妊娠合并B族链球菌感染相关因素调查

Investigation on related factors of pregnancy complicated with GBS infection

目的 分析本地区妊娠合并B族链球菌(group B streptococcus,GBS)感染率和相关因素。方法 收集符合标准的2 005例病历档案,采集35~37孕周妊娠孕妇阴道和直肠标本,并进行培养和鉴定,采用临床常用抗生素对分离出GBS阳性菌株进行药敏试验。统计分析GBS感染率的影响因素。结果 2 005例妊娠晚期孕妇中有115例患者检出GBS,感染率为5.74%。本次研究中GBS感染率与年龄、BMI、文化程度、经济条件、作息规律、流产史、剖宫产分娩史、妊娠期高血压数据差异无统计学意义(P>0.05)。GBS感染率与阴道分娩史、妊娠期糖尿病、念珠菌性阴道炎、滴虫、线索细胞和阴道清洁度数据差异具有统计学意义(P<0.05)。GBS对红霉素、阿奇霉素、环丙沙星耐药率分别为82.91%、35.90%和29.06%。未检出对青霉素、氨苄西林、头孢唑啉、头孢噻肟和万古霉素耐药菌株。讨论妊娠孕妇应进行GBS筛查。妊娠期糖尿病、滴虫、念珠菌性阴道炎、线索细胞和阴道清洁度是GBS感染相关因素。GBS感染首选青霉素类药物治疗。

Objective To analyze the infection rate and related factors of pregnancy complicated with GBS in this area.Methods The medical records of 2005 cases meeting the standards were collected.The drug sensitivity test of GBS positive strains was carried out by using commonly used antibiotics in clinic.The influencing factors of GBS infection rate were statistically analyzed.Results GBS was detected in 115 of the 2005 late pregnant women,and the infection rate was 5.74%.In this study,there was no significant difference between GBS infection rate and age,BMI,educational level,economic conditions,work and rest rules,abortion history,cesarean delivery history and gestational hypertension(P>0.05).GBS infection rate was significantly different from vaginal delivery history,gestational diabetes mellitus,candidal vaginitis,trichomonas,clue cell and vaginal cleanliness data(P<0.05).The resistance rates of GBS to erythromycin,azithromycin and ciprofloxacin were 82.91%,35.90% and 29.06% respectively.There was no resistance to penicillin,ampicillin,cefazolin,cefotaxime and vancomycin.Conclusion Pregnant women should be screened for GBS.Gestational diabetes mellitus,trichomoniasis,Candida vaginitis,clue cells and vaginal cleanliness are related factors of GBS infection.Penicillins are the first choice for the treatment of GBS infection.