3433例围产期妇女B族溶血性链球菌感染分析(1)
[摘要] 目的 探讨温州地区3433例不同育龄妇女围产期B族链球菌(GBS)感染状态及GBS携带耐药率情况。 方法 收集我院2018年8～12月3433例孕晚期孕妇生殖道分泌物标本，采用实时荧光定量PCR技术对标本GBS核酸检测，并对核酸阳性的患者进行GBS培养确认和药敏实验。 结果 温州地区3433例孕妇中检出GBS感染399例，感染阳性率为11.6%;将20～45岁阶段的孕妇按年龄分成5组，其GBS阳性感染率分别为10.3%、12.0%、11.6%、13.4%、9.6%。药敏结果统计发现耐药率高的抗生素为四环素、氯霉素、红霉素、克林霉素、环丙沙星、左氧氟沙星，GBS的一线抗生素青霉素耐药率为1.1%，未检测到GBS对氨苄西林、万古霉素耐药的菌株。不同年龄组感染率比较，差异无统计学意义(P>0.05)。 结论 对温州地区孕妇采用PCR核酸技术筛查GBS感染，能够缩短传统培养法的检测时间，使临床医生提前评估孕产妇状态，及时采用一线抗生素(青霉素、氨苄西林)干预治疗。
[关键词] B-族链球菌;围产期感染;实时荧光定量PCR;产时抗生素干预策略
[中图分类号] R714.7;R446.5 [文献标识码] B [文章編号] 1673-9701(2020)24-0139-03
[Abstract] Objective To investigate the status of group B streptococcus(GBS) infection and the rate of resistance to GBS in perinatal period of 3， 433 women of different reproductive age in Wenzhou. Methods A total of 3，433 reproductive tract secretions of pregnant women in late pregnancy were collected in ourhospital from August 2018 to December 2018. Real-time fluorescence quantitative PCR was used to detect GBS nucleic acids in the specimens. And the GBS culture confirmation and drug sensitivity test were performed on nucleic acid positive patients. Results 399 cases of GBS infection were detected in 3，433 pregnant women in Wenzhou，with a positive infection rate of 11.6%. The pregnant women aged 20-45 were divided into 5 groups， and their GBS-positive infection rates were 10.3%，12.0%，11.6%，13.4%， and 9.6%，respectively. Antibiotic susceptibility statistics showed that the antibiotics with high resistance rate were tetracycline，chloramphenicol，erythromycin， clindamycin，ciprofloxacin，and levofloxacin. The first-line antibiotic penicillin resistance rate of GBS was 1.1%. No GBS strains resistant to ampicillin， vancomycin were detected.There was no significant difference in infection rate between different age groups(P>0.05). Conclusion The PCR nucleic acid technology was used to screen GBS infection for pregnant women in Wenzhou，which can shorten the testing time of traditional culture methods，allow clinicians to evaluate maternal status in advance，and intervene treatment with first-line antibiotics (penicillin，ampicillin) in time.
[Key words] B-family streptococcus; Perinatal infection; Real-time PCR; Perinatal antibiotic intervention strategies
B-族链球菌(GBS)寄生于健康人的下消化道，带菌率为15%～35%，其往往能够发展到泌尿生殖道，并常与念珠菌感染共存。针对于特殊人群(孕妇和新生儿)，GBS携带和持续性感染的危害远远高于普通群体，可引起孕产妇的早产、胎膜早破、产褥感染或宫内感染及新生儿死亡等[1-2]。然而文献发现GBS带菌率的种族和地区差异非常大，故本文研究温州地区孕35～37周孕妇GBS不同年龄组的GBS感染状况及GBS的地区耐药率情况，来了解温州地区GBS的流行特点，为临床的诊疗提供科学依据，现报道如下。, http://www.100md.com(吴海丹 童郁 林建萍)
[关键词] B-族链球菌;围产期感染;实时荧光定量PCR;产时抗生素干预策略
[中图分类号] R714.7;R446.5 [文献标识码] B [文章編号] 1673-9701(2020)24-0139-03
[Abstract] Objective To investigate the status of group B streptococcus(GBS) infection and the rate of resistance to GBS in perinatal period of 3， 433 women of different reproductive age in Wenzhou. Methods A total of 3，433 reproductive tract secretions of pregnant women in late pregnancy were collected in ourhospital from August 2018 to December 2018. Real-time fluorescence quantitative PCR was used to detect GBS nucleic acids in the specimens. And the GBS culture confirmation and drug sensitivity test were performed on nucleic acid positive patients. Results 399 cases of GBS infection were detected in 3，433 pregnant women in Wenzhou，with a positive infection rate of 11.6%. The pregnant women aged 20-45 were divided into 5 groups， and their GBS-positive infection rates were 10.3%，12.0%，11.6%，13.4%， and 9.6%，respectively. Antibiotic susceptibility statistics showed that the antibiotics with high resistance rate were tetracycline，chloramphenicol，erythromycin， clindamycin，ciprofloxacin，and levofloxacin. The first-line antibiotic penicillin resistance rate of GBS was 1.1%. No GBS strains resistant to ampicillin， vancomycin were detected.There was no significant difference in infection rate between different age groups(P>0.05). Conclusion The PCR nucleic acid technology was used to screen GBS infection for pregnant women in Wenzhou，which can shorten the testing time of traditional culture methods，allow clinicians to evaluate maternal status in advance，and intervene treatment with first-line antibiotics (penicillin，ampicillin) in time.
[Key words] B-family streptococcus; Perinatal infection; Real-time PCR; Perinatal antibiotic intervention strategies
B-族链球菌(GBS)寄生于健康人的下消化道，带菌率为15%～35%，其往往能够发展到泌尿生殖道，并常与念珠菌感染共存。针对于特殊人群(孕妇和新生儿)，GBS携带和持续性感染的危害远远高于普通群体，可引起孕产妇的早产、胎膜早破、产褥感染或宫内感染及新生儿死亡等[1-2]。然而文献发现GBS带菌率的种族和地区差异非常大，故本文研究温州地区孕35～37周孕妇GBS不同年龄组的GBS感染状况及GBS的地区耐药率情况，来了解温州地区GBS的流行特点，为临床的诊疗提供科学依据，现报道如下。, http://www.100md.com(吴海丹 童郁 林建萍)