萧山区基层医院围产期孕妇B族链球菌筛查及流行病学研究

Screening and epidemiological study of group B streptococcus in pregnant women during perinatal period in Xiaoshan District primary hospitals

目的探究萧山区基层医院围产期孕妇B族链球菌(GBS)筛查的意义及流行病学特点。方法回顾性选取2020年5月至2021年6月于杭州市萧山区基层医院产科门诊就诊的1225例围产期孕妇作为研究对象,检测其GBS感染情况,对GBS阳性菌株进行耐药性检测,并分析GBS感染对妊娠结局的影响。结果1225例孕妇中,GBS阳性孕妇98例(8.00%);GBS阳性孕妇早产､宫内感染､胎膜早破､产褥感染发生率明显高于GBS阴性孕妇(P<0.05);GBS阳性孕妇分娩的新生儿肺炎､窒息､宫内窘迫的发生率明显高于GBS阴性孕妇分娩的新生儿(P<0.05)。常用抗菌药物中,GBS菌株对利奈唑胺､万古霉素的敏感率高达100.00%,对氨苄西林､青霉素､头孢曲松､头孢唑林的敏感率均在90.00%以上,而对四环素的耐药率仅为60.21%。结论孕妇GBS感染可造成早产､宫内感染､胎膜早破､产褥感染,以及新生儿肺炎､窒息､宫内窘迫等不良妊娠结局,GBS菌株对利奈唑胺､万古霉素､氨苄西林､青霉素､头孢曲松等抗菌药物均有较高敏感性。

Objective To explore the screening significance and epidemiological characteristics of group B streptococcus(GBS)in pregnant women during the perinatal period in the primary hospitals in Xiaoshan District.Methods A retrospective analysis was performed on 1,225 perinatal women who visited the Clinic of Obstetrics of the primary hospitals in Xiaoshan District of Hangzhou from May 2020 to June 2021.The GBS infection,and the resistance of the tested GBS-positive strains were detected,and its impact on pregnancy outcome was analyzed.Results Among 1,225 pregnant women,98(8.00%)were GBS positive.The incidence of premature delivery,intrauterine infection,premature rupture of membranes and puerperal infection in GBS positive pregnant women was significantly higher than that in GBS negative pregnant women(P<0.05).The incidence of pneumonia,asphyxia and intrauterine distress in neonates delivered by GBS positive pregnant women was significantly higher than that of neonates delivered by GBS negative pregnant women(P<0.05).Among the commonly used antibacterial drugs,the sensitivity rate of GBS strain to linezolid and vancomycin was as high as 100.00%,and the sensitivity rate to ampicillin,penicillin,ceftriaxone and cefazolin was above 90.00%,while the resistance rate to tetracycline was only 60.21%.Conclusions GBS infection can cause premature delivery,intrauterine infection,premature rupture of membranes,puerperal infection,and neonatal pneumonia,asphyxia,intrauterine distress and other adverse pregnancy outcomes.However,it has higher sensitivity to linezolid,vancomycin,ampicillin,penicillin,and ceftriaxone.