摘要
目的分析围产期孕妇阴道分泌物无乳链球菌(Group B Streptococcus,GBS)的分布及耐药性,为优化针对GBS感染的围产期孕妇的抗菌药物的治疗方案提供参考依据.方法以2020年-2023年在中山市坦洲人民医院产科进行产检或住院分娩的5420例围产期孕妇为研究对象,取其阴道分泌物进行细菌培养,并经细菌形态、溶血、触酶试验、CAMP试验筛查GBS阳性者,对其进行常用的8种抗菌药物的耐药性分析.结果5420例围产期孕妇中,GBS感染共计250例,阳性率为4.61%.其中209例分布在21-35岁年龄组,阳性率为5.27%,36例分布在36-40岁年龄组,阳性率为3.15%.在<20岁和>40岁年龄组分别检出3例和2例,阳性率分别为1.62%和1.60%,21-35岁年龄组围产期孕妇的GBS感染率高于其他各年龄组,差异有统计学意义(P均<0.05).抗菌药物耐药性结果显示,GBS对抗菌药物出现耐药性由强到弱依次为四环素(83.20%)、红霉素(74.80%)、克林霉素(70.40%)、左氧氟沙星(16.80%),对美罗培南(2.80%)、利奈唑胺(0.40%)、万古霉素(0.40%)、头孢曲松(0.00%)、青霉素(0.00%)、氨苄西林(0.00%)、替考拉宁(0.00%)显示出较弱耐药性或未显示出耐药性.结论GBS在21-35岁年龄组的孕妇阴道分泌物中检出率最高,同时对四环素、红霉素、克林霉素具有较高的耐药性,而对青霉素、氨苄西林、替考拉宁、头孢曲松、万古霉素、利奈唑胺高度敏感,并且青霉素、氨苄西林仍为预防和治疗GBS的首选药物.因此,应加大对围产期孕妇的GBS感染的筛检力度,并根据其耐药性结果合理选用抗菌药物.
Objective To analyze the distribution and drug resistance of Group B Streptococcus(GBS)in vaginal secretions of perinatal women,and to provide reference for optimizing the treatment regimen of antibacterial drugs for GBS infection in perinatal women.Methods A total of 5420 perinatal women who underwent prenatal examination or inpatient delivery in the Department of Obstetrics of Tanzhou People's Hospital,Zhongshan,from 2020 to 2023 were selected as the research objects.Vaginal secretions were collected for bacterial culture,and GBS-positive cases were screened by bacterial morphology,hemolysis,enzyme test,and CAMP test.The drug resistance of eight commonly used antibacterial drugs was analyzed.Results Among the 5420 perinatal women,there were 250 cases of GBS infection,with a positive rate of 4.61%.Among them,209 cases were in the 21-35 age group,with a positive rate of 5.27%,and 36 cases were in the 36-40 age group,with a positive rate of 3.15%.Three cases were detected in the age group<20,and two cases were detected in the age group>40,with positive rates of 1.62%and 1.60%,respectively.The GBS infection rate of perinatal women aged 21-35 was higher than that of other age groups,and the difference was statistically significant(P<0.05).The drug resistance results showed that the drug resistance of GBS to antibacterial drugs from strong to weak was as follows:tetracycline(83.20%),erythromycin(74.80%),clindamycin(70.40%),levofloxacin(16.80%),meropenem(2.80%),linezolid(0.40%),vancomycin(0.40%),ceftriaxone(0.00%),penicillin(0.00%),ampicillin(0.00%),and teicoplanin(0.00%).Conclusion GBS had the highest detection rate in the vaginal secretions of perinatal women aged 21-35,and it showed high resistance to tetracycline,erythromycin,and clindamycin.It was highly sensitive to penicillin,ampicillin,teicoplanin,ceftriaxone,vancomycin,and linezolid.Therefore,the screening for GBS infection in perinatal women should be strengthened,and antibacterial drugs should be selected reasonably according to the drug resistance results.
作者
刁文铭
Diao Wenming(Tanzhou People's Hospital,Zhongshan,Guangdong 5528400,China)
出处
《首都食品与医药》
2024年第20期92-95,共4页
Capital Food Medicine
关键词
无乳链球菌
围产期
阴道分泌物
耐药性
Group B Streptococcus
Perinatal period
Vaginal secretions
Drug resistance
