重庆地区胎膜早破孕妇胎膜分离菌的分布及耐药特征分析  

Analysis of the distribution and drug resistance characteristics of bacteria isolated from fetal membranes of pregnant women with premature rupture of membranes in Chongqing area

作　　者：贺潇[1] 李秋红[1] 李春莉[1] HE Xiao;LI Qiuhong;LI Chunli(Department of Clinical Laboratory,Chongqing Health Center for Women and Children,Chongqing 401174,China)

机构地区：[1]重庆市妇幼保健院检验科,重庆401174

出　　处：《检验医学与临床》2020年第24期3597-3600,共4页Laboratory Medicine and Clinic

摘　　要：目的分析重庆地区2015-2018年胎膜早破(PROM)孕妇胎膜分离菌的分布及耐药特征。方法收集该院2015-2018年收治的PROM孕妇8393例作为研究对象,采集胎膜标本进行菌株分离培养、鉴定和药敏试验,分析2015-2018年胎膜分离菌的分布情况及对常见抗菌药物的耐药率。结果8393例PROM孕妇中,胎膜分离菌培养阳性率为50.7%。2015-2018年胎膜分离菌以革兰阴性菌为主,占76.08%,分离的主要革兰阴性菌为大肠埃希菌,主要革兰阳性菌为粪肠球菌。大肠埃希菌产超广谱β内酰胺酶菌株检出率为17.92%。大肠埃希菌对四环素、氨苄西林、哌拉西林、甲氧苄啶-磺胺甲噁唑、头孢唑啉耐药率较高;粪肠球菌对红霉素、四环素、利福平和环丙沙星的耐药率较高;无乳链球菌对克林霉素、红霉素和四环素耐药率较高。结论2015-2018年重庆地区PROM孕妇胎膜分离菌培养阳性率较高,胎膜分离菌以大肠埃希菌为主,临床应根据药敏试验结果合理选用抗菌药物。Objective To analyze the distribution and drug resistance characteristics of bacteria isolated from fetal membranes of pregnant women with premature rupture of membranes(PROM)in Chongqing area from 2015 to 2018.Methods A total of 8393 cases of PROM pregnant women admitted to the hospital from 2015 to 2018 were selected as the research objects,and fetal membrane samples were collected for strain isolation,culture,identification and drug sensitivity test.Analyzed the distribution of bacteria isolated from fetal membranes from 2015 to 2018 and their resistance to common antibacterial drugs.Results Among 8393 pregnant women with PROM,the positive rate of fetal membranes bacterial culture was 50.7%.From 2015 to 2018,the bacteria isolated from fetal membranes were mainly gram-negative bacteria,accounting for 76.08%.The main gram-negative bacteria was Escherichia coli,and the main gram-positive bacteria was Enterococcus faecalis.The detection rate of Escherichia coli strains producing extended-spectrumβ-lactamase was 17.92%.The resistance rates of Escherichia coli to tetracycline,ampicillin,piperacillin,trimethoprim sulfamethoxazole and cefazolin were high.The resistance rates of Enterococcus faecalis to erythromycin,tetracycline,rifampicin and ciprofloxacin were high.The resistance rates of Streptococcus agalactiae to clindamycin,erythromycin and tetracycline were high.Conclusion From 2015 to 2018,the positive rate of fetal membranes bacterial culture in PROM pregnant women in Chongqing is high,and the bacteria isolated from fetal membranes are mainly Escherichia coli.The clinical application of antimicrobial drugs should base on the results of drug sensitivity test.

关 键 词：胎膜早破 孕妇 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]