围生期孕妇无乳链球菌感染及其妊娠结局  

Perinatal Streptococcus agalactiae infection in pregnant women and pregnancy outcomes

作　　者：张雪梅[1] 王海龙[1] 白春[1] 王秀萍 于冰 ZHANG Xue-mei;WANG Hai-long;BAI Chun;WANG Xiu-ping;YU Bing(Jiuquan People's Hospital of Gansu Province,Jiuquan,Gansu 7350o0,China)

机构地区：[1]甘肃省酒泉市人民医院产科,甘肃酒泉735000

出　　处：《中华医院感染学杂志》2022年第17期2694-2697,共4页Chinese Journal of Nosocomiology

基　　金：甘肃省科技支撑项目(1804FKCA121),甘肃省科技支撑项目(1804FKCA135)。

摘　　要：目的分析围生期孕妇无乳链球菌(SA)感染和耐药性及其对妊娠结局的影响,为临床治疗工作提供研究依据。方法选取2019年10月-2020年10月在甘肃省酒泉市人民医院接受产检的1658例围生期孕妇为研究对象,检测生殖道SA感染情况,分析检出SA菌株的耐药性及其对母婴结局的影响。结果纳入孕妇其中SA感染119例,感染率为7.18%。119株SA对青霉素、头孢克肟等药物的敏感率均为100%,对氨苄西林、苯唑西林等药物的敏感率均高于90%,而对克林霉素、红霉素等药物的敏感率均低于50%。感染组孕妇双胎妊娠、有流产史、合并妊娠期糖尿病占比分别为4.20%、10.08%、21.85%,均高于未感染组(P<0.05)。感染组孕妇剖宫产、胎膜早破、早产、产褥感染、子宫内膜感染、胎儿窘迫、新生儿窒息的比例分别为49.58%、36.97%、15.13%、16.81%、23.53%、26.89%、11.76%,均高于未感染组(P<0.05)。结论围生期孕妇生殖道SA感染可对其分娩方式和母婴结局产生不良影响,临床分离的菌株对大环内酯类等药物的耐药率较高,青霉素类仍然是首选的敏感性抗感染治疗药物。OBJECTIVE To investigate the prevalence of perinatal Streptococcus agalactiae infection in pregnant women,analyze the drug resistance and observe the influence on pregnancy outcomes so as to provide guidance for clinical treatment.METHODS A total of 1658 perinatal pregnant women who received prenatal checkups in Jiuquan People′s Hospital of Gansu Province from Oct 2019 to Oct 2020 were recruited as the study objects.The prevalence of genital tract S.agalactiae infection was detected,the drug resistance of the isolated S.agalactiae strains was analyzed,and the influence of the drug resistance on maternal and infant outcomes was observed.RESULTS Among the pregnant women who were enrolled in the study,119 had S.agalactiae infection,with the infection rate 7.18%.The drug susceptibility rates of the 119 strains of S.agalactiae to penicillin and cefixime were 100%,the drug susceptibility rate to ampicillin and oxacillin were more than 90%,while the drug susceptibility rates to clindamycin and erythromycin were less than 50%.The proportions of pregnant women with twin pregnancy,abortion history and gestational diabetes mellitus of the infection group were respectively 4.20%,10.08%and 21.85%,significantly higher than those of the no infection group(P<0.05).The pregnant women with cesarean section,premature rupture of membrane,premature delivery,puerperal infection,endometrial infection,fetal distress and neonatal asphyxia of the infection group were respectively 49.58%,36.97%,15.13%,16.81%,23.53%,26.89%and 11.76%,significantly higher than those of the no infection group(P<0.05).CONCLUSION The perinatal genital tract S.agalactiae infection could have adverse effect on delivery mode and maternal and infant outcomes.The clinical isolates are highly resistant to macrolides,and penicillin remains the preferred drug for treatment of the infection.

关 键 词：围生期 无乳链球菌 B族链球菌 生殖道感染 耐药性 妊娠结局 

分 类 号：R715.3[医药卫生—妇产科学]