需氧菌性阴道炎孕妇B族链球菌定植和血清型及基因型

Colonization, serotypes and genotypes of group B Streptococcus in pregnant women with aerobic vaginitis

目的 探讨需氧菌性阴道炎(AV)孕妇B族链球菌(GBS)定植情况、GBS血清型及基因型。方法 选取2019年5月-2021年5月河南省中医院收治的AV孕妇384例为研究对象,分析AV孕妇GBS定植、药敏情况,使用乳胶凝集法、多位点序列分型(MLST)法分别检测GBS血清、基因分型。结果 AV孕妇中GBS定植有134例(34.90%)、大肠埃希菌97例(25.26%)、粪肠球菌64例(16.67%)。GBS对万古霉素、青霉素、氨苄西林的敏感率均为100.00%,红霉素的耐药率为100.00%,对环丙沙星、克林霉素、左氧氟沙星、四环素表现出不同程度耐药性。GBS血清型Ⅲ型51株(38.06%)、Ib型29株(21.64%)、Ⅴ型24株(17.91%),GBS基因型ST19型49株(36.57%)、ST23型28株(20.90%)。多因素Logistic回归模型分析结果显示孕早期BMI、GBS定植、GBS血清Ⅲ型、GBS基因ST19型是AV孕妇不良妊娠结局危险因素(P<0.05)。结论 AV孕妇GBS对红霉素耐药性高,血清型以Ⅲ型、Ib型、Ⅴ型为主,基因型以ST19型、ST23型为主,可影响妊娠结局。

OBJECTIVE To explore the colonization, serotypes and genotypes of group B Streptococcus(GBS) in pregnant women with aerobic vaginitis(AV). METHODS A total of 384 pregnant women with AV who were treated in Henan Hospital of Traditional Chinese Medicine from May 2019 to May 2021 were recruited as the research subjects. The colonization of GBS and the result of drug susceptibility testing were observed. The serotypes of GBS were detected by latex agglutination assay, and the genotypes were detected by multilocus sequence typing(MLST). RESULTS Among the pregnant women with AV, 134(34.90%) cases were colonized with GBS, 97(25.26%) cases were colonized with Escherichia coli(25.26%), and 64(16.67%) cases were colonized with Enterococcus faecalis. The drug susceptibility rates of the GBS strains to vancomycin, penicillin and ampicillin were 100.00%, the drug resistance rate to erythromycin was 100.00%, and the strains varied in the drug resistance rates to ciprofloxacin, clindamycin, levofloxacin and tetracycline. With regard to the serotypes of GBS, there were 51(38.06%) strains of type Ⅲ, 29(21.64%) strains of type Ib and 24(17.91%) strains of type V. With the regard to genotypes of GBS, there were 49(36.57%) strains of type ST19 and 28(20.90%) strains of type ST23. The result of multivariate logistic regression analysis showed that BMI during early pregnancy, colonization of GBS, serotype Ⅲ of GBS, and ST19 genotype of GBS were the risk factors for adverse pregnancy outcomes of the pregnant women with AV(P<0.05). CONCLUSION The GBS strains isolated from the pregnant women with AV are highly resistant to erythromycin. Type Ⅲ, type Ib and type V are the major serotypes;ST19 and ST23 are the major genotypes, and the pregnancy outcomes can be affected.