妊娠期无症状尿路感染特征及妊娠结局分析  

The characteristics of asymptomatic urinary tract infection and pregnancy outcome in pregnant women

作　　者：尚露梦 戴显宁 郑文静 赵秘胜 许锴 SHANG Lu-meng;DAI Xian-ning;ZHENG Wen-jing;ZHAO Bi-sheng;XU Kai(Clinical Laboratory,Wenzhou People’s Hospital,Zhejiang 325000,China)

机构地区：[1]温州市人民医院检验科,浙江325000

出　　处：《中国卫生检验杂志》2023年第20期2493-2496,共4页Chinese Journal of Health Laboratory Technology

基　　金：温州市基础性科研项目(2020Y0256)。

摘　　要：目的通过对妊娠期无症状尿路感染(ASB)病原菌特征、易感因素及妊娠结局的分析,为临床治疗ASB提供指导。方法收集2020年1月—2022年12月在温州市人民医院孕检的315例无尿路感染临床表现的孕妇,采用VITEK质谱仪和VITEK 2 Compact分析仪分析菌群分布和耐药情况,并收集所有研究对象的临床资料。结果315例孕妇发生尿路感染84例,感染率为26.67%,共检出92株病原菌,其中大肠埃希菌32株,占34.78%,且分离出产β-内酰胺酶的大肠埃希菌(ESBLs)16株,ESBLs对头孢曲松、头孢他啶、头孢吡肟、复方新诺明的耐药性较高。logistic回归分析,发现年龄≥35岁、尿白细胞酯酶≥1+、伴妊娠期糖尿病是发生ASB的危险因素(P<0.05)。先兆早产、先兆流产在感染组与非感染组之间差异有统计学意义(P<0.01)。结论ASB检出率较高,且主要为大肠埃希菌。对于有危险因素的孕妇,临床应重点关注,及时给予干预治疗,避免早产、流产的发生。Objective This paper aims to provide favorable guidance for the clinical treatment by analyzing the characteristics,risk factors and pregnancy outcome of asymptomatic urinary tract infection(ASB)in pregnant women.Methods A total of 315 pregnant women without clinical manifestations of urinary tract infection in Wenzhou People’s Hospital from January 2020 to December 2022 were selected.VITEK mass spectrometer and VITEK 2 Compact analyzer were used to analyze the distribution characteristics and drug resistance.Clinical data were collected from all subjects.Results Eighty-four cases of urinary tract infections were detected in 315 cases of pregnant women,and the infection rate was 26.67%.A total of 92 strains of pathogenic bacteria were detected,of which 32 strains were Escherichia coli(34.78%),and 16 strains of Escherichia coli producedβ-lactamase(ESBLs).ESBLs are highly resistant to ceftriaxone,ceftazidime,cefepime and cotrimoxazole.Logistic regression analysis showed that age≥35,urinary leucocyte esterase≥1+and gestational diabetes mellitus were risk factors for asymptomatic urinary tract infection(P<0.01).There was statistical significance on the differences in the occurrence of threatened preterm labor and threatened abortion between the infected group and the non-infected group(P<0.01).Conclusion The detection rate of asymptomatic urinary tract infection during pregnancy is high,and the main pathogenic bacteria is Escherichia coli.Those pregnant women with risk factors should be paid special attention to and timely intervention and treatment to avoid the occurrence of premature labor and abortion.

关 键 词：妊娠期 无症状尿路感染 耐药 危险因素 妊娠结局 

分 类 号：R446[医药卫生—诊断学]