需氧菌与假丝酵母菌感染对胎膜早破母婴结局影响的研究  

The Correlation between Aerobic Bacteria and Candida Infection and the Poor Pregnancy Outcomes of Premature Rup- ture of Membranes

作　　者：杨淑华[1] 刘颖[1] 王建红[1] 张月香[1] 

机构地区：[1]天津市中心妇产科医院,300100

出　　处：《中国全科医学》2014年第7期803-806,共4页Chinese General Practice

摘　　要：目的探讨需氧菌与假丝酵母菌感染对胎膜早破母婴不良结局的影响。方法对2012年1月—2013年1月,因胎膜早破而入住我院产科的296例患者生殖道分泌物进行细菌培养检测,依据培养结果进行分组,并对组间母婴不良结局,如生产方式、早产、胎儿产前感染、新生儿窒息、新生儿死亡等进行分析比较。结果 296例胎膜早破患者中,检出致病菌生长131例(44.3%)。其中需氧菌64例,主要为大肠埃希菌和B型溶血性链球菌;真菌共67例,光滑拟球酵母菌为非白假丝酵母菌首位。致病菌组母婴不良结局的发生率均高于无致病菌组,差异有统计学意义(P<0.05);需氧菌组新生儿的产前感染、胎儿窘迫、围生儿死亡的发生率高于假丝酵母菌组,差异有统计学意义(P<0.05);非白假丝酵母菌组新生儿疾病和围生儿死亡的发生率均高于白假丝酵母菌组,差异有统计学意义(P<0.05)。且非假丝酵母菌组3例发生围生儿死亡的产妇生殖道分泌物培养均为光滑拟球酵母菌。结论需氧菌与假丝酵母菌感染与胎膜早破母婴不良结局密切相关。大肠埃希菌和B型溶血性链球菌感染对于新生儿重度感染有重要意义,非白假丝酵母菌感染对于胎膜早破新生儿致病的临床意义也不容忽视。加强孕期生殖道病原微生物的检查,积极有效的抗菌药物治疗,可降低胎膜早破及新生儿感染的发生,改善母婴结局。Objective To investigate the correlation between aerobic bacteria and Candida infection and the poor pregnancy outcomes of premature rupture of membranes （PROM）.Methods The bacterial culture of genital tract secretions from the patients with PROM in the author＇s hospital from January 2012 to January 2013 were detected,according to the results of which the patients were divided into different groups.The poor outcomes of mother and child such as way of bearing,premature delivery,prenatal period infection of the child,neonatal asphyxia and neonatal death were compared and analyzed between groups.Results Among 296 patients with PROM,pathogenic bacteria growth was detected in 131 cases （44.3％） including aerobic bacteria （64 cases）,which were mainly Escherichia coli and B hemolytic streptococcus,and fungi infection （67 cases）,of which candida glabrata was the first non candida albicans.In the group of growth of pathogenic bacteria,the complications of poor outcomes of mothers and infants were higher than that of no growth of pathogenic bacteria group and the difference was significant （P ＜ 0.05） ; In the aerobic bacteria group,the incidence rates of neonatal infection,fetal distress,perinatal death were higher than those in candida group （P ＜ 0.05） ; compared with candida albicans group,the rates of newborn disease and perinatal mortality of non candida albicans group were higher （P ＜ 0.05）.Cryptococcus strains were isolated from the bacterial culture of genital tract secretions from three parturients of perinatal death cases.Conclusion Aerobic bacteria and candida infection is closely related to the poor pregnancy outcomes of premature rupture of membranes.Escherichia coli and B hemolytic streptococcus infection is significant in newborns with severe infection.The clinical significance of non-albicans candida infection cannot be ignored.Paying attention to genital pathogenic microorganism examination and effective antibiotic treatment can decrease the occurrence of premature ruptu

关 键 词：需氧菌 假丝酵母菌 妊娠结局 胎膜早破 

分 类 号：R714.433[医药卫生—妇产科学]