摘要
目的分析孕妇B族链球菌(GBS)感染和阴道微生态失衡与新生儿围产期感染的相关性。方法选取2019年1月-2020年12月日照市妇幼保健院92例出生7 d内感染的新生儿及其孕妇作为病例组,记录新生儿感染疾病、病原菌分布情况,并以孕妇年龄为匹配因素,1∶1纳入92例出生7 d内未发生感染的新生儿及其孕妇作为对照组,比较两组孕妇GBS感染、阴道微生态失衡、胎膜早破及新生儿胎龄等资料,分析阴道微生态失衡情况与新生儿围产期感染的相关性,采用条件Logistic回归模型分析影响新生儿围产期感染的影响因素。结果92例感染新生儿中感染性肺炎为主(53.26%),其次为脐炎、败血症;共培养分离病原菌133株,其中革兰阴性菌69株占51.88%,以肺炎克雷伯菌、大肠埃希菌为主,革兰阳性菌64株占48.12%,以表皮葡萄球菌、金黄色葡萄球菌为主;Spearman秩相关分析显示,新生儿围产期感染与阴道pH值、阴道清洁度分级、乳酸杆菌分级呈正相关(r=0.569、0.392、0.415,P<0.001)。孕期肥胖、妊娠期糖尿病、GBS感染、阴道pH值、乳酸杆菌分级Ⅲ级、胎膜早破均为新生儿围产期感染的影响因素(OR=2.036、1.889、2.540、2.497、2.149、2.300,P均<0.05),阴道清洁度Ⅰ~Ⅱ级则为保护因素(OR=0.440,P=0.003)。结论孕晚期GBS感染及阴道微生态失衡可增加新生儿围产期感染风险,临床可针对高危因素制定干预措施,保护母婴健康。
OBJECTIVE To analyze the correlation between group B Streptococcus(GBS)infection and vaginal microecological imbalance of pregnant mothers and perinatal infection of neonates.METHODS Totally 92 neonates who were infected within 7 d of birth and their pregnant mothers in Rizhao Maternal and Child Health Care Hospital between Jan.2019 and Dec.2020 were selected as case group,and the distribution status of neonatal infectious diseases and pathogenic bacteria were recorded.With maternal age as the matching factor,92 neonates who did not develop infection within 7 d of birth and their pregnant mothers were included as control group by 1∶1.The data such as GBS infection and vaginal microecological imbalance of pregnant mothers,premature rupture of membranes and neonatal gestational age were compared between the two groups,and the correlation between vaginal microecological imbalance and neonatal perinatal infection was analyzed.Conditional Logistic regression model was used to analyze the influencing factors affecting neonatal perinatal infection.RESULTS Among the 92 infected neonates,infectious pneumonia accounted for the most(53.26%),followed by omphalitis and sepsis.A total of 133 strains of pathogenic bacteria were cultured,of which 69 strains were Gram-negative bacteria(51.88%,mainly Klebsiella pneumoniae and Escherichia coli)and 64 strains were Gram-positive bacteria(48.12%,mainly Staphylococcus epidermidis and Staphylococcus aureus).Spearman rank correlation analysis showed that neonatal perinatal infection was positively correlated with vaginal pH value,vaginal cleanliness grading and Lactobacillus grading(r=0.569,0.392,0.415,P<0.001).Obesity during pregnancy,gestational diabetes mellitus,GBS infection,vaginal pH value,Lactobacillus grade III and premature rupture of membranes were the influencing factors for neonatal perinatal infection(OR=2.036,1.889,2.540,2.497,2.149,2.300,P<0.05),and vaginal cleanliness grade I to II was a protective factor(OR=0.440,P=0.003).CONCLUSION GBS infection and vaginal microecolo
作者
魏飞燕
徐丽丽
牟娜
李凤
杜晓洁
WEI Fei-yan;XU Li-li;MU Na;LI Feng;DU Xiao-jie(Rizhao Maternal and Child Health Care Hospital,Rizhao,Shandong 276800,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第19期3007-3011,共5页
Chinese Journal of Nosocomiology
基金
山东省卫生计生行业科研基金资助项目(20A202018)。
关键词
B族链球菌
新生儿
围产期感染
孕妇
阴道微生态
胎膜早破
Group B Streptococcus
Neonates
Perinatal infection
Pregnant woman
Vaginal microecology
Premature rupture of membranes
