围生期孕妇B族链球菌耐药性和血清型、基因型与妊娠结局的关系  

Relation of drug resistance,serotypes and genotypes of Group B Streptococcus in perinatal pregnant females and pregnancy outcomes

作　　者：赵亚楠 肖伟利 曹啟新 闫彦 崔秀格 赵建平 ZHAO Yanan;XIAO Weili;CAO Qixin;YAN Yan;CUI Xiuge;ZHAO Jianping(Department of Clinical Laboratory,Inner Mongolia People's Hospital,Hohhot 010010,Inner Mongolia,China)

机构地区：[1]内蒙古自治区人民医院检验科,内蒙古呼和浩特010010

出　　处：《检验医学》2024年第4期382-386,共5页Laboratory Medicine

基　　金：内蒙古自治区卫生健康委科技计划项目(202202008)。

摘　　要：目的 分析围生期孕妇B族链球菌(GBS)耐药性和血清型、基因型与妊娠结局的相关性,为临床用药和疫苗研发提供参考。方法 选取2020年1月—2022年12月内蒙古自治区人民医院123例GBS阳性围生期孕妇(研究组),同比例选取123例GBS阴性孕妇作为对照组。比较2个组孕妇的妊娠结局。对GBS菌株进行体外药物敏感性试验。采用乳胶凝集法、多位点序列分型(MLST)对GBS进行血清分型和基因分型。分析不同血清型、基因型GBS的耐药性与致病力的相关性。结果 GBS菌株对万古霉素、奎奴普丁-达福普汀、利奈唑胺、庆大霉素、氨苄西林、青霉素、头孢曲松的敏感率均>91.00%,对呋喃妥因、左氧氟沙星、克林霉素、红霉素不同程度耐药。GBS血清型以Ⅲ、Ⅰb和Ⅰa型为主,基因型以ST19、ST17和ST23型为主;Ⅲ型GBS基因型以ST19和ST17型为主,Ⅰb型以ST10和ST12型为主,Ⅰa型以ST23型为主。Ⅲ型、Ⅰa型血清型和ST19、ST17基因型GBS对红霉素的耐药率最高,对呋喃妥因、左氧氟沙星、克林霉素、红霉素的耐药率差异有统计学意义(P<0.05);不同血清型GBS对呋喃妥因、左氧氟沙星、克林霉素、红霉素的耐药率差异均有统计学意义(P<0.05),Ⅲ型GBS对这4种抗菌药物的耐药率最高。研究组孕妇更易发生妊娠不良结局(P<0.05)。孕妇定植感染Ⅰa型和ST23型GBS的发生率较高;Ⅲ型GBS克隆株多导致新生儿侵袭性感染,且基因型主要为ST17型。结论 GBS对青霉素类、头孢类抗菌药物和万古霉素高度敏感,GBS血清型以Ⅲ型、Ⅰa型、Ⅰb型为主,基因型以ST19、ST17、ST23型为主。GBS感染易引起不良妊娠结局,Ⅰa型和ST23型GBS易引起孕妇定植感染,Ⅲ型和ST17型GBS易致新生儿侵袭性感染。Objective To analyze the correlation of drug resistance,serotypes and genotypes of Group B Streptococcus(GBS)in perinatal pregnant females and pregnancy outcomes,and to provide a reference for clinical drug use and vaccine development.Methods A total of 123 GBS positive perinatal pregnant females(study group)and 123 GBS negative pregnant females(control group)were enrolled from January 2020 to December 2022 in Inner Mongolia People's Hospital.The pregnancy outcome of the 2 groups was compared.The drug susceptibility of GBS was analyzed in vitro.Serotyping and genotyping of GBS were performed by latex agglutination and multilocus sequence typing(MLST).The correlation between drug resistance and pathogenicity of GBS in different serotypes and genotypes was analyzed.Results The susceptibility rates of GBS to vancomycin,quinupristindafoputin,linezolid,gentamicin,ampicillin,penicillin and ceftriaxone were all>91.00%,and they were resistant to furantoin,levofloxacin,clindamycin and erythromycin in different degrees.The serotypes of GBS were mainly typeⅢ,Ⅰb andⅠa,and the genotypes were mainly ST19,ST17 and ST23.TypeⅢGBS genotypes were mainly ST19 and ST17,typeⅠb was mainly ST10 and ST12,and typeⅠa was mainly ST23.TypeⅢ,typeⅠa and ST19,ST17 GBS had the highest resistance rate to erythromycin,and the difference in resistance rate to furantoin,levofloxacin,clindamycin and erythromycin was statistically significant(P<0.05).The drug resistance rate of different serotypes of GBS to furantoin,levofloxacin,clindamycin and erythromycin was statistically significant(P<0.05),and the drug resistance rate of typeⅢGBS to the 4 antibiotics was the highest.The study group was more likely to have adverse pregnancy outcomes(P<0.05).The incidence of typeⅠa and ST23 GBS was higher in pregnant females.TypeⅢGBS clones mostly caused invasive infection in neonates,and ST17 was the main type.Conclusions GBS is highly sensitive to penicillins,cephalosporins and vancomycin.The main serotypes of GBS are typeⅢ,typeⅠa and t

关 键 词：B族链球菌 血清型 基因型 耐药性 妊娠结局 

分 类 号：R378.1[医药卫生—病原生物学]