国际妇产科学杂志

国际妇产科学杂志 ›› 2019, Vol. 46 ›› Issue (5): 515-518.

• 论著 • 上一篇    下一篇

沈阳地区孕晚期妇女携带B群链球菌不同血清型的调查研究

高爽，孙晓娟，柳中洋，丛桂敏，阮强   

  1. 110011 沈阳市妇婴医院检验科（高爽，孙晓娟，丛桂敏）；中国医科大学附属盛京医院病毒室（柳中洋，阮强）
  • 收稿日期:2018-11-27 修回日期:2019-03-10 出版日期:2019-10-15 发布日期:2019-10-21
  • 通讯作者: 高爽，E-mail：gaosllz@163.com E-mail:gaosllz@163.com
  • 基金资助:
    辽宁省自然科学基金项目（20170540839）

Investigation of Different Serotype Distribution of Group B Streptococcus in Women with Late Pregnancy in Shenyang Area

GAO Shuang, SUN Xiao-juan, LIU Zhong-yang, CONG Gui-min, RUAN Qiang   

  1. Clinical Diagnostic Laboratory, Shenyang Women′s and Children′s hospital, Shenyang 110011, China (GAO Shuang, SUN Xiao-juan, CONG Gui-min); Virus Laboratory, Affiliated Shengjing Hospital, China Medical University, Shenyang 110004, China (LIU Zhong-yang, RUNA Qiang)
  • Received:2018-11-27 Revised:2019-03-10 Published:2019-10-15 Online:2019-10-21
  • Contact: GAO Shuang, E-mail: gaosllz@163.com E-mail:gaosllz@163.com
  • Supported by:
     

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摘要： 目的：调查沈阳地区孕晚期妇女携带B群链球菌（GBS）不同血清型分布情况及各型别间的耐药差异。方法：选取2016年5月—2017年8月于沈阳市妇婴医院产科就诊的19 122例孕晚期妇女中经细菌鉴定为GBS阳性，以居住沈阳地区3年以上的孕妇携带的GBS纯培养菌株为标本。通过聚合酶链反应（PCR）和基因测序确定GBS的血清型，比较不同GBS血清型的耐药率和胎膜早破发生率。结果：19 122例孕晚期妇女中GBS阳性者572例，GBS携带率为3.0%。源自沈阳地区的251株纯培养菌株中，GBS血清型以Ⅰa（44.22%）、Ⅴ（38.65%）、Ⅲ（13.94%）为主，并发现与血清型Ⅴ具有高度同源性的血清型NT。未发现血清型Ⅰa、Ⅲ、Ⅴ和NT存在对青霉素、氨苄西林、万古霉素、美罗培南、利奈唑胺耐药菌株。红霉素、克林霉素、左氧氟沙星和四环素对4个血清型的耐药率差异无统计学意义（均P＞0.05）。血清型Ⅰa、Ⅲ、Ⅴ对红霉素、克林霉素、左氧氟沙星和四环素4种药物的耐药率差异有统计学意义（P＜0.05），而血清型NT对4种药物的耐药率差异无统计学意义（P＞0.05）。携带Ⅰa、Ⅲ、Ⅴ和NT 4个不同血清型的孕晚期妇女胎膜早破发生率分别为23.42%、34.28%、10.31%和25.00%，差异有统计学意义（χ2=11.128，P=0.011）。结论：沈阳地区GBS携带率为3.0%，血清型Ⅰa、Ⅴ和Ⅲ为主，且各血清型间不存在耐药差异。应重视孕晚期妇女GBS的筛查工作，根据筛查结果针对性地给予抗感染治疗，减少不良妊娠结局的发生。

关键词: 链球菌, 无乳, 感染, 血清型, 药物耐受性, 胎膜早破

Abstract: Objective：To investigate the distribution of different serotypes of Group B Streptococcus (GBS) in late pregnant women in Shenyang area and the difference of drug resistance among different serotypes. Methods: 19 122 cases of late pregnant women visited to obstetrics department of Shenyang Materal and Infant Hosipital from May 2016 to August 2017 and were identified as GBS positive. The pure culture strain of GBS colleted from the pregnant women who had lived in Shenyang for more than 3 years will be selected as specimens. The serum types of GBS were determined by polymerase chain reaction (PCR) and gene sequencing. The rates of drug resistance and premature rupture of membranes were compared among different serotypes of GBS. Results: Among the 19 122 cases of late pregnant women, 572 cases were GBS positive, with a GBS carrier rate of 3.0%. Among 251 cases of pure culture strains from Shenyang area, GBS serotypes mainly were Ⅰa (44.22%) ,Ⅴ (38.65%) , Ⅲ (13.94%) , and serum NT with high homology to serotype Ⅴ was found. No resistance to Penicillin, Ampicillin, Vancomycin, Meropenem, Linezolid was found in serotypes Ⅰa, Ⅲ, Ⅴand NT. There was no significant difference in the resistance rates of Erythromycin, Clindamycin, Levofloxacin and Tetracycline to the four serotypes (All P＞0.05). There were significant differences in the resistance rates of Erythromycin, Clindamycin, Levofloxacin and Tetracycline among serotypes Ⅰa, Ⅲ, Ⅴ(P＜0.05). However, there was no statistical significant difference in drug resistance rate of serotype NT to four drugs (P＞0.05). The incidences of premature rupture of membranes in late pregnant women with serotype Ⅰa, Ⅲ, Ⅴ and NT respectively were 23.42%, 34.28%, 10.31% and 25.00%. There was significant difference ( χ2=11.128, P=0.011). Conclusions: The carrying rate of GBS was 3.0% in Shenyang area, and the main serotypes were Ⅰa, Ⅴ and Ⅲ. There was no difference in drug resistance among different serotypes. Attention should be paid to the screening of GBS in the third trimester of pregnancy, and anti-infection therapy should be given according to the screening results to reduce the occurrence of adverse pregnancy outcomes.

Key words: Streptococcus, Agalactiae, Infection, Serotype, Drug tolerance, Fetal membranes, premature rupture

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