三种方法筛查孕妇B族链球菌的效果评价  

Evaluation of Three Methods for Detection of Group B Streptococcus in Pregnant Women

作　　者：贾忠兰[1] 卢新[1] 许丽风[1] JIA Zhong- lan LU Xin XU Li- feng(Laboratory of Microbiology, Haidian Women ＆ Children Healthcare Hospital, Beijing 100080, China)

机构地区：[1]北京市海淀区妇幼保健院检验科,北京100080

出　　处：《标记免疫分析与临床》2017年第3期338-340,共3页Labeled Immunoassays and Clinical Medicine

摘　　要：目的比较三种不同的方法检测B族链球菌的结果,对三种B族链球菌筛查方法进行效果评价。方法收集我院2014年1月至2015年12月产科门诊孕35~37周孕妇1374例,采集孕妇的阴道拭子和肛周拭子标本,分别用血琼脂培养法,LIM肉汤增菌培养法和PCR方法检测B族链球菌。结果 1374例孕妇标本中,血琼脂培养法阳性60例,阳性检出率为4.4%,PCR方法检测阳性66例,阳性检出率为4.8%,LIM肉汤增菌培养法阳性128例,阳性检出率9.3%。三种筛查方法比较,LIM肉汤增菌培养法阳性率与PCR法,血琼脂培养法比较差异具有统计学意义。血琼脂培养法和PCR法筛查阳性率差异不具有统计学意义。以LIM肉汤增菌法为金标准,血琼脂培养法的灵敏度、特异性、阳性预测值、阴性预测值分别为46.9%,100%,100%,94.8%,PCR法的灵敏度、特异性、阳性预测值、阴性预测值分别为50%,99.6%,96.9%,95.1%。结论LIM肉汤增菌培养法筛查B族链球菌的阳性率最高,血琼脂培养法和PCR法检测灵敏度较低,只能筛查出50%左右的GBS定植孕妇。建议临床筛查B族链球菌使用LIM肉汤增菌培养法筛查GBS,灵敏度高,特异性好。Objective To evaluate methods of 5% sheep blood agar culture, Polymerase chain reaction and LIM enrichment broth culture for detection of GBS in Pregnant women. Methods Vagino-rectal（VR） swabs were collected from 1374 women at 35 to 37 weeks of gestation. Culture on 5% sheep blood agar, a selective Lim enrichment broth with subsequent culture on 5 % sheep blood agar and PCR assay were performed. The performance of 5 % sheep blood agar detection and PCR methods were compared with LIM enrichment broth culture. Statistical analysis was performed by Chi-Square test. Results LIM broth enrichment cultures were positive for 9.3% of the specimen（ 128 out of 1374）, Culture on 5% sheep blood agar for 4.4% （60 out of 1374）, PCR assay for 4.8% （66 out of 1374）. Set LIM broth culture as a gold standard, the Sensitivity, Specificity, Positive predictive values and Negative predictive value of Culture on 5 % sheep blood agar were 46.9% ,100%, 100% ,94.8%, and for that of PCR were 50% ,99.6% ,96.9% ,95. 1%, respectively. Conclusion LIM broth culture method is the test with high sensitivity and specificity for the detection of GBS colonizers during pregnancy.

关 键 词：B族链球菌 妊娠 LIM肉汤增菌培养法 

分 类 号：R714.251[医药卫生—妇产科学] R440[医药卫生—临床医学]