摘要
目的:探讨可疑临床感染孕产妇微生物菌群结构、感染分布及对常用抗菌药物敏感性,为孕产妇感染性疾病的临床诊治提供参考数据。方法:针对2016年1月1日至2019年12月31日在首都医科大学附属北京妇产医院(北京妇幼保健院)产科就诊和住院的可疑临床感染孕产妇微生物菌群分布及药物敏感性进行回顾性研究。以产科门急诊患者及住院患者检出的病原微生物为研究对象,采用基质辅助激光解吸电离飞行时间质谱法进行菌株鉴定,法国梅里埃全自动细菌鉴定及药敏分析系统进行常用抗菌药物敏感性检测。采用描述性方法进行分析。结果:研究期间从3225例孕产妇的3781个送检标本中分离培养出4086株阳性菌株,其主要来源于分泌物标本1670个(44.17%),包括宫颈分泌物767个、外阴阴道分泌物423个、会阴伤口分泌物318个和宫腔分泌物117个。所有菌株中,大肠埃希菌最常见[1728株(42.29%)],其次为酵母菌属[901株(22.05%)]、链球菌属[429株(10.50%)]、肠球菌属[377株(9.23%)]和葡萄球菌属[300株(7.34%)]。肠球菌属在阳性菌中的占比由2016年的第5位升高至2019年的第3位,而葡萄球菌属由2016年的第4位降至2019年的第5位。药敏分析结果显示,大肠埃希菌对碳青霉烯类、哌拉西林/他唑巴坦、阿米卡星、呋喃妥因、头孢他啶的敏感性均大于90%,但对氨苄西林、头孢唑林的敏感率均低于35%。所有假丝酵母菌对两性霉素B敏感率均>98%,但对伊曲康唑的敏感率均<56%。2016年至2019年期间,大肠埃希菌对头孢呋辛钠及头孢曲松敏感性无明显变化,约为65%。白假丝酵母菌对伏立康唑及氟康唑的敏感率由90%左右逐渐下降至56%左右。肠球菌属中以粪肠球菌为主,对万古霉素、氨苄西林、青霉素、利奈唑胺、呋喃妥因及左氧氟沙星的敏感率均>90%。结论:大肠埃希菌是临床可疑感染孕产妇最常见菌,对头孢呋辛钠及头�
Objective To investigate the microbiota distribution and drug resistance in gravidas with suspected infection to provide a reference for the treatment of maternal infectious diseases.Methods This retrospective study analyzed the distribution and in vitro antimicrobial susceptibility of microorganisms isolated from obstetric patients in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University(Beijing Maternal and Child Health Care Hospital)from January 1,2016.to December 31,2019.Matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF-MS)was used to identify pathogenic microorganisms.The susceptibility of isolated pathogenic bacteria to common antimicrobial agents was detected using bioMerieux VITEK-2(France).Descriptive statistical methods was used.Results A total of 4086 strains were isolated from 3781 samples of 3225 gravidas and 44.17%(1670)of the strains were from secretion specimens,including 767 cervical,423 vulvovaginal,318 perineum wound and 117 uterine secretion specimens.The most common bacterium was Escherichia coli(1728,42.29%),followed by Saccharomyces(901,22.05%),Streptococcus(429,10.50%),Enterococcus(377,9.23%),and Staphylococcus(300,7.34%).The proportion of Enterococcus among all the positive bacteria increased during the study period with its ranking rising from the 5th in 2016 to the 3rd in 2019,while the ranking of the proportion of Staphylococcus fell from the 4th in 2016 to the 5th in 2019.More than 90%of Escherichia coli were sensitive to carbapenems,piperacillin/tazobactam,amikacin,nitrofurantoin and ceftazidime,but only 35%or less to ampicillin and cefazolin.More than 98%of Candida strains were sensitive to amphotericin,but less than 56%to itraconazole.From 2016 to 2019,the sensitivity of Escherichia coli to cefuroxime sodium and ceftriaxone remained around 65%.The sensitive rate of Candida albicans to voriconazole and fluconazole gradually decreased from about 90%to 56%.The most common Enterococcus was Enterococcus faecalis and its
作者
王风娟
刘朝晖
尚翔
白会会
姜艳
程冬梅
刘晓巍
Wang Fengjuan;Liu Zhaohui;Shang Xiang;Bai Huihui;Jiang Yan;Cheng Dongmei;Liu Xiaowei(Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University(Beijing Maternal and Child Health Care Hospital),Beijing 100026,China;Department of Gynecology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University(Beijing Maternal and Child Health Care Hospital),Beijing 100026,China;Department of Clinical Laboratory,Beijing Obstetrics and Gynecology Hospital,Capital Medical University(Beijing Maternal and Child Health Care Hospital),Beijing 100026,China;Department of Intensive Care Unit,Beijing Obstetrics and Gynecology Hospital,Capital Medical University(Beijing Maternal and Child Health Care Hospital),Beijing 100026,China)
出处
《中华围产医学杂志》
CAS
CSCD
北大核心
2022年第12期904-911,共8页
Chinese Journal of Perinatal Medicine
基金
国家自然科学基金(81771530)。
关键词
微生物群
妊娠并发症
感染性
抗药性
微生物
微生物敏感性试验
Microbiota
Pregnancy complications,infectious
Drug resistance,microbial
Microbial sensitivity tests
