妊娠期糖尿病剖宫产后切口感染病原学及与STING基因多态性的关联  

Etiological characteristics of postoperative incision infection in cesarean section puerpera with gestational diabetes mellitus and its association with STING gene polymorphism

作　　者：蔡春苗 符爱贞 翁叶蕊 陈巍[1] 韩幸真 CAI Chun-miao;FU Ai-zhen;WENG Ye-rui;CHEN Wei;HAN Xing-zhen(Haikou Hospital of the Maternal and Child Health,Haikou,Hainan 570203,China)

机构地区：[1]海口市妇幼保健院产科,海南海口570203

出　　处：《中华医院感染学杂志》2023年第6期894-898,共5页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(813265)。

摘　　要：目的 分析妊娠期糖尿病(GDM)剖宫产后切口感染病原学及与干扰素基因刺激蛋白(STING)基因多态性的关联。方法 选择2019年3月-2021年6月在海口市妇幼保健院接受剖宫产的GDM产妇116例为研究对象。根据术后是否发生切口感染分为感染组28例和未感染组88例,分析切口感染病原菌及耐药性,采用聚合酶链反应-限制片段长度多态(PCR-RFLP)分析STING基因启动子序列多态性,采用Logistic回归分析STING基因多态性位点与GDM产妇剖宫产后切口感染的关联。结果 GDM产妇剖宫产后切口感染以革兰阴性菌为主,其中大肠埃希菌、铜绿假单胞菌对氨苄西林以及头孢类抗菌药物耐药性较高,肠球菌属、金黄色葡萄球菌对青霉素、氨苄西林耐药性较高;两组产妇STING基因rs1131769、rs7380824位点基因频率以及相应的等位基因频率比较,无统计学差异,感染组STING基因rs7380272 TT基因频率以及T等位基因频率低于未感染组(P<0.05)。Logistic多因素回归分析显示,羊水污染、阴道检查次数是导致GDM产妇剖宫产后切口感染的相关因素(P<0.05),而rs7380272 TT基因型与切口感染无相关性。结论 GDM产妇剖宫产后切口感染以革兰阴性菌为主;STING基因位点基因多态性与GDM产妇剖宫产后切口感染无相关性,但感染患者rs7380272 TT基因型以及T等位基因频率低于未感染患者。OBJECTIVE To investigate the etiological characteristics of postoperative incision infection in cesarean section puerpera with gestational diabetes mellitus(GDM) and analyze its association with polymorphisms of stimulator of interferon genes(STING). METHODS A total of 116 puerpera with GDM who underwent cesarean section in Haikou Hospital of the Maternal and Child Health from Mar 2019 to Jun 2021 were recruited as the research subjects and were divided into the infection group with 28 cases and the no infection group with 88 cases according to the status of postoperative incision infection. The distribution and drug resistance of pathogens causing the incision infection were observed, the polymorphisms of STING gene promoter sequences were analyzed by means of polymerase-chain-reaction–restriction-fragment-length polymorphism(PCR-RFLP) assay, and logistic regression analysis was performed for the association of STING gene polymorphisms with postoperative incision infection in the cesarean section puerpera with GDM. RESULTS Gram-negative bacteria were dominant among the pathogens isolated from the GDM puerpera with incision infection after cesarean section. Escherichia coli and Pseudomonas aeruginosa strains were highly resistant to ampicillin and cephalosporins;Enterococci and Staphylococcus aureus were highly resistant to penicillin and ampicillin. There were no significant differences in the frequencies of genotypes and corresponding alleles at rs1131769 and rs7380824 loci between the two groups. The frequencies of TT genotype and T allele at rs7380272 locus of STING gene were significantly lower in the infection group than in the no infection group(P<0.05). Multivariate logistic regression analysis showed that amniotic fluid contamination and number of times of vaginal examination were the related factors for the postoperative incision infection in the cesarean section puerpera with GDM(P<0.05), while the TT genotype at rs7380272 locus was not associated with the incision infection. CONCLUSION The gram-nega

关 键 词：干扰素基因刺激蛋白 启动子序列多态性 妊娠期糖尿病 剖宫产 切口感染 

分 类 号：R714.255[医药卫生—妇产科学]