两种不同检测方法在孕晚期妇女B 族链球菌筛查中的应用  

Application of two different detection methods in screening group B streptococcus in women in late pregnancy

作　　者：赖新华[1] 陈少青 李庆兰 刘琼[2] LAI Xin-hua;CHEN Shao-qing;LI Qing-lan(Department of the Laboratory,Dongguan Chang'an Hospital,Dongguan 523846,China)

机构地区：[1]东莞市长安医院检验科,广东东莞523846 [2]东莞市长安医院妇产科,广东东莞523846

出　　处：《中国处方药》2023年第12期180-183,共4页Journal of China Prescription Drug

基　　金：东莞市科技计划项目(20211800902142)。

摘　　要：目的探讨不同检测方法在孕晚期妇女B族链球菌(GBS)筛查中的应用。方法选取在2022年1月~2023年4月于产前门诊进行B族链球菌筛查的孕妇,用随机数字表法筛选其中900例作为研究对象。以细菌培养法结合组合型特异性试验判断孕产妇的B族链球菌感染情况,采用GBS肉汤增菌培养法联合荧光定量聚合酶链反应(PCR)法+尿培养检测,对孕晚期妇女B族链球菌进行筛查。结果以细菌培养法为金标准,检出阳性103例,检出率为11.44%,阴道分泌物GBS肉汤增菌培养法联合荧光PCR检测检出阳性101例,检出率为11.22%。尿液GBS培养检出阳性82例,检出率为9.11%。阴道分泌物GBS肉汤增菌培养法联合荧光PCR检测、尿液GBS培养的敏感度分别为95.14%、69.90%,特异度分别为99.62%、98.74%,Kappa值分别为0.955、0.753,具有一致性。阴道分泌物GBS肉汤增菌培养法联合荧光PCR检测的敏感度、特异度及准确率明显高于尿液GBS培养(P<0.05)。结论阴道分泌物GBS肉汤增菌培养法联合荧光PCR检测的敏感度、特异度较尿液GBS培养高,诊断效能较高,能明显提升GBS的检出率。Objective To explore the application of different detection methods in screening group B streptococcus(GBS)in late pregnant women.Methods Pregnant women who were screened for group B streptococcus in the prenatal clinic from June 2021 to April 2023 were selected,and 900 of them were selected by random number table method.The bacterial culture method combined with the combined type specific test was used to determine the group B streptococcus infection in pregnant women.According to this study,GBS broth enhancement culture method,fluorescence quantitative polymerase chain reaction(PCR)method+urine culture and combined detection were used to screen the group B streptococcus in women in late pregnancy.Results With bacterial culture method as the gold standard,103 cases were detected positive,the detection rate was 11.44%,and 101 cases were detected positive,the detection rate was 11.22%.Urine GBS culture was positive in 82 cases,the detection rate was 9.11%.The sensitivities,specificities and Kappa values were 95.14%and 69.90%,99.62%,98.74%,0.955 and 0.753,respectively,and were consistent in the detection of GBS broth in vaginal secretions combined with fluorescent PCR and urine GBS culture,respectively.The sensitivity,specificity and accuracy of vaginal secretions GBS broth enhanced culture combined with fluorescent PCR were significantly higher than that of urine GBS culture(P<0.05).Conclusion The sensitivity and specificity of vaginal secretions GBS broth culture combined with fluorescent PCR are higher than that of urine GBS culture,and the diagnostic efficiency is higher,which can significantly improve the detection rate of GBS.

关 键 词：肉汤增菌培养法 荧光定量PCR法 尿培养 孕晚期 B族链球菌 

分 类 号：R714[医药卫生—妇产科学] R446.5[医药卫生—临床医学]