B群链球菌感染状况及耐药性分析  

Analysis of Group B Streptococcus Infection Status and Antimicrobial Resistance

作　　者：张金花 施建丰[1] 赵巧燕 ZHANG Jinhua;SHI Jianfeng;ZHAO Qiaoyan(Department of Clinical Laboratory,Afiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine/Jiangsu Province Academy of Traditional Chinese Medicine,Nanjing 210028,China)

机构地区：[1]南京中医药大学附属中西医结合医院/江苏省中医药研究院检验科,江苏南京210028

出　　处：《药物生物技术》2024年第6期643-646,共4页Pharmaceutical Biotechnology

基　　金：国家自然科学基金(No.82202364)。

摘　　要：分析B群链球菌的临床分布和耐药性,为临床合理用药提供指导,收集江苏省中医药研究院2019年8月1日至2022年8月1日临床分离的B群链球菌115株,采用MALDI-TOF MS(郑州安图)进行细菌鉴定,应用MIC法或纸片法进行药敏试验。B群链球菌感染人群集中在40~60岁,对青霉素、头孢曲松、头孢噻肟、利奈唑胺、替加环素、万古霉素、美罗培南敏感率为100%,对氨苄西林和奎奴普丁/达福普丁的耐药率较低(3%以下),对莫西沙星、环丙沙星、左氧氟沙星的耐药率为30%~40%,对红霉素、四环素、克林霉素耐药率较高(耐药率>70%)。无乳链球菌感染最常见的部位是泌尿生殖道感染,患者主要分布于妇产科、泌尿外科及肾内科。β-内酰胺类可作为B群链球菌感染的首选一线药物,临床医生应根据药敏结果合理选择使用红霉素、四环素、克林霉素、莫西沙星、环丙沙星、左氧氟沙星,谨慎使用最后一道防线药物万古霉素。To analyze the clinical distribution and antimicrobial resistance profiles of Group B Streptococcus(GBS)and provide evidence-based guidance for the judicious selection of antimicrobial agents in clinical settings,over a three-year period from August 2019 to August 2022,115 GBS strains were meticulously collected at the Jiangsu Provincial Academy of Traditional Chinese Medicine.Bacterial identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDITOF MS,Autobio),and antimicrobial susceptibility testing was conducted using the minimum inhibitory concentration(MIC)method or disk diffusion method.This study revealed a distinct predilection for GBS infections within the 40~60 years age cohort.A uniformly high sensitivity to penicillin,cefotaxime,ceftriaxone,linezolid,tigecycline,vancomycin,and meropenem was observed,with a remarkable 100%sensitivity rate across all tested strains.In contrast,a low resistance of less than 3%was detected for ampicillin and quinupristin/dalfopristin.Moderate resistance was noted for moxifloxacin,ciprofloxacin,and levofloxacin,with rates hovering between 30%to 40%.However,an alarmingly high resistance exceeding 70%was documented for erythromycin,tetracycline,and clindamycin,underscoring a pressing clinical concern.The analysis revealed that the predilection site for GBS infections is notably the genitourinary tract,affecting patients who are predominantly encountered within the realms of gynecology and obstetrics,urology,and nephrology.Given the high sensitivity rates observed,β-lactam antibiotics stand out as the premier therapeutic agents,recommended as the firstline drugs of choice for treating GBS infections.The imperative for clinical physicians lies in the judicious and informed selection of alternative antimicrobial agents.This includes erythromycin,tetracycline,clindamycin,moxifloxacin,ciprofloxacin,and levofloxacin,which should be carefully chosen in alignment with the detailed profiles obtained from antimicrobial suscepti

关 键 词：B群链球菌 耐药性 喹诺酮 四环素 感染 临床分布 

分 类 号：R446.5[医药卫生—诊断学]