某院2020-2022年产科胎盘拭子培养中病原菌的分布、耐药性及对新生儿结局的影响  

Distribution,antimicrobial resistance and impact on neonatal outcomes of pathogenic bacteria in placental swab cultures from obstetrics in a hospital during 2020-2022

作　　者：高阳[1] 杨冬梅[1] 李幽然 高正平 寇晨[2] GAO Yang;YANG Dongmei;LI Youran;GAO Zhengping;KOU Chen(Department of Laboratory Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China;Department of Neonatology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院检验科,北京100026 [2]首都医科大学附属北京妇产医院/北京妇幼保健院新生儿科,北京100026

出　　处：《中国实验诊断学》2024年第12期1436-1440,共5页Chinese Journal of Laboratory Diagnosis

基　　金：首都医科大学附属北京妇产医院青年基金课题(编号:FCYYQN-202102)。

摘　　要：目的本研究旨在调查某院2020年至2022年产科胎盘拭子培养中病原菌的分布情况,分析其耐药性,并探讨这些病原菌对新生儿结局的影响。方法收集2020年至2022年产科胎盘拭子培养的临床数据作为研究样本。通过标准的微生物学方法,对胎盘拭子样本进行培养和鉴定,确定病原菌的种类。同时,对鉴定出的病原菌进行药敏试验,评估其对不同抗生素的耐药性。结果病原菌分布情况为革兰阴性菌以大肠埃希菌为主、产ESBLs大肠埃希菌次之;革兰阳性菌以粪肠球菌为主;真菌则以白色念珠菌为主。菌株耐药情况为革兰阴性菌对青霉素类抗生素氨苄西林耐药率最高(64.59%);革兰阳性菌对大环内酯类药物红霉素的耐药率最高(65.22%);真菌对三唑类抗生素伊曲康唑耐药率最高(60.00%),而对多烯类抗生素两性霉素则未检测出耐药株。培养阳性产妇分娩的新生儿中,共有94人生后24小时内因存出现呼吸症状或血常规异常住院治疗,其中住院诊断主要为新生儿感染(86.17%);培养阳性对新生儿生后早期住院可以产生影响(P<0.05),当病原菌为溶血葡萄球菌时,新生儿生后早期住院治疗的可能性越高(P<0.05)。结论产科胎盘拭子培养中存在广泛的病原菌分布,其中许多菌株表现出耐药性。这些病原菌的存在和耐药性与新生儿的结局密切相关,特别是对早产儿和低出生体重儿的影响更为显著。Objective The aim of this study was to investigate the distribution of pathogenic bacteria in placental swab cultures from obstetrics in a hospital between 2020 and 2022,to analyze their drug resistance,and to explore the impact of these pathogenic bacteria on neonatal outcomes.Methods Clinical data from obstetrical placental swab cultures from 2020 to 2022 were collected as study samples.Through standard microbiological methods,placental swab samples were cultured and identified to determine the species of pathogens.At the same time,the identified pathogens were tested for drug susceptibility to evaluate their resistance to different antibiotics.Results the distribution of pathogens was that Escherichia coli was the main Gram-negative bacteria,ESBLs-producing Escherichia coli was the second;Gram-positive bacteria were mainly Enterococcus faecalis;Fungi are dominated by Candida albicans.The resistance rate of Gram-negative bacteria to penicillin antibiotic ampicillin was the highest(64.59%);Gram-positive bacteria had the highest resistance rate to erythromycin(65.22%);The resistance rate of fungi to the triazole antibiotic itraconazole was the highest(60.00%),while the resistance to the polyene antibiotic amphotericin was not detected.A total of 94 newborns delivered by culture-positive parturients were hospitalized for respiratory symptoms or abnormal blood routine within 24 hours after birth,of which neonatal infection was the main diagnosis in hospitalization(86.17%);Positive culture may have an effect on neonatal hospitalization in the early postnatal period(P<0.05).When the pathogen is Staphylococcus haemolyticus,the possibility of neonatal hospitalization in the early postnatal period is higher(P<0.05).Conclusion There is a wide distribution of pathogens in obstetric placental swab cultures,many of which exhibit drug resistance.The presence and resistance of these pathogens are closely related to the outcome of newborns,especially in premature and low birth weight infants.

关 键 词：胎盘 病原菌 新生儿结局 

分 类 号：R446.5[医药卫生—诊断学]