research subjects.A total of 6345 pregnant women were enrolled.Anal and vaginal swabs were taken for culture,identification and drug sensitivity test,and the status of GBS carrying and drug sensitivity were statistically analyzed.Results The positive rate of GBS in women in the third trimester of pregnancy in this region was 7.2%,which was lower than the reported rate of 14%~30%in developed countries,and there were some differences with the carrying rate in other regions of China.The detection rate of vaginal swab was 3.9%,and the detection rate of rectal swab was 5.5%,which was lower than the comprehensive detection rate,and the difference was statistically significant(P<0.05).The bacterial carrying rate of the 31~35 year old group was the highest(7.70%),and there was no statistical significance compared with other age groups(P>0.05).The sensitivity rates of GBS in this area to penicillin,amoxicillin,linezolid,meropenem,cefepime,cefotaxime and vancomycin were 100%,and the sensitivity rates to erythromycin,clindamycin,chloramphenicol,tetracycline and levofloxacin were 21%,32.5%,89.5%,70.2%and 31.5%,respectively.Conclusion There were differences in the bacterial carrying rate of GBS among pregnant women in different regions,and there was no significant difference among different age groups.Simultaneously sending vaginal and rectal swabs for examination can improve the detection rate,penicillin could still be used as the first choice for preventing GBS infection,and drug sensitivity test was recommended for penicillin allergic patients.