176例细菌性宫内感染的病原学特征和妊娠结局分析  

Analysis of etiological characteristics and pregnancy outcomes of bacterial intrauterine infection:a summary of 176 cases

作　　者：梁敏洪[1] 李帼姬[2] 黎张燕 莫红滔 LIANG Min-hong;LI Guo-ji;LI Zhang-yan;MO hong-tao(Department of Obstetrics,Boai Hospital of Zhongshan,Zhongshan 528400,Guangdong,CHINA;Department of Pharmacy,Boai Hospital of Zhongshan,Zhongshan 528400,Guangdong,CHINA)

机构地区：[1]中山市博爱医院产科,广东中山528400 [2]中山市博爱医院药学部,广东中山528400

出　　处：《海南医学》2022年第4期472-475,共4页Hainan Medical Journal

摘　　要：目的探讨三甲医院细菌性宫内感染的病原学特征和妊娠结局。方法通过回顾性研究的方法,选择2015年1月1日至2019年12月31日在中山市博爱医院就诊并确诊为细菌性宫内感染的176例孕妇作为研究对象,收集其阴道分泌物、羊水、血液等生物标本的细菌培养结果和胎盘病理检查结果,查阅其妊娠结局并做统计学分析。结果176例宫内感染患者共分离病原菌180株,其中大肠埃希氏菌80株(44.44%),无乳链球菌44株(24.44%),粪肠球菌24株(13.33%),肺炎克雷伯氏菌10株(5.56%),其他细菌22株(12.22%);对于大部分细菌而言,羊水样品检出细菌阳性的构成比明显高于其他类型的样品;大肠埃希氏菌和肺炎克雷伯氏菌对亚胺培南、哌拉西林他唑巴坦较敏感,无乳链球菌和粪肠球菌对青霉素和氨苄青霉素、万古霉素、利奈唑胺较敏感;176例宫内感染患者中,166例(94.32%)患者的胎盘病理检查结果为急性绒毛膜羊膜炎,发生胎膜早破者68例(38.64%)。结论尽快采集样品进行病原体培养,选择敏感的抗生素,积极预防胎膜早破和新生儿感染,可能对治疗细菌性宫内感染具有重要意义。Objective To study the etiological characteristics and pregnancy outcomes of bacterial intrauterine infection in a third-grade A hospital.Methods A total of 176 pregnant women,who was diagnosed as bacterial intrauterine infections from January 1,2015 to December 31,2019 in Boai Hospital of Zhongshan,were selected as the objects of this study and analyzed by retrospective research methods.Bacterial culture results of their vaginal fluid,amniotic fluid,blood and other biological specimens and placental pathology were collected,and their pregnancy outcomes were reviewed and statistically analyzed.Results A total of 180 pathogenic strains were isolated from 176 patients with intrauterine infections,including 80 strains of Escherichia coli(44.44%),44 strains of Streptococcus agalactiae(24.44%),24 strains of Enterococcus faecalis(13.33%),10 strains of Klebsiella pneumoniae(5.56%)and 22 strains of other bacteria(12.22%).For most bacteria,the composition ratio of positive bacteria detected in amniotic fluid samples was significantly higher than that in other types of samples.It was found that Escherichia coli and Klebsiella pneumoniae were sensitive to imipenem and piperacillin-tazobactam,while Streptococcus agalactiae and Enterococcus faecalis were sensitive to penicillin,ampicillin,vancomycin,linezolid.Among 176 patients with intrauterine infection,placental pathology was found to be acute chorioamnionitis in 166 patients(94.32%),and premature rupture of membranes occurred in 68 patients(38.64%).Conclusion Early and rapid sample collection for pathogen culture,selection of sensitive antibiotics,and aggressive prevention of premature rupture of membranes and neonatal infections were potential ways for the treatment of bacterial intrauterine infection.

关 键 词：宫内感染 细菌 病原学特征 妊娠结局 

分 类 号：R711.74[医药卫生—妇产科学]