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    孕晚期妇女B族链球菌定植情况与高危因素分析

    Analysis of the colonization and high risk factors of group B Streptococcus for women in the third trimester of pregnancy

    • 摘要: 目的调查绵阳地区围产期妇女B族链球菌(GBS)定植情况及高危因素,以便预防和控制围产期妇女及新生儿GBS感染。方法对2016年10月—2017年4月在我院作孕期检查的孕晚期孕妇取阴道直肠拭子进行GBS培养、分离、鉴定及药物敏感试验,分析GBS定植率及耐药性。采用多因素二元Logistic回归分析GBS定植的高危因素。结果本地区孕晚期孕妇阴道及直肠GBS定植率为 11.29%(77/682)。2组研究对象在年龄、孕产史、妊娠期糖尿病、妊娠期高血压方面的差异无统计学意义(P>0.05);妊娠期甲状腺功能异常是围产期妇女GBS定植的高危因素(OR=0.398,95% CI:0.205~0.774,P<0.01)。GBS对红霉素、克林霉素、左氧氟沙星、四环素的耐药率分别为74.03%、67.53%、53.25%、10.39%,未分离出对青霉素、头孢噻肟、万古霉素耐药的GBS菌株。结论有必要对本地区的孕晚期孕妇进行GBS普遍筛查,尤其是合并甲状腺功能异常的高危孕妇。青霉素可作为围产期孕妇预防GBS感染的首选药物。

       

      Abstract: ObjectiveTo investigate the colonization and high risks of group B Streptococcus (GBS) in perinatal women in Mianyang area, so as to prevent and control GBS infection in perinatal women and neonates. MethodsPregnant women in the third trimester who were examined in our hospital from October 2016 to April 2017 were enrolled. Their vaginal and rectal samples were collected for GBS colonization, separation, identification and drug resistance test. The GBS colonization and tolerance were analyzed. The high risks of GBS colonization were analyzed using multinomial logistic regression. ResultsThe positive rate of GBS colonization was 11.29% (77/682). There was no significant difference between the two groups in age, pregnancy history, gestational diabetes, and gestational hypertension (P>0.05). Gestational thyroid dysfunction was a high risk factor for perinatal GBS colonization (OR=0.398, 95% CI:0.205~0.774, P=0.007). The resistance rates of GBS to erythromycin, clindamycin, levofloxacin and tetracycline were 74.03%, 67.53%, 53.25%, and 10.39% respectively. No GBS resistant stains to penicillin, cefotaxime and vancomycin were screened out. ConclusionsIt is necessary to perform GBS screening for women in the third trimester of pregnancy in the local area, especially for those with thyroid dysfunction. Penicillin can be used as the first choice for preventative treatment of GBS infection for perinatal women.

       

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