围产期孕妇感染B群链球菌对母婴预后的临床影响研究  

Clinical effect of perinatal pregnant women infected group B Streptococcus on maternal and infant prognosis

作　　者：杨小兰[1] 李娟[2] 李伟强[1] 黄春花[1] 邱淑妍 江碧薇[3] 

机构地区：[1]惠州市第三人民医院检验科,广东惠州516002 [2]新疆维吾尔自治区人民医院临床检验中心,新疆维吾尔自治区830011 [3]惠州市第三人民医院产科,广东惠州516002

出　　处：《中华医院感染学杂志》2016年第20期4698-4700,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨围产期孕妇感染B群链球菌（GBS）对母婴预后的临床影响研究,指导临床使用抗菌药物治疗,改善母婴预后,提高新生儿健康水平、降低孕晚期并发症。方法收集2014年10月-2015年9月医院妇产科门诊孕期35~37周入院待产1 670份孕妇阴道分泌物和分娩后新生儿的脐带血,采用B群链球菌选择性显色培养基（液体法）培养,分析围产期孕妇B群链球菌感染及对妊娠结局的影响,并通过药敏试验（K-B法）分析其对常用药物的耐药性。结果 1 670份孕妇阴道和分娩后新生儿的脐带血标本中检出GBS 101株,检出率6.05%;检出的B群链球菌中,未发现耐青霉素、头孢曲松和万古霉素菌株,其对左氧氟沙星的耐药率为20.79%,而对红霉素和克林霉素的耐药率相对较高,分别为69.31%和51.49%;结果表明,体质量指数（BMI）≥28kg/m2、妊娠期糖尿病（GDM）、阴道念珠菌病（VVC）以及贫血是妊娠晚期孕妇GBS感染的独立危险因素（P〈0.05）;GBS阳性孕妇早产、胎膜早破的发生率较高;GBS阳性孕妇发生新生儿肺炎、新生儿上呼吸道感染明显高于GBS阴性孕妇,且差异有统计学意义（P〈0.05）。结论围产期孕妇携带B群链球菌会增加早产、流产、产褥感染、胎儿窘迫和新生儿感染的发生,对妊娠结局造成不良影响;临床发现GBS阳性应对该菌株进行药敏试验,以便有效的进行干预治疗,以保证围产儿健康。OBJECTIVE To study the clinical effect of perinatal pregnant women infected group B Streptococcus on maternal and infant prognosis, so as to guide the clinical treatment, improved the health level of the newborn and reduced the complications of the third trimester of pregnancy. METHODS A total of 1670 cases of vaginal secre- tions and neonatal umbilical cord blood after birth were collected from Oct. 2014 to Sep. 2015 from 35 ~ 37 weeks of pregnancy of department of obstetrics and gynecology. Group B Streptococcus selective chromogenic me- dium （liquid） culture was used to analyze perinatal women＇s group B Streptococcus infection status and the influ- ence on pregnancy outcomes, and drug resistance situation was analyzed by the drug sensitive test method （K - B） analysis. RESULTS Totally 101 strains of group B Streptococcus were detected from 1670 cases of perinatal preg- nant women specimens, with the positive rate of 6.05 %. There were no penicillin, ceftriaxone and vancomycin re- sistant strains. The drug resistant rate to levofloxacin was 20.79%, and to erythromycin and clindamycin were relatively high of 69. 31% and 51. 49%. The multi-factor analYsis results showed that the BMI≥28 kg/m2, GDM, VVC and anemia were independent risk factors for GBS infection in pregnant women （P〈0.05）. GBS pos- itive women had high incidence rates of premature birth and premature rupture of membranes. The neonatal pneu- monia and neonatal upper respiratory tract infection of GBS positive women were significantly higher than those of GBS negative pregnant women（P〈0.05）. CONCLUSION Perinatal women carrying group B Streptococcus can in- crease the premature birth, abortion, puerperal infection and the incidence of fetal distress and neonatal infections, having adverse effects on the pregnancy outcome. Pathogens with clinical positive response should be conducted of drug sensitive test for effective intervention therapy, so as to guarantee the perinatal health.

关 键 词：围产期孕妇 B群链球菌 检测 母婴预后 

分 类 号：R378.12[医药卫生—病原生物学]