B族链球菌感染对孕妇阴道微生态失衡和血清炎性因子与母婴结局的影响

Influence of group B infection on the imbalance of vaginal microecosystem, serum inflammatory factors and maternal and neonatal outcomes of pregnant women

目的 探讨B族链球菌(GBS)感染对孕妇阴道微生态失衡、血清炎性因子、母婴结局的影响。方法 选取2019年1月-2020年7月于海南医学院第一附属医院行宫颈分泌物GBS检测的妊娠中晚期孕妇为研究对象,其中阳性孕妇102例纳入GBS阳性组,阴性孕妇100例纳入GBS阴性组,比较不同组别孕妇阴道微生态菌落、血清炎性因子、临床结局。结果 GBS对青霉素类药物、头孢类药物、利奈唑胺、万古霉素均敏感;GBS阳性组阴道微生态失衡比例(39.21%)高于GBS阴性组(25.00%)(P<0.05);GBS阳性组血清白细胞介素-6(IL-6)、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)水平高于GBS阴性组(P<0.05);GBS阳性组胎膜早破、绒毛膜羊膜炎、胎儿窘迫、早产、新生儿窒息、新生儿感染、产褥感染发生率均高于GBS阴性组(P<0.05)。结论 GBS感染可加重妊娠期阴道微生态紊乱,血清炎性因子水平升高,增加不良妊娠结局发生风险。

OBJECTIVE To explore the influence of group B Streptococcus(GBS) infection on the imbalance of vaginal microecosystem, serum inflammatory factors and maternal and neonatal outcomes of pregnant women. METHODS Pregnant women in the middle and late pregnancy who underwent GBS testing of cervical secretions in the First Affiliated Hospital of Hainan Medical College from Jan 2019 to Jul 2020 were selected as the research subjects. Among which, a total of 102 pregnant women with positive results were included in the GBS-positive group, and 100 pregnant women with negative test results were included as GBS-negative group. The vaginal microecological colonies, serum inflammatory factors and clinical outcomes of pregnant women in different groups were compared. RESULTS GBS was sensitive to penicillins, cephalosporins, linezolid and vancomycin, azithromycin and clindamycin. The proportion of vaginal microecological imbalance in GBS-positive group was 39.21%, significantly higher than that in GBS-negative group(P<0.05). The levels of serum interleukin-6(IL-6), procalcitonin(PCT) and high sensitivity C-reactive protein(hs-CRP) in GBS-positive group were significantly higher than those in GBS-negative group(P<0.05), and incidence of premature rupture of membranes, chorioamnionitis, fetal distress, premature delivery, neonatal asphyxia, neonatal infection and puerperal infection was significantly higher than that in GBS-negative group(P<0.05). CONCLUSION GBS infection aggravated gestational vaginal microecological disorders, increased levels of serum inflammatory factors and the risk of adverse pregnancy outcomes.