PPROM生殖道感染GBS血清型、基因型和毒力基因及其对妊娠结局的影响  

Serotypes,genotypes and virulence genes of GBS in PROM pregnant women with genital tract infection and influence on pregnancy outcomes

作　　者：汪虹 刘珈宸 蔡小琴 段海燕 叶续立 WANG Hong;LIU Jia-chen;CAI Xiao-qin;DUAN Hai-yan;YE Xu-li(Jingdezhen Maternal and Child Health Hospital,Jingdezhen,Jiangxi 333000,China)

机构地区：[1]景德镇市妇幼保健院妇产科,江西景德镇333000

出　　处：《中华医院感染学杂志》2022年第21期3302-3306,共5页Chinese Journal of Nosocomiology

基　　金：江西省卫生健康委科技计划基金资助项目(20202653)。

摘　　要：目的研究未足月胎膜早破(PPROM)孕妇生殖道感染B族链球菌(GBS)血清型、基因型和毒力基因及其对妊娠结局的影响。方法以2018年1月-2021年1月景德镇市妇幼保健院79例PPROM合并GBS感染孕妇为样本,采集孕妇阴道下1/3处分泌物,检测GBS感染情况及其血清型、基因型和毒力基因,随访妊娠结局并据此将孕妇分为不良组和良好组,比较两组检测结果。结果PPROM合并GBS感染孕妇GBS血清型Ⅲ型、Ⅴ型、Ⅰa型、Ⅰb型、Ⅳ型及Ⅱ型,占比分别为48.10%、25.68%、11.39%、7.59%、3.80%和2.53%,GBS基因型ST19型、ST12型、ST23型、ST10型及ST862型占比分别为30.38%、21.52%、16.46%、13.92%和11.39%,毒力基因fbsB、cylE、hylB、cfb、lmb、scpB、bca、rib和cpsⅢ检出率分别为100.00%、100.00%、98.73%、98.73%、96.20%、94.94%、94.94%、65.82%和56.96%;79例PPROM合并GBS感染孕妇中发生产妇不良结局17例(21.52%),新生儿不良结局31例(39.24%),不良组合计37例(46.84%);不良组rib和cpsⅢ检出率高于良好组,差异有统计学意义(P<0.05)。结论PPROM合并GBS感染容易引起母婴不良妊娠结局,其中GBS血清型以Ⅲ型为主,基因型以ST19型为主,毒力基因主要为scpB、lmb、hylB、cylE、bca、rib、cpsⅢ、fbsB和cfb,其中rib和cpsⅢ可能导致PPROM合并GBS感染孕妇不良妊娠结局发生风险升高。OBJECTIVE To explore the serotypes,genotypes and virulence genes of group B Streptococcus(GBS)in preterm premature rupture of membranes(PPROM)pregnant women with genital tract infection and observe the influence on pregnancy outcomes.METHODS A total of 79 PROM pregnant women who were complicated with GBS infection and treated in Jingdezhen Maternal and Child Health Hospital from Jan 2018 to Jan 2021 were enrolled in the study.The vaginal secretions specimens were collected at 1/3 of lower vaginal tract,the prevalence of GBS infection,serotypes,genotypes and virulence genes were detected,and the pregnant women were divided into the poor prognosis group and the favorable prognosis group according to the result of follow-up for pregnancy outcomes,and the detection results were compared.RESULTS The PROM pregnant women complicated with GBS infection who had serotypeⅢ,serotypeⅤ,serotypeⅠa,serotypeⅠb,serotypeⅣand serotypeⅡof GBS accounted for 48.10%,25.68%,11.39%,7.59%,3.80%and 2.53%,respectively;the pregnant women who had genotype ST19,genotype ST12,genotype ST23,genotype ST10 and genotype ST862 of GBS accounted for 30.38%,21.52%,16.46%,13.92%and 11.39%,respectively.The detection rates of virulence genes fbsB,cylE,hylB,cfb,lmb,scpB,bca,riband cpsⅢwere 100.00%,100.00%,98.73%,98.73%,96.20%,94.94%,94.94%,65.82%and 56.96%,respectively.Among the 79 PROM pregnant women complicated with GBS infection,17(21.52%)had adverse pregnancy outcomes,and 31(39.24%)had adverse neonatal outcomes,with 37 cases(46.84%)in the adverse prognosis group.The detection rates of rib and cpsⅢof the adverse prognosis group were higher than those of the favorable prognosis group(P<0.05).CONCLUSION The GBS infection in the PROM pregnant women tend to lead to the adverse pregnancy outcomes of mothers and infants,serotypeⅢand genotype ST19 are dominant among the GBS;scpB,lmb,hylB,cylE,bca,rib,cpsⅢ,fbsB and cfb are the major virulence genes;rib and cpsⅢmay lead to the increase of risk for adverse pregnancy outcomes.

关 键 词：未足月胎膜早破 B族链球菌 血清分型 基因分型 毒力基因 妊娠结局 

分 类 号：R714.433[医药卫生—妇产科学]