晚期妊娠孕妇B族链球菌感染状况及妊娠结局分析  

Prevalence of group B Streptococcus infection in pregnant women during late pregnancy and pregnancy outcomes

作　　者：张淑珍[1] 金卓杏[1] 陈晓方[1] 季红薇[1] 廖燕[1] ZHANG Shu-zhen JIN Zhuo-xing CHEN Xiao-fang JI Hong-wei LIAO Yan(Lishui Central Hospital, Lishui, Zhejiang 323000, Chin)

机构地区：[1]丽水市中心医院妇产科,浙江丽水323000

出　　处：《中华医院感染学杂志》2017年第12期2801-2804,共4页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2012RCB041)

摘　　要：目的分析晚期妊娠孕妇B族链球菌(GBS)感染状况及妊娠结局,提高产妇和新生儿的生活质量。方法选择2014年1月-2016年1月在医院接受产检240例晚期妊娠孕妇进行研究;比较分析晚期妊娠孕妇B族链球菌感染状况和孕妇妊娠结局;同时比较新生儿不良结局发生率;分析40株GBS对抗菌药物的耐药率;并根据药敏测试结果分析GBS耐药机制。结果 240例晚期妊娠孕妇中,GBS阳性者40例,GBS阳性率为16.67%;GBS阳性孕妇早产率和剖宫产率分别为35.00%和37.50%,明显高于GBS阴性孕妇组早产率,患者早产和剖宫产率差异显著(P<0.05);GBS阳性孕妇羊水污染、宫内感染、胎儿窘迫和产后出血发生率均高于GBS阴性孕妇,患者在羊水污染和宫内感染差异有统计学意义(P<0.05),产后出血和胎儿窘迫方面的差异无统计学意义;分离40株GBS对青霉素G、头孢唑林、红霉素、氯霉素、左氧氟沙星和克林霉素的耐药率分别为65.00%、70.00%、67.50%、17.50%、35.00%和60.00%。对头孢唑林、头孢噻肟、头孢曲松和万古霉素的敏感率高达100.00%,对青霉素G的敏感率为95.00%。结论晚期妊娠孕妇感染GBS后可导致新生儿早产、羊水污染、宫内感染等妊娠结局,剖宫产率相应增加,应加强妊娠晚期GBS的防范工作,提高产妇和新生儿的生活质量,一旦发现感染要做到合理用药。OBJECTIVE To investigate the prevalence of group B Streptococcus （GBS） infection in pregnant women during late pregnancy and observe the pregnancy outcomes so as to improve the quality of life of puerpera and neonates.METHODS A total of 240 pregnant women of late pregnancy who received prenatal examination in the hospital from Jan 2014 to Jan 2016 were enrolled in the study.The prevalence rate of GBS infection and pregnancy outcomes were compared among the pregnant women of late pregnancy,meanwhile,the incidence of adverse outcomes was compared among the neonates,the drug resistance rates of 40 strains of GBS were analyzed,and the drug resistance mechanisms of the GBS strains were observed on the basis of the result of drug susceptibility testing.RESULTS Of the 240 pregnant women of late pregnancy,40 were positive for GBS,with the positive rate of GBS 16.67%;the premature delivery rate and cesarean section rate of the pregnant women who were positive for GBS were respectively 35.00% and 37.50%,significantlyy higher than the premature delivery rate of the pregnant women who were negative for GBS;there was significant difference in the premature delivery rate or cesarean section rate （P〈0.05）.The incidence rates of amniotic fluid contamination,intrauterine infection,fetal distress,and postpartum hemorrhage were significantly higher in the GBS-positive pregnant women than in the GBS-negative pregnant women,there was significant difference in the incidence of amniotic fluid contamination or intrauterine infection （P〈0.05）,while there was no significant difference in the incidence rate of postpartum hemorrhage or fetal distress.The drug resistance rates of the 40 strains of isolated GBS to penicillin G,cefazolin,erythromycin,chloramphenicol,levofloxacin,and clindamycin were 65.00%,70.00%,67.50%,17.50%,35.00%,and 60.00%,respectively;the drug susceptibility rates to cefazolin,cefotaxime,ceftriaxone,and vancomycin were as high as 100.00%,and the drug susceptibility rate to penicillin G was 95.00%.CONCLUSI

关 键 词：妊娠晚期 B族链球菌 感染 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]