孕产妇生殖道B族链球菌感染特征及其妊娠结局

Characteristics of puerpera with genital tract group B Streptococcus infection and pregnancy outcomes

目的探究生殖道感染孕产妇B族链球菌分离株血清型、耐药及毒力基因和妊娠结局。方法随机选取2020年11月-2022年11月于济南市第二妇幼保健院产检的56例生殖道B族链球菌感染孕产妇(研究组)和58名产检未发生生殖道B族链球菌感染孕产妇(对照组)为研究对象,比较两组妊娠结局,分析生殖道B族链球菌分离株对常见抗菌药物耐药情况和其耐药基因及血清型、毒力基因分布。结果研究组早产(16.07%)、产后出血(14.29%)占比高于对照组(P<0.05);56株B族链球菌药敏试验结果显示,对头孢克肟、头孢曲松、青霉素、万古霉素敏感,对左氧氟沙星、红霉素、四环素、克林霉素均表现出不同程度的耐药;耐药基因占比较高的为ermB、mefA/E,gyrA、ermTR占比较少;血清型Ⅰb型、Ⅰa型占比较高,其余占比依次为Ⅲ型、Ⅱ型、Ⅴ型,Ⅵ型和NT型,所有菌株均携带毒力基因,其中hylB、scpB占比较高。结论B族链球菌感染能够造成孕产妇发生不良妊娠结局,对左氧氟沙星、红霉素、四环素、克林霉素均表现出不同程度的耐药,主要耐药基因为ermB、mefA/E,血清型Ⅰb型、Ⅰa型为最常见,所有菌株中携带毒力基因hylB、scpB占比较高。

OBJECTIVE To explore the serotypes,drug resistance and virulence genes in group B Streptococcus(GBS)isolates from the puerpera with genital tract infection and analyze the pregnancy outcomes.METHODS A total of 56 puerpera with genital tract GBS infection who received prenatal examinations in Jinan Second Maternal and Child Health Hospital from Nov 2020 to Nov 2022 were assigned as the study group,and 58 puerpera who received prenatal examinations but did not have genital tract GBS infection were chosen as the control group.The pregnancy outcomes were compared between the two groups,the drug resistance rates of the genital GBS isolates to the commonly used antibiotics were analyzed;the drug resistance genes,serotypes and virulence genes were observed.RESULTS The proportions of puerpera with premature delivery,postpartum hemorrhage were respectively(16.07%),(14.29%)higher in the study group than in the control group(P<0.05);the result of drug susceptibility testing for 56 strains of GBS showed that the strains were sensitive to cefixime,ceftriaxone,penicillin and vancomycin and varied in the drug resistance to levofloxacin,erythromycin,tetracycline and clindamycin.ermB and mefA/E were dominant among the drug resistance genes,while the gyrA and ermTR were less common.The typeⅠb and typeⅠa were the predominant serotypes,followed by the typeⅢ,typeⅡ,typeⅤ,typeⅥand the type NT.The strains that carried with hylB and scpB were dominant among the strains carrying with virulence genes.CONCLUSION The GBS infection may result in the adverse pregnancy outcomes of the puerpera.The GBS strains show varying degree of drug resistance to levofloxacin,erythromycin,tetracycline and clindamycin.The ermB and mefA/E are the major drug resistance genes;the serotypeⅠb and Ia are the most common.The strains that carry with hylB and scpB are dominant among the strains carrying with virulence genes.