围产期妇女无乳链球菌感染及耐药情况调查
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摘要
目的:探讨围产期妇女阴道分泌物中无乳链球菌(GBS)的感染情况,并根据其药敏结果判断GBS的耐药情况,为临床用药提供依据。方法:对2016年6月-2017年12月到本院产检或住院的围产期妇女进行GBS检测,按年龄分为4个组:<20岁组,20～30岁组,31～40岁组,>40岁组。对各组孕妇取阴道分泌物进行培养,根据细菌形态、溶血、触酶试验、CAMP试验筛查为GBS者,需采用梅里埃ATB自动细菌鉴定及药敏分析系统进行鉴定和药物敏感性分析。结果:共检查3 055病例,检出169株GBS,其中检出例数最多的是20～30岁组为128例,其检出率也最高为6.2%,年龄段比较差异有统计学意义(P<0.05)。169株GBS药敏结果显示:对氯霉素、左氧氟沙星、喹奴普汀/达福普汀、红霉素、四环素的耐药率分别为:20.1%、24.2%、11.8%、70.4%、87.6%,未发现对青霉素、万古霉素、头孢噻肟的耐药株。结论:加强对GBS的培养检测,关注其耐药趋势,为临床用药提供更好的依据。
Objective:To explore the infection of group B streptococci(GBS)in the vaginal secretions of perinatal women and judge the drug resistance of GBS according to the results of antimicrobial susceptibility test,and to provide a basis for clinical medication.Method:Perinatal women received prenatal examination or hospitalized in our hospital who underwent GBS detection from June 2016 to December 2017 were divided into four groups,<20 years old group,20-30 years old group,31-40 years old group,>40 years old group.The vaginal secretions of pregnant women in each group were collected and cultured.The women who screened as GBS positive on the basis of bacterial morphology,beta hemolysis,catalase test and CAMP test needed to perform identification and drug susceptibility analysis with Merieux ATB automatic microorganism identification/drug susceptibility analysis system.Result:Totally 3 055 cases were examined and 169 strains of GBS were detected.The positive number was the highest in the 20-30 years group(128 cases),and similar result was found in the detection rate(6.2%),which suggested that the age had statistically significant difference(P<0.05).The drug susceptibility results of 169 strains of GBS revealed that the drug resistance rate to Chloroamphenicol,Levofloxacin,Quinupristin/Dalfopristin,Erythromycin and Tetracycline were 20.1%,24.2%,11.8%,70.4%,87.6%,respectively.GBS strain resistant to penicillin,vancomycin or cefotaxime was not found.Conclusion:Enhancing of the GBS culture detection and concerning of the trend of drug resistance of GBS can offer a preferable foundation for clinical medication.
Objective:To explore the infection of group B streptococci(GBS)in the vaginal secretions of perinatal women and judge the drug resistance of GBS according to the results of antimicrobial susceptibility test,and to provide a basis for clinical medication.Method:Perinatal women received prenatal examination or hospitalized in our hospital who underwent GBS detection from June 2016 to December 2017 were divided into four groups,<20 years old group,20-30 years old group,31-40 years old group,>40 years old group.The vaginal secretions of pregnant women in each group were collected and cultured.The women who screened as GBS positive on the basis of bacterial morphology,beta hemolysis,catalase test and CAMP test needed to perform identification and drug susceptibility analysis with Merieux ATB automatic microorganism identification/drug susceptibility analysis system.Result:Totally 3 055 cases were examined and 169 strains of GBS were detected.The positive number was the highest in the 20-30 years group(128 cases),and similar result was found in the detection rate(6.2%),which suggested that the age had statistically significant difference(P<0.05).The drug susceptibility results of 169 strains of GBS revealed that the drug resistance rate to Chloroamphenicol,Levofloxacin,Quinupristin/Dalfopristin,Erythromycin and Tetracycline were 20.1%,24.2%,11.8%,70.4%,87.6%,respectively.GBS strain resistant to penicillin,vancomycin or cefotaxime was not found.Conclusion:Enhancing of the GBS culture detection and concerning of the trend of drug resistance of GBS can offer a preferable foundation for clinical medication.
引文
[1]史兴泉,吴文华,王莹超.围产期孕妇泌尿生殖道无乳链球菌耐药性分析及临床意义[J].中国微生态学杂志,2013,25(8):966-968.
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[3]林爱心,袁春雷,汪伟山,等.孕妇无乳链球菌的感染及药物敏感性分析[J].当代医学,2015,21(7):115-116.
[4]钟媛媛,周洁琼.武汉市孕妇B族链球菌感染与妊娠结局的关系[J].中国妇幼保健,2016,31(1):33-34.
[5]魏超平,李敏.新生儿无乳链球菌败血症8例临床分析并文献复习[J].中国医学创新,2014,11(34):147-150.
[6]孙丹华,王李利,张磊,等.妊娠35~37周孕妇B族链球菌带菌与妊娠结局[J].中国妇产科临床杂志,2013,14(4):312-314.
[7]李金丽,宋晓光.B群链球菌两种检测方法的比较[J].临床输血与检验,2018,20(1):89-91.
[8]陆少颜,徐烨,陈泳言,等.江门市围产期妇女B族链球菌的分布及耐药情况[J].中国妇幼保健,2016,31(7):1383-1385.
[9]侯雅萍,俞菁,樊程.上海长宁地区孕晚期B族链球菌感染及耐药情况分析[J].检验医学与临床,2018,15(14):2132-2133+2136.
