B族链球菌孕晚期分离株耐药、毒力基因分布及其对肠道菌群、妊娠结局的影响  

Drug resistance and virulence genes in group B Streptococcus isolates from late pregnancy women and influence on intestinal flora and pregnancy outcomes

作　　者：方雪[1] 马莱超 隋红梅 FANG Xue;MA Lai-chao;SUI Hong-mei(Tianjin Beichen Hospital of Traditional Chinese Medicine,Tianjin 300400,China)

机构地区：[1]天津市北辰中医医院产科,天津300400

出　　处：《中华医院感染学杂志》2023年第1期105-109,共5页Chinese Journal of Nosocomiology

基　　金：天津市自然科学基金(2020MS142)。

摘　　要：目的 分析B族链球菌(GBS)孕晚期阴道分泌物分离株耐药和毒力基因分布及其对肠道菌群和新生儿感染的影响。方法 选取2018年2月-2021年5月于天津市北辰中医医院生殖道GBS培养阳性孕晚期孕妇98例为研究组,同期GBS培养阴性孕晚期孕妇50名为对照组,聚合酶链式反应(PCR)分析GBS耐药及毒力基因,比较两组肠道菌群多样性、妊娠结局及新生儿感染情况。结果 GBS菌株对四环素、阿奇霉素、克林霉素及红霉素耐药率较高,对氨苄青霉素、头孢噻肟、环丙沙星、左氧氟沙星敏感;GBS检出大环内酯类与林可霉素类药物耐药基因主要为ermB、mefA/E,喹诺酮类药物耐药基因主要为gyrA突变S81L型、gyrB、parC突变S79Y型;主要毒力基因为hylB、cylE和CAMP,且各菌株均检测到菌毛岛;肠道菌群主坐标分析(PCoA)显示,两组肠道菌群构成情况于pc1-3、pc2-3能够分开,组间存在统计学差异;研究组胎膜早破、早产、新生儿感染发生率均高于对照组(P<0.05)。结论 孕晚期GBS感染耐药基因以ermB、mefA/E为主,毒力基因以hylB、cylE、CAMP、菌毛岛基因为主,可导致肠道菌群紊乱,增加新生儿感染风险。OBJECTIVE To investigate the drug resistance and virulence genes in group B Streptococcus(GBS) isolates from vaginal secretions of late pregnancy women and observe the influence on intestinal flora and neonatal infection. METHODS A total of 98 late pregnancy women who were cultured positive for genital tract GBS in Tianjin Beichen Hospital of Traditional Chines Medicine from Feb 2018 to May 2021 were assigned as the study group, meanwhile, 50 late pregnancy women who were cultured negative for GBS were chosen as the control group. The drug resistance and virulence genes in the GBS strains were detected by polymerase chain reaction(PCR). The diversity of intestinal flora, pregnancy outcomes and incidence of neonatal infection were observed and compared between the two groups. RESULTS The drug resistance rates of the GBS strains to tetracycline, azithromycin, clindamycin and erythromycin were high, while the strains were sensitive to ampicillin, cefotaxime, ciprofloxacin and levofloxacin. ermB and mefA/E were the major macrolides-and lincomycin resistance genes that detected in the GBS strains;gyrA mutant S81L type and gyrB, parC mutant S79Y type were the major quinolones resistance genes. HylB,cylE and CAMP were the major virulence genes. All of the strains were detected with pilus islands. The principal co-ordinates analysis(PCoA) for the intestinal flora showed that there was difference in the composition of intestinal flora between the two groups in terms of pc1-3 and pc2-3. The incidence rates of premature rupture of membranes, premature delivery and neonatal infection were higher in the study group than in the control group(P<0.05). CONCLUSION ermB and mefA/E are the major drug resistance genes in the late pregnancy women with GBS infection, hylB, cylE, CAMP and pilus islands genes are the major virulence genes, which may lead to disturbance of intestinal flora and increase the risk of neonatal infection.

关 键 词：孕晚期孕妇 B族链球菌 耐药基因 毒力基因 肠道菌群 新生儿感染 妊娠结局 

分 类 号：R711.31[医药卫生—妇产科学]