妊娠中期孕妇宫颈分泌物病原菌特征及其对母婴结局的影响  

Characteristics of pathogenic bacteria in cervical secretions of pregnant women in mid pregnancy and their impact on maternal and infant outcomes

作　　者：徐君娜 王新彦 王月 卢白雪 葛建营 XU Junna;WANG Xinyan;WANG Yue;LU Baixue;GE Jianying(First Department of Obstetrics,Cangzhou Municipal Maternal and Child Healthcare Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]河北省沧州市妇幼保健院产一科,河北沧州061000

出　　处：《检验医学与临床》2024年第12期1775-1778,共4页Laboratory Medicine and Clinic

基　　金：河北省卫生健康委医学科学研究项目(20181537)。

摘　　要：目的分析妊娠中期孕妇宫颈分泌物病原菌特征及其对母婴结局的影响。方法选取2021年1月至2022年6月在该院产科行常规产前检查的560例妊娠中期孕妇作为研究对象,分析妊娠中期孕妇宫颈分泌物病原菌检出情况。根据宫颈分泌物中病原菌检出情况将孕妇分为检出组(检出病原菌)和未检出组(未检出病原菌),比较宫颈分泌物病原菌检出组和未检出组孕妇阴道分泌物清洁度异常、细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)、B链球菌(GBS)感染等发生率,以及母婴结局。结果560例妊娠中期孕妇宫颈分泌物检测共检出致病菌368株。368株病原菌中革兰阴性菌116株(31.52%),以大肠埃希菌(13.04%)和肺炎克雷伯菌(7.61%)为主;革兰阳性菌80株(21.74%),以金黄色葡萄球菌(9.78%)为主;真菌172株(46.74%),以白色假丝酵母菌(28.26%)和克柔假丝酵母菌(8.70%)为主。按宫颈分泌物中病原菌检出情况将孕妇分为检出组162例和未检出组398例。宫颈分泌物病原菌检出组孕妇阴道分泌物清洁度异常、BV、VVC和GBS感染发生率均明显高于未检出组(P<0.05)。检出组孕妇足月分娩率为75.93%,显著低于未检出组的91.21%(P<0.05),胎膜早破、羊水污染和产时新生儿呼吸窘迫发生率均明显高于未检出组(P<0.05)。结论妊娠中期孕妇宫颈分泌物菌种分布广,以白色假丝酵母菌、大肠埃希菌和金黄色葡萄球菌为主,这可能是造成妊娠中期孕妇不良母婴结局发生风险增高的主要因素。Objective To analyze the characteristics of pathogenic bacteria in cervical secretions of pregnant women in mid pregnancy and their impact on maternal and infant outcomes.Methods A total of 560 mid pregnancy pregnant women with routine prenatal examinations in the obstetrics department of this hospital from January 2021 to June 2022 were selected as the research subjects and divided into the detected group(with detected pathogens)and non-detected group(without detected pathogens)according to the detection situation of pathogens in cervical secretions.The abnormal cleanliness of vaginal secretions,bacterial vaginosis(BV),vulvovaginal candidiasis(VVC)and B-streptococcal(GBS)infections,as well as maternal and infant outcomes,were compared between the detected and undetected groups.Results In 368 cases of cervical secretions detection,368 strains of pathogenic bacteria were detected.Among 368 pathogenic bacteria,116 strains(31.52%)were Gram negative,mainly Escherichia coli(13.04%)and Klebsiella pneumoniae(7.61%);80 strains(21.74%)of Gram positive bacteria,mainly Staphylococcus aureus(9.78%);172 strains of fungi(46.74%),mainly Candida albicans(28.26%)and Candida krusei(8.70%).The pregnant women were divided into the detection group(162 cases)and non-detection group(398 cases)based on the detection situation of pathogens in cervical secretions.The incidence rates of abnormal cleanliness of vaginal secretions and infections of BV,VVC and GBS in the cervical secretion pathogen detection group were significantly higher than those in the non-detection group(P<0.05).The full-term delivery rate of the pregnant women in the detection group was 75.93%,which was significantly lower than 91.21%in the non-detection group(P<0.05).The incidence rates of premature rupture of membranes,amniotic fluid contamination and neonatal respiratory di stress during delivery were all significantly higher those in the non-detection group(P<0.05).Conclusion The cervical secretions bacterial species of pregnant women in mid pregnancy are widely di

关 键 词：妊娠中期孕妇 宫颈分泌物 病原菌分布 母婴结局 

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