围产期孕妇B群链球菌感染的检测及耐药率分析

李明+卢炯堂+郭文婷

[摘要] 目的 分析围产期孕妇B群链球菌感染的检测及其对抗菌药物的耐药率。 方法 随机选取我院2016年1月～2017年4月进行产前检查的783例孕妇以及常规体检非妊娠期的780例女性为本次实验参与者，其中围产期孕妇占783例，非妊娠期女性780例，围产期孕妇以及非妊娠期女性均采用梅里埃B链显色平板以及布鲁克质谱仪进行B群链球菌感染检测，分析围产期孕妇B群链球菌感染检出情况，并观察B群链球菌耐药率。 结果 本次实验1563例参与者共有197例B群链球菌培养阳性，其中围产期孕妇占57.4%，阳性率12.6%，B群链球菌对青霉素、氨苄西林、头孢曲松、万古霉素未检出耐药株，对左氧氟沙星、红霉素和克林霉素的耐药率分别为27.9%、69.0%和64.5%，其中诱导克林霉素耐药17.3%。 结论 梅里埃B链显色平板可以更好地用于孕产妇B群链球菌的筛查，青霉素、氨苄青霉素、头孢菌素可用于孕产妇B群链球菌携带者的经验治疗，但采用大环内酯类和克林霉素治疗时需根据药敏试验。

[关键词] 围产期孕妇；B群链球菌感染；检测；耐药率

[中图分类号] R446.5 [文献标识码] A [文章编号] 2095-0616（2017）13-107-03

[Abstract] Objective To analyze the detection of group B streptococcus infection in perinatal pregnant women and the rate of resistance to antibiotics. Methods 783 cases of pregnant women for prenatal examination and 780 cases of non pregnant women for routine examination were randomly selected in our hospital in January 2016 to April 2017 were selected as the study participants，including perinatal pregnancy accounted for 783 cases，780 cases of non pregnant women.The perinatal pregnant women and non pregnant women were tested by bioMerieux B color plate chain Brook and the mass spectrometer for detection of group B streptococcus infection.The perinatal pregnant women group B streptococcal infection detection，and drug resistance rate of observation group B streptococcus were analyzed. Results In this experiment， among the 1563 participants，there were a total of 197 cases of group B streptococcus culture positive，including perinatal pregnant women accounted for 57.4%，the positive rate was 12.6%.The group B Streptococcus to penicillin，ampicillin，ceftriaxone，vancomycin resistant strains were not detected.The levofloxacin，erythromycin and clindamycin resistance rates were 27.9%，69% and 64.5%，of which 17.3% clindamycin resistance. Conclusion B chain color plate can be better used for screening of pregnant women of group B Streptococcus，penicillin，ampicillin，cephalosporins for treatment experience of pregnant women group B Streptococcus carriers，but the use of macrolides and clindamycin treatment should be as drug sensitivity test.

[Key words] Perinatal pregnancy；Group B streptococcus；Detection；Drug resistance

B群鏈球菌（Group B streptococcus，GBS）又名无乳链球菌是一种长期寄居于人体阴道、肠道的荚膜多糖型革兰氏阳性致病菌。围产期孕妇 B群链球菌感染几率明显高于正常健康人群，可导致围产期孕妇出现泌尿道感染、产褥期感染、早产以及胎膜早破等疾病的发生，除此之外B群链球菌还可通过母婴传播，将B群链球菌传染给新生儿，使新生儿出现肺炎、败血症、脑膜炎等疾病[1-2]。……