某妇产医院B族链球菌临床分布特征及耐药性变迁  

Characteristics of clinical distribution and change in antimicrobial resistance of Group B Streptococcus from an obstetrics and gynecology hospital

作　　者：张敬蕊 许红[1] 许彩红 杨如刚 刘菁菁 刘增宾 刘力[1] ZHANG Jing-rui;XU Hong;XU Cai-hong;YANG Ru-gang;LIU Jing-jing;LIU Zeng-bin;LIU Li(Department of Laboratory Medicine, The Fourth Hospital of Shijiazhuang, Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang 050000, China;Department of Laboratory Medicine, The Second Hospital of Hebei Medical University, Shijia-zhuang 050000, China)

机构地区：[1]石家庄市第四医院石家庄市妇产医院检验科,河北石家庄050000 [2]河北医科大学第二医院检验科,河北石家庄050000

出　　处：《中国感染控制杂志》2019年第8期751-755,共5页Chinese Journal of Infection Control

摘　　要：目的调查B族链球菌(GBS)临床分布特征及其耐药性变迁,为临床患者GBS感染的预防与治疗提供科学依据。方法回顾性分析石家庄市某妇产医院2014年1月1日-2017年12月31日临床送检标本中GBS的分离情况,分析GBS的临床分布特征,比较不同年份GBS检出情况及耐药率。结果共分离GBS 2 368株,标本来源主要为阴道和肛门括约肌拭子(2 229株,占94.13%),检出的主要病区为产科门诊及其病房(占94.97%)。孕35~37周孕妇阴道和肛门括约肌拭子标本中共检出GBS 2 229株,检出率为3.68%。围产期孕妇阴道和肛门括约肌拭子标本GBS检出率呈逐年升高趋势,差异有统计学意义(χ2趋势=44.78,P<0.05)。25~34岁年龄段孕妇阴道和肛门括约肌拭子标本中的GBS检出率最高(3.69%)。2 368株GBS对阿奇霉素的耐药率最高(78.21%),其次是红霉素(77.62%)、克林霉素(77.15%)和左氧氟沙星(47.68%),对青霉素、万古霉素、利奈唑胺、头孢呋辛及头孢曲松均敏感。趋势卡方检验结果表明,GBS对红霉素、阿奇霉素、克林霉素及左氧氟沙星的耐药率呈逐年增高的趋势,差异均有统计学意义(均P<0.05)。结论该院孕35~37周孕妇分离的GBS及GBS对部分抗菌药物的耐药率呈逐年升高趋势,但青霉素可作为该地区治疗GBS感染的首选药物,临床医务人员应注重GBS的检测及耐药变化趋势。Objective To investigate characteristics of clinical distribution and change in antimicrobial resistance of Group B Streptococcus (GBS), and provide scientific basis for the prevention and treatment of GBS infection in clinical patients. Methods The isolation of GBS from clinical specimens from an obstetrics and gynecology hospital in Shijiazhuang City between January 1, 2014 and December 31, 2017 was retrospectively analyzed, clinical distribution characteristics of GBS were analyzed, detection and antimicrobial resistance rates of GBS in different years were compared. Results A total of 2 368 strains of GBS were isolated, the main specimens were vaginal and anal sphincter swabs (2 229 strains, 94.13%), obstetric clinics and wards were the main detected wards (94.97%). A total of 2 229 strains of GBS were isolated from vaginal and anal sphincter swabs of pregnant women at 35 to 37 weeks of gestation, with a isolation rate of 3.68%. Isolation rate of GBS in vaginal and anal sphincter swabs of pregnant women during perinatal period was increasing year by year, difference was statistically significant (χ 2 trend =44.78, P <0.05 ). Isolation rate of GBS was the highest in vaginal and anal sphincter swabs of pregnant women aged 25-34 years (3.69%). 2 368 strains of GBS had the highest resistance rate to azithromycin (78.21%), followed by erythromycin (77.62%), clindamycin (77.15%) and levofloxacin (47.68%), but all were sensitive to penicillin, vancomycin, linezolid, cefuroxime and ceftriaxone. Trend chi-square test results showed that resistance rates of GBS to erythromycin, azithromycin, clindamycin and levofloxacin increased year by year, with statistical significance (all P <0.05). Conclusion GBS isolated from pregnant women at 35-37 weeks of gestation in this hospital as well as antimicrobial resistance rate of GBS is increasing year by year, penicillin can be used as the preferred antimicrobial agent for treatment of GBS infection, clinicians should pay attention to the detection of GBS and the changing trend

关 键 词：B族链球菌 感染 临床分布 耐药性 孕产妇 

分 类 号：R378.12[医药卫生—病原生物学]