妊娠晚期B族链球菌感染的耐药性及对孕产妇凝血功能影响  

Drug resistance of the group B streptococcus infection of pregnant women during the third trimester of pregnancy and its influence on the coagulation function of the women

作　　者：徐雪丽 王彩娟 马学娟[2] 赵赛红 XU Xueli;WANG Caijuan;MA Xuejuan;ZHAO Saihong(Linhai Maternal and Child Health Care Hospital,Zhejiang Province,317000;Taizhou Hospital,Zhejiang Province)

机构地区：[1]浙江省临海市妇幼保健院,317000 [2]浙江省台州医院

出　　处：《中国计划生育学杂志》2021年第6期1277-1281,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠晚期B族链球菌(GBS)感染的耐药性及其对孕产妇凝血功能的影响。方法:回顾性分析2017年2月-2020年2月本院诊治的286例妊娠晚期孕妇的临床资料,根据有无GBS感染(经细菌培养检测)分为感染组(n=96)与非感染组(n=190),评估两组孕妇凝血功能及妊娠结局,且对感染组予以抗生素治疗,观察治疗后凝血功能及新生儿结局。结果:药敏结果,121株GBS对万古霉素、氨苄西林、青霉素G、头孢吡肟、头孢曲松、美洛培南、利奈唑胺抗菌药物无耐药性;对红霉素、左氧氟沙星、四环素、加替沙星、克林霉素抗菌药物检出耐药菌株。感染组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比率(INR)、凝血酶时间(TT)低于非感染组,而纤维蛋白原(FIB)及胎膜早破、宫腔感染、胎儿窘迫、早产所占比率高于非感染组(P<0.05)。感染组持续治疗3d、7d时PT、APTT、INR、TT均高于治疗前,而FIB低于治疗前(P<0.05);持续治疗7d时PT、APTT、INR均高于持续治疗3d,而FIB低于持续治疗3d(P<0.05)。感染组经青霉素钠治疗后,出现1例(2.1%)新生儿肺炎、1例(2.1%)新生儿窒息、2例(4.2%)病理学黄疸及1例(2.1%)脑膜炎,总发生率为8.3%。结论:GBS感染是影响孕妇凝血功能及改变妊娠结局的重要原因,予以合适抗生素治疗是改善妊娠结局及降低新生儿并发症的关键。Objective: To investigate the drug resistance of the group B streptococcus(GBS) infection of women during the third trimester of pregnancy, and to study its influence on the coagulation function. Method: The clinical data of 286 pregnant women during the third trimester of pregnancy from February 2017 to February 2020 were analyzed retrospectively. According to the situation of GBS infection(confirmed by bacterial culture), these women were divided into group A(96 women with GBS infection) and group B(190 women without GBS infection). The coagulation function and pregnancy outcomes of women in the two groups were evaluated. The women in group A were given antibiotics, and the coagulation function of the women and neonatal outcomes were observed after treatment. Results: 121 strains of GBS had showed no resistance to vancomycin, ampicillin, penicillin G, cefepime, ceftriaxone, meropenem and linezolid. Antibacterial strains resistant to erythromycin, levofloxacin, tetracycline, gatifloxacin and clindamycin had been detected. The values of prothrombin time(PT), activated partial thromboplastin time(APTT), international normal ratio(INR), and thrombin time(TT) of the women in group A were significant lower than those of the women in group B, while the fibrinogen(FIB) value, and the rates of premature rupture of membranes, intrauterine infection, fetal distress, and premature delivery of the women in group A were significant higher than those of the women in group B(P<0.05). In group A, the values of PT, APTT, INR and TT of the women had increased significantly after treatment for 3 days and 7 days,while the FIB value of the women had decreased significantly after treatment(P<0.05).In group A,the values of PT,APTT and INR of the women after continuous treatment for 7 days were significant higher than those of the women after continuous treatment for 3 days,while the FIB value of the women after continuous treatment for 7 days was significant lower than those of the women after continuous treatment for 3 days(P<0.05).I

关 键 词：妊娠晚期 B族链球菌感染 耐药性 凝血功能 新生儿感染 

分 类 号：R714.251[医药卫生—妇产科学]