围产期孕妇无乳链球菌感染的检测及耐药性分析  

Detection of streptococcus agalactiae and analysis of drug resistance in perinatal pregant women

作　　者：黄来荣 王娅 余高旺 王文强 陈潇灵 王陆佰 蔡霖 乔君 HUANG Lairong;WANG Ya;YU Gaowang;WANG Wenqiang;CHEN Xiaoling;WANG Lubai;CAI Lin;QIAO Jun(Fuzhou KingMed for Clinical Laboratory Co.,Ltd.Clinical Microbiology Laboratory,Fuzhou,Fujian 350005,China;Department of Pathology,Fuzhou Children's Hospital,Fuzhou,Fujian 350005,China;Hefei KingMed for Clinical Laboratory Co.,Ltd.Clinical Microbiology Laboratory.Hefei,AnHui 230088,China)

机构地区：[1]福州金域医学检验所有限公司微生物室,福建福州350003 [2]福建省福州儿童医院病理科,福建福州350005 [3]合肥金域医学检验实验室有限公司实验诊断部微生物室,安徽合肥230088

出　　处：《检验医学与临床》2019年第S02期83-87,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨围产期孕妇无乳链球菌感染状况的检测方法及耐药性,为临床医师治疗提供依据。方法选取2019年1—8月送检福州金域医学检验所有限公司836份围产期孕妇无乳链球菌阴道及肛周分泌物拭子标本,应用细菌培养及实时荧光定量PCR两种方法进行无乳链球菌检测,并对分离培养出的无乳链球菌进行耐药性分析。结果836份标本中实时荧光定量PCR方法检测出阳性标本138例,阳性检出率为16.51%,显色培养法检测出阳性标本60例,阳性检出率为7.18%,实时荧光定量PCR法的阳性检出率高于显色培养法。显色培养分离出的60株无乳链球菌对青霉素、氯霉素、万古霉素、头孢噻肟、氨苄西林、头孢吡肟、利奈唑胺、左氧氟沙星的敏感率较高,分别为:90.00%、86.67%、75.00%、96.67%、93.33%、85.00%、96.67%、56.67%,而对红霉素、克林霉菌耐药率较高,分别为76.67%、63.33%。结论围产期孕妇无乳链球菌筛查时,可选用具有较高的灵敏度和特异性的实时荧光定量PCR法。同时,对于围产期无乳链球菌感染的孕妇,可使用青霉素作为首选治疗药物,临床医师应重视无乳链球菌的药敏试验,并根据药敏试验结果指导临床的治疗和用药。Objective To investigate the detection method and drug resistance of the streptococcus agalactiae infection in perinatal pregnant women,and to provide evidence for clinical application specialist.Methods From January to August 2019,836 samples of vaginal and anal secretions swabs from perinatal pregnant women were selected from Fuzhou KingMed for Clinical Laboratory Co.,Ltd,and bacterial culture and Real-time quantitative PCR were used for the detection of streptococcus agalactii,and the drug resistance of isolated streptococcus agalactii was analyzed.Results The 836 samples,138 positive samples were detected by Real-time fluorescence quantitative PCR,with a positive detection rate of 16.51%,and 60 positive samples were detected by streptococcus agalactiae chromogenic medium,with a positive detection rate of 7.18%.The positive detection rate of Real-time fluorescence quantitative PCR was higher than that of color-developing culture.60 strains isolated from the chromogenic culture without milk streptococcus pneumoniae to penicillin,chloramphenicol,vancomycin,cefotaxime,ampicillin,cefepime,rina thiazole amine,levofloxacin sensitive rate is higher,respectively,90.00%,86.67%,75.00%,96.67%,93.33%,85.00%,96.67%,56.67%and for erythromycin,franklin mould resistant rate is higher,at 76.67%,63.33%respectively.Conclusion In perinatal pregnant women without streptococcus alactiae screening,Real-time fluorescence quantitative PCR with high sensitivity and specificity can be used.Meanwhile,for pregnant women without streptococcus alactiae infection during perinatal period,penicillin can be used as the first choice of treatment.Clinicians should pay attention to the drug sensitivity test of streptococcus lactococcus and guide clinical treatment and medication according to the drug sensitivity test results.

关 键 词：无乳链球菌 围产期孕妇 感染性 药敏试验 

分 类 号：R44[医药卫生—诊断学]