[10]曾选.江西1019例孕妇生殖道B群链球菌感染情况分析[J].中国妇幼保健,2014,29(27):4457-4459.
[11]季修庆,陆根生,胡平,等.荧光定量PCR检测南京地区孕晚期妇女生殖道B族链球菌的带菌情况[J].检验医学,2014,29(6):628-630.
[12]曹雪莲,温国明,颜春荣,等.深圳市孕妇B族链球菌携带与影响因素分析[J].现代预防医学,2018,45(11):1986-1991.
[13]张丽华,杨维青,张丽,等.广东东莞地区2009-2014年围产期孕妇B群链球菌的分离与耐药性分析[J].中国感染与化疗杂志,2015,15(6):575-578.
[14]吕磊,吴海军,汪俊,等.围产期孕妇阴道B群链球菌感染及其药敏实验研究[J].国际检验医学杂志,2015,36(12):1784-1785.
[15]许爱霞,余跃华,舒向荣,等.围产期孕妇B群链球菌感染的检测及耐药性分析[J].实验与检验医学,2015,33(1):46-47.
[16]刘镜光,叶晓涛.深圳地区B族链球菌耐药基因流行研究[J].中华医院感染学杂志,2017,27(1):54-56,81.
[17]杨玮,詹碧翠,楼正青.我院2005-2011年无乳链球菌的药物敏感性分析[J].实用医技杂志,2014,21(02):139-140.
[18]高晶,刘晓艳.女性泌尿生殖道无乳链球菌的耐药性分析[J].检验医学,2015,30(1):13-16.
[19]Elikwu C,Oduyebo O,Anorlu R,et al.Antibiotic susceptibility/resistant gene profiles of Group B streptococci isolates from pregnant women in a tertiary institution in Nigeria[J].J Clin Sci,2016,13(3):132.
[20]王双杰,岑贞娇,曾尚娟,等.孕晚期孕妇与婴儿B群链球菌感染情况分析[J].广西医学,2017,39(12):1925-1927,1942.
[2]张志强,钟继生,陈翔.女性生殖道无乳链球菌带菌状况及药物敏感性分析[J].中国医疗前沿,2013,8(20):91-91.
[3]林爱心,袁春雷,汪伟山,等.孕妇无乳链球菌的感染及药物敏感性分析[J].当代医学,2015,21(7):115-116.
[4]钟媛媛,周洁琼.武汉市孕妇B族链球菌感染与妊娠结局的关系[J].中国妇幼保健,2016,31(1):33-34.
[5]魏超平,李敏.新生儿无乳链球菌败血症8例临床分析并文献复习[J].中国医学创新,2014,11(34):147-150.
[6]孙丹华,王李利,张磊,等.妊娠35~37周孕妇B族链球菌带菌与妊娠结局[J].中国妇产科临床杂志,2013,14(4):312-314.
[7]李金丽,宋晓光.B群链球菌两种检测方法的比较[J].临床输血与检验,2018,20(1):89-91.
[8]陆少颜,徐烨,陈泳言,等.江门市围产期妇女B族链球菌的分布及耐药情况[J].中国妇幼保健,2016,31(7):1383-1385.
[9]侯雅萍,俞菁,樊程.上海长宁地区孕晚期B族链球菌感染及耐药情况分析[J].检验医学与临床,2018,15(14):2132-2133+2136.
[10]曾选.江西1019例孕妇生殖道B群链球菌感染情况分析[J].中国妇幼保健,2014,29(27):4457-4459.
[11]季修庆,陆根生,胡平,等.荧光定量PCR检测南京地区孕晚期妇女生殖道B族链球菌的带菌情况[J].检验医学,2014,29(6):628-630.
[12]曹雪莲,温国明,颜春荣,等.深圳市孕妇B族链球菌携带与影响因素分析[J].现代预防医学,2018,45(11):1986-1991.
[13]张丽华,杨维青,张丽,等.广东东莞地区2009-2014年围产期孕妇B群链球菌的分离与耐药性分析[J].中国感染与化疗杂志,2015,15(6):575-578.
[14]吕磊,吴海军,汪俊,等.围产期孕妇阴道B群链球菌感染及其药敏实验研究[J].国际检验医学杂志,2015,36(12):1784-1785.
[15]许爱霞,余跃华,舒向荣,等.围产期孕妇B群链球菌感染的检测及耐药性分析[J].实验与检验医学,2015,33(1):46-47.
[16]刘镜光,叶晓涛.深圳地区B族链球菌耐药基因流行研究[J].中华医院感染学杂志,2017,27(1):54-56,81.
[17]杨玮,詹碧翠,楼正青.我院2005-2011年无乳链球菌的药物敏感性分析[J].实用医技杂志,2014,21(02):139-140.
[18]高晶,刘晓艳.女性泌尿生殖道无乳链球菌的耐药性分析[J].检验医学,2015,30(1):13-16.
[19]Elikwu C,Oduyebo O,Anorlu R,et al.Antibiotic susceptibility/resistant gene profiles of Group B streptococci isolates from pregnant women in a tertiary institution in Nigeria[J].J Clin Sci,2016,13(3):132.
[20]王双杰,岑贞娇,曾尚娟,等.孕晚期孕妇与婴儿B群链球菌感染情况分析[J].广西医学,2017,39(12):1925-1927,1942.