摘要
目的分析核酸环介导恒温扩增法(LAMP)、增菌培养法及直接培养法在妊娠晚期孕妇B族链球菌(GBS)感染筛查的效能。方法选取海南西部中心医院2020年1月-2020年6月常规检查的500例孕妇为研究对象,分别进行增菌培养法、LAMP法、直接培养法筛查,并以增菌培养法为参考方法,比较LAMP法、直接培养法的检验效能;利用乳胶凝集试验和管家基因测序确定GBS阳性孕妇的血清型和基因序列分型(ST),并用纸片扩散法检测GBS药敏性;统计所有孕妇围产结果。结果500例孕妇的样本中增菌培养法检出68例GBS阳性,阳性率为13.60%,肛直肠拭子GBS检出阳性率82.35%(56/68)要高于阴道拭子的36.76%(25/68)(P<0.05);以增菌培养法为标准,直接培养法和LAMP法灵敏度分别为82.35%、100.00%,特异度分别为100.00%、98.84%,一致性Kappa值分别为0.890、0.959;乳胶凝集实验共检出8种GBS血清型,前5位分别为III型、V型、Ia、Ib、II型;管家基因测序共发现14个ST型,前5位的分别为ST19、ST17、ST862、ST12、ST10;68株GBS对青霉素G、头孢唑林、氨苄西林、万古霉素等敏感;GBS阳性孕妇的胎膜早破、宫内感染、早产、胎儿窘迫及新生儿感染的发生率显著升高。结论LAMP法在妊娠晚期孕妇GBS检测的准确性与增菌培养法一致,且更加快速便捷,一旦发现感染要及时用药,提高产妇和新生儿的生活质量。
OBJECTIVE To analyze the efficiencies of nucleic acid loop-mediated isothermal amplification(LAMP),enrichment culture and direct culture methods in screening of group B Streptococcus(GBS)infection in pregnant women in late pregnancy.METHODS A total of 500 pregnant women who underwent routine examination in Western Hainan Central Hospital from Jan to Jun 2020 were enrolled as the research subjects.The screening of GBS infection was carried out by means of enrichment culture,LAMP and direct culture methods.Taking the enrichment culture as the reference method,the test efficiencies of LAMP and direct culture methods were compared.The serotypes and gene sequence typing(ST)of the GBS-positive pregnant women were determined by latex agglutination test(LAT)and housekeeping gene sequencing,the drug susceptibility testing was performed for the GBS strains by using disk diffusion method,and the perinatal results of all the pregnant women were statistically analyzed.RESULTS Of 500 pregnant women,68 were tested positive for GBS by using enrichment culture method,with the positive rate 13.60%;the positive rate of GBS of the anorectal swabs was 82.35%(56/68),significantly higher than 36.76%(25/68)of the vaginal swabs(P<0.05).Taking the enrichment culture method as the standard,the sensitivity of the direct culture method was 82.35%,LAMP 100.00%;the specificity of the direct culture method was 100.00%,LAMP 98.84%;the consistency Kappa values were 0.890 and 0.959,respectively.Totally 8 serotypes of GBS were detected through LAT,and the top 5 were type III,V,Ia,Ib and II,respectively.Totally 14 ST types were found by housekeeping gene sequencing,and the top 5 were ST19,ST17,ST862,ST12 and ST10,respectively.The 68 strains of GBS were sensitive to penicillin G,cefazolin,ampicillin and vancomycin.The incidence rates of premature rupture of membranes,intrauterine infection,premature delivery,fetal distress and neonatal infection were remarkably increased among the GBS-positive pregnant women.CONCLUSION The accuracy of LAMP is constit
作者
符叶
沈婕
管翠
李煜
王海燕
FU Ye;SHEN Jie;GUAN Cui;LI Yu;WANG Hai-yan(Western Hainan Central Hospital,Danzhou,Hainan 571700,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第5期753-757,共5页
Chinese Journal of Nosocomiology
基金
海南省科研基金资助项目(201251111)。
关键词
妊娠晚期
B族链球菌
核酸环介导恒温扩增法
增菌培养法
妊娠结局
Late pregnancy
Group B Streptococcus
Nucleic acid loop-mediated isothermal amplification
Enrichment culture
Pregnancy outcome
