摘要
目的 探讨围产期孕妇B族链球菌（GBS）的培养方法和实时定量PCR方法检测阳性率的对比,并对分离培养出的GBS进行耐药性分析,结合临床评估GBS感染对妊娠结局的影响.方法 依照病例定义选择2011年8月～2012年7月陕西省人民医院妇产科门诊围产期孕妇520例,在孕35～37周时取阴道下1/3分泌物及肛周分泌物拭子,应用培养法及实时定量PCR两种方法进行GBS检测的对比,并对培养分离出的29株GBS进行药敏试验.结果 520例孕妇中GBS培养29例阳性（阳性率5.6%）,实时PCR检测54例阳性（阳性率10.4%）;29例GBS培养阳性的孕妇,实时PCR检测均为阳性;25例实时PCR检测GBS阳性,而细菌培养GBS阴性标本在进行扩增测序后证实,24例为GBS 阳性,1例为阴性.实时PCR检测GBS的对培养分离出的29例GBS经定量药敏分析,其对青霉素、氨苄青霉素、头孢噻肟、万古霉素的敏感率为100%;对红霉素、阿奇霉素、克林霉素的敏感率分别为34.5%,44.8%和58.6%;对左氧氟沙星的敏感率为69.0%.实时PCR检测围产期GBS感染阳性率较高,与培养法相比差异有统计学意义（χ2=8.2,P＜0.01）;同时PCR法与培养法相比有较高的灵敏度为100%,特异度为94.91%,约登指数为94.9%.结论 实时PCR检测GBS感染有望成为妊娠晚期孕妇常规检测GBS感染的一种准确快速的方法,同时妊娠晚期孕妇携带GBS会增加胎膜早破、宫内感染及早产的发生率,对妊娠结局造成不良影响.
Objective To compare the cultivation method method of the perinatal pregnancy group B streptococcus with the real-time quantitative polymerase chain reaction （PCR） （GBS）, analyze the resistance of the separated GBS, evaluate the GBS infection effects on pregnancy outcome combined with clinical manifestations. Methods Selected 520 cases of pregnant women in pregnancy between 35 and 37 weeks from August 2011 to July 2012 outpatients of obstetrics and gynecology hospital,collected the vaginal secretion under 1/3 and perianal swab secretion,tested GBS with the method of bacterial cultivation and the method of real-time quantitative polymerase chain reaction （PCR）, compared the difference between the two methods. Quantitative analysis on drugs of the cultivated and isolated 29 strains GBS were performed at last. Results 520 cases of pregnant women in GBS culture 29 cases were positive （5.6%）,and in real-time polymerase chain reaction （PCR） 54 were positive （10. 4 %） ; 29 patients with GBS culture positive of pregnant women,were all positive in the detection of real-time polymerase chain reaction （PCR）,25 GBS positive in real-time PCR detection, but negative in bacterial cultivation, were confirmed 24 cases of GBS to be positive and 1 cases to be negative after amplification sequencing of the secretion of pregnant women swab. To analyze the quantitative antimicrobial susceptibility, the sensitivity of penicillin, ampicillin, cefotaxime and vancomycin was 100%, the sensitivities of erythromycin, azithromycin, clindamycin were 34. 5%, 44. 8% and 34. 5 % respectively; and the levofloxacin＇ s was 69.0 %. Real-time PCR detection perinatal GBS infection positive rate was higher,and the culture method compared with statistical difference （χ^2= 8.2, P（0.01）;The sensitivity of real-time polymerase chain reaction （PCR） testing of GBS was 100 %, and the specificity was 94. 91%, about an index was 94.9 %. Conclusion Real-time PCR which is expected to become later a quick,accurate method in
出处
《现代检验医学杂志》
CAS
2013年第1期87-89,共3页
Journal of Modern Laboratory Medicine
基金
陕西省科技厅自然科学基金（No：2010JM403）.
关键词
围产期孕妇B族链球菌
感染检测
耐药分析
妊娠结局的影响
pregnant women group B streptococcus
infection and detection
drug resistance
the influence of the pregnancyoutcome
