胎膜早破产妇胎膜细菌培养及药敏结果分析  

Result Analysis on Bacterial Culture and Drug Susceptibility of Fetal Membranes in Women with Prem ature Rupture of Membranes

作　　者：杨晓燕[1] 周玮[1] YANG Xiaoyan,ZHOU Wei(Chongqing Health Center for Women and Children, Chongqing 400021, Chin)

机构地区：[1]重庆市妇幼保健院,重庆400021

出　　处：《实用妇产科杂志》2018年第3期223-227,共5页Journal of Practical Obstetrics and Gynecology

基　　金：重庆市卫生计生委科学研究项目(编号:2016 MSXM091)

摘　　要：目的:分析胎膜早破(PROM)产妇胎膜细菌培养及药敏结果,为围生期感染用药提供科学依据。方法:对2016年7月至12月在我院分娩的1041例PROM产妇胎膜标本进行细菌培养及药敏试验。结果:1041例PROM患者胎膜细菌培养中,369例(35.4%)培养阳性,革兰阴性菌占66.7%,革兰阳性菌占33.1%。足月PROM期待时间延长,培养阳性率无相应升高的趋势(P>0.05);未足月PROM(PPROM)期待时间延长,培养阳性率呈增高趋势(P<0.05)。产前未使用抗生素组培养菌株种类35种,多于产前使用抗生素组培养菌株种类17种。主要感染病菌为大肠埃希菌,占59.7%。大肠埃希菌对哌拉西林、氨苄西林、四环素耐药明显,耐药率均在45.0%以上,对其余抗菌药物的较敏感。大肠埃希菌产前使用抗生素组较未使用抗生素组药物耐药率升高(P<0.05)。革兰阳性球菌对呋喃妥因、替考拉宁、万古霉素、利奈唑胺耐药率为0。结论:胎膜早破产妇胎膜感染以革兰阴性杆菌为主,主要感染菌为大肠埃希菌。经验性预防使用抗生素可能会增加细菌耐药率,应根据病原学特征合理应用抗生素。Objective：To analyze the bacterial distribution and drug resistance of fetal membrane sample from women suffered premature rupture of membranes（PROM） ,so as to provide evidence for rational use of antibiotics. Methods：A total of 1041 fetal membrane samples in women with premature rupture of membranes were cul- tured and drug susceptibility tests were done. Among those samples, 258 of them came from women who had used antibiotics during prenatal period, while the others came from women who unused. Results ：Among the 1041 fetal membrane samples, 369 （35.4%） were infected. The infection of Gram-negative bacteria accounted for 66.7% ,whereas gram positive bacteria accounted for 33. 1%. The expectant time prolonged, and the positive rate of infection from women with PROM did not increase（ P 〉 0.05） ,whereas the positive rate of infection among PPROM increased （P 〈 0. 05）. There were 35 strains of bacteria identified in non-antibiotics group during prenatal period,while 17 strains of bacteria were identified in the antibiotics group. The main strain was Escherichia coli which accounted for 59.7%. Escherichia coli were resistant to piperacillin, ampicillin and tetracycline. For the men- tioned drugs,the resistance rates were all above 45.0%. The resistance rate of Escherichia coli in antibiotics group was higher than that in the non-antibiotics group（ P 〈0. 05）. The resistance rate of Gram positive bacteria to Nitrofurantoin,Teicoplanin,Vancomycin and Linezolid was 0. Conclusions： Escherichia coli is the main patho- genic bacteria isolated from fetal membrane samples of women with premature rupture of membranes. It is important to use antibiotics rationally according to the feature of pathogenic bacteria.

关 键 词：胎膜早破 细菌培养 药敏试验 

分 类 号：R714.4[医药卫生—妇产科学]