43034例妊娠晚期孕妇无乳链球菌感染现状及耐药性分析

The infection status of streptococcus agalactiae and antimicrobial resistance in 43034 pregnant women in the third trimester of pregnancy

目的:分析温州地区妊娠晚期孕妇无乳链球菌(GBS)感染现状和耐药情况以及比较不同年龄结构孕妇的感染情况。方法:收集2016年1月至2020年12月在温州医科大学附属第二医院育英儿童医院产科就诊的43034例妊娠晚期(36~42周)孕妇的病例资料,统计其泌尿生殖道分泌物的GBS培养和药敏试验结果,比较不同年龄段妊娠晚期孕妇GBS检出情况。结果:43034例孕妇的泌尿生殖道标本内检出GBS共2928例,检出率为6.80%,其中2016—2019年GBS检出率呈上升趋势,2019年GBS检出率最高,差异有统计学意义(P<0.05),2020年稍有下降,但差异无统计学意义。在GBS定值年龄分布中,大于40岁孕妇检出率最高,为7.92%(P<0.05)。GBS感染孕妇在药敏试验中发现其对万古霉素敏感率为100.00%,耐药性最高为红霉素(74.11%),后依次为克林霉素(72.81%)、左氧氟沙星(37.06%),三种药物之间耐药率差异均有统计学意义(P<0.05)。结论:温州地区孕晚期孕产妇GBS检出率较高,约6.80%,其中大于40岁孕妇检出率最高,对于GBS感染的孕妇,青霉素仍然是产时首选预防药物。对于青霉素过敏妇女,应根据药敏试验结果科学合理地使用抗生素。

Objective:To analyze the infection status and antibiotic resistant of Group B streptococcus(GBS)in the third trimester of pregnancy women in Wenzhou,and to compare the infection status of pregnant women between different age groups.Methods:Data were collected from 43034 pregnant women in third trimester of pregnancy(36-42 gestational week)treated in the Obstetrics Department of the Second Affiliated Hospital of Wenzhou Medical University from January 2016 to December 2020.The statistical analysis was conducted on GBS culture and antibiotic sensitivity test of their urogenital tract,accompanied with the comparison in the detection of GBS in the third trimester of pregnancy of different ages.Results:Of 43034 pregnant women,2928 cases of GBS lactis were detected from the urogenital tract samples with a detection rate of 6.80%.The detection rate displayed an upward trend from 2016 to 2019,as was the highest in 2019,showing statistical difference(P<0.05);the detection rate had a slight decrease in 2020,but exhibited no significant difference.The detection rate was the highest in the pregnant women over 40 years old(7.92%),with statistical significance(P<0.05).In the drug sensitivity test of pregnant women with GBS infection,the sensitivity rate to vancomycin was found to be 100.00%,and the highest antibiotic resistance was erythromycin(74.11%),followed by clindamycin(72.81%),levofloxacin(37.06%),with significant difference among the three drugs(P<0.05).Conclusion:The detection rate of GBS in the third trimester of pregnancy women in Wenzhou was relatively high,reaching about 6.80%,highest in the pregnant women over 40 years.For pregnant women with GBS infection,penicillin is still the preferred prophylactic drug during labor.For women with penicillin allergy,antibiotics should be reasonably used according to the results of drug sensitivity test.