孕晚期孕妇无乳链球菌定植与阴道分泌物化学检查的关系及耐药谱分析  

Relationship between Streptococcus agalactiae colonization and chemical examination of vaginal secretions in pregnant women in the third trimester of pregnancy and analysis of drug resistance spectrum

作　　者：余清源 刘华[1] 唐权[1] 罗芳 YU Qingyuan;LIU Hua;TANG Quan;LUO Fang(Department of Clinical Laboratory,Lichuan People′s Hospital,Lichuan,Hubei 445400,China)

机构地区：[1]利川市人民医院检验科,湖北利川445400

出　　处：《检验医学与临床》2022年第13期1766-1769,1774,共5页Laboratory Medicine and Clinic

基　　金：恩施土家族苗族自治州医疗卫生类指导性项目(JCY2019000014)。

摘　　要：目的了解孕晚期孕妇无乳链球菌(SGC)定植与阴道分泌物化学检查的关系,并分析SGC的耐药谱,为预防和治疗SGC感染提供依据。方法采集2019年1月至2021年2月在该院就诊的806例孕晚期孕妇的阴道和直肠拭子进行SGC分离培养,采用VITEK 2 Compact细菌鉴定药敏分析仪进行菌株鉴定和药敏试验,采用Whonet5.6软件进行耐药谱分析。将79例SGC阳性孕妇作为研究组,随机选取80例SGC阴性孕妇作为对照组,比较两组孕妇阴道分泌物化学检查结果,采用二元Logistic回归分析孕晚期孕妇SGC定植的危险因素。结果(1)阴道和直肠拭子中SGC检出率为9.80%(79/806)。SGC定植与阴道分泌物中酸碱度(P<0.01)、白细胞酯酶(P=0.02)、N-乙酰氨基己糖苷酶(P=0.02)、β-葡萄糖醛酸酶(P<0.01)、乳酸(P=0.04)及过氧化氢酶(P=0.01)均有明显相关性。二元Logistic回归分析结果显示,β-葡萄糖醛酸酶阳性是SGC定植的危险因素(P<0.01)。(2)79株SGC对万古霉素、利奈唑胺、美罗培南、头孢曲松、氨苄西林、青霉素的耐药率均为0.00%;对克林霉素、红霉素、四环素的耐药率均较高。(3)Whonet5.6软件分析结果显示有7种耐药谱,其中红霉素、四环素、克林霉素、左氧氟沙星同时耐药占比最高,为44.3%;其次是红霉素、四环素、克林霉素同时耐药,占比为20.3%。结论利川市孕晚期孕妇SGC定植率高于全国平均水平,阴道分泌物中β-葡萄糖醛酸酶阳性是孕妇SGC定植的危险因素。分离的SGC菌株耐药谱较为集中,且表现出多重耐药的特征,青霉素可以作为预防或治疗的首选药物。Objective To understand the relationship between Streptococcus agalactiae(SGC)colonization and chemical examination of vaginal secretions in pregnant women in the third trimester of pregnancy,and to analyze the drug resistance spectrum of SGC to provide evidence for the prevention and treatment of SGC infection.Methods Vaginal and rectal swabs of 806 pregnant women in the third trimester of pregnancy treated in the hospital were collected from January 2019 to February 2021 for SGC isolation and culture.Bacterial identification and drug susceptibility tests were carried out with VITEK 2 Compact bacterial identification and drug susceptibility analyzer,and the drug resistance spectrum analysis was carried out with Whonet5.6 software.Seventy-nine SGC-positive pregnant women were selected as the study group,and 80 SGC-negative pregnant women were randomly selected as the control group.The chemical examination results of vaginal secretions of pregnant women in the two groups were compared,and the risk factors of SGC colonization in pregnant women in the third trimester of pregnancy were analyzed by binary Logistic regression.Results(1)The detection rate of SGC in vaginal and rectal swabs was 9.80%(79/806).The colonization of SGC was associated with pH(P<0.01),leukocyte esterase(P=0.02),N-acetylhexosaminidase(P=0.02),β-glucuronidase(P<0.01),lactic acid(P=0.04)and catalase(P=0.01)in vaginal secretions.Binary Logistic regression analysis showed thatβ-glucuronidase positive was a risk factor for SGC colonization(P<0.01).(2)The resistance rates of 79 SGC strains to vancomycin,linezolid,meropenem,ceftriaxone,ampicillin and penicillin were all 0.00%.The resistance rates to clindamycin,erythromycin and tetracycline were all high.(3)Whonet5.6 software analysis results showed that there were 7 drug-resistant spectrum,among which erythromycin,tetracycline,clindamycin and levofloxacin accounted for the highest proportion of resistance at the same time,accounting for 44.3%;followed by erythromycin,tetracycline,clindamycin was re

关 键 词：无乳链球菌 耐药谱 阴道分泌物 

分 类 号：R446.5[医药卫生—诊断学]