孕晚期妇女定植无乳链球菌的三种筛查方法比较  

Comparison of three different screening methods for detecting Group B Streptococcus in late pregnant women

作　　者：李东[1] 张树琛[1] 时琰丽[1] 李雪清[1] 鲁炳怀[1] LI Dong ZHANG Shu-chen SHI Yan-li LI Xue-qing LU Bing-huai(Civil Aviation General Hospital,Beijing 100123, China)

机构地区：[1]民航总医院检验科,北京100123

出　　处：《中华医院感染学杂志》2017年第4期899-902,共4页Chinese Journal of Nosocomiology

基　　金：基金项目:北京市科委首都临床特色应用研究(Z141107002514036)

摘　　要：目的探讨妊娠晚期孕产妇生殖道/直肠内B族链球菌的定植情况,并通过比较常规普通细菌培养、显色培养及聚合酶链反应3种检测方法鉴定无乳链球菌(GBS)的特异性及灵敏度。方法选择2016年1月1日-2016年3月31日医院就诊469例孕晚期妇女,于35~37孕周产前检查时或早产孕妇在入院时,取阴道下段1/3处分泌物及直肠拭子采用常规培养鉴定、显色培养鉴定及聚合酶链反应3种方法进行GBS检测,比较3种方法的GBS检测阳性率与特异性及灵敏度,数据采用SPSS17.0软件进行统计分析。结果 469例孕晚期妇女经普通细菌培养检测阳性30例,阳性率为6.4%,增菌后的显色培养检测阳性41例,阳性率为8.7%,增菌后的聚合酶链反应检测阳性45例,阳性率9.6%,增菌后的显色培养和聚合酶链反应检测阳性率高于普通细菌培养检测阳性率,差异有统计学意义(P<0.05),而增菌后的显色培养和聚合酶链反应检测阳性率之间相比,差异无统计学意义。结论通过针对不同检测方法的比较,找到方法学之间的差异,增菌后的显色培养和聚合酶链反应检测方法对于GBS的筛查有更高的阳性率和灵敏度,在临床上可选择使用该种方法进行筛查,更利于GBS的检出,降低新生儿感染率。OBJECTIVE To investigate the colonization of Group B Streptococcus（GBS）in the reproductive tract/rectum in late pregnant women,and compare the specificity and sensitivity of three common methods of general bacterial culture,staining chactenstis and polymerase chain reaction for the identification of GBS.METHODS A total of 469 cases of late pregnant women from Jan.1,2016 to Mar.31,2016 were selected,the vaginal lower third of the secretions and rectal swabs were used for GBS detection using three methods at 35 to 37weeks of prenatal examination or preterm delivery of pregnant women in the admission,The positive rate,specificity and sensitivity of the three methods for detection of GBS were compared.The data were analyzed by SPSS 17.0software.RESULTS In 469 cases of late pregnant women,30 cases were positive detected by general bacterial culture,with the positive rate of 6.4%,41 cases were positive detected by staining with the positive rate of 8.7%,and 45 cases were positive detected by PCR after pruification,with the positive rate of 9.6%.The positive rates detected by staining and PCR were higher than that of common bacteria cultiration,and the difference was statistically significant（P〈0.05）.There was no significant difference in the positive rate detected by staining and PCR after pruification.CONCLUSION Through the comparison of different detection methods to find the differences among the methods,the methods of staining after pruification and PCR for screening of GBS have a higher positive rate and sensitivity.These methods can be used for screening in clinic,which are more conductive to the detection of GBS,and can reduce neonatal infection rate.

关 键 词：显色培养基 聚合酶链反应 无乳链球菌 

分 类 号：R378.12[医药卫生—病原生物学]