国际妇产科学杂志 ›› 2019, Vol. 46 ›› Issue (6): 657-660.

• 论著 • 上一篇    下一篇

围生期孕妇生殖道B族链球菌耐药性变迁及血清型分布研究

谢云,杨柳,屈蕾,王丽滨,孟改利,杨军兰   

  1. 710061 西安,西北妇女儿童医院医学检验中心
  • 收稿日期:2019-04-16 修回日期:2019-05-06 出版日期:2019-12-15 发布日期:2019-12-15
  • 通讯作者: 杨军兰,E-mail:2675751@qq.com E-mail:2675751@qq.com
  • 基金资助:
    陕西省自然科学基础研究(2016JQ8058)

Changes of Antibiotic Resistance and Serotype Distribution of Group B Streptococcus in the Reproductive Tract of Pregnant Women during Perinatal Period

XIE Yun,YANG Liu,QU Lei,WANG Li-bin,MENG Gai-li,YANG Jun-lan   

  1. Department of Clinical Laboratory,Northwest Women′s and Children′s Hospital,Xi′an 710061,China
  • Received:2019-04-16 Revised:2019-05-06 Published:2019-12-15 Online:2019-12-15
  • Contact: YANG Jun-lan,E-mail:2675751@qq.com E-mail:2675751@qq.com
  • Supported by:
     

摘要: 目的:了解西安地区孕产妇生殖道B族链球菌(group B Streptococcus,GBS)的血清型分布特征及GBS对常规抗菌药物的耐药谱,为临床预防与治疗提供依据。方法:收集2015年1月—2017年12月在西北妇女儿童医院产科接受产前GBS筛查的孕晚期孕妇阴道拭子培养出的GBS共498株。采用多重聚合酶链反应(PCR)方法测定GBS血清型,并进行药物敏感性试验和表型筛查试验。结果:所有GBS分离株均对青霉素、头孢曲松、万古霉素、利奈唑胺敏感。GBS对红霉素、克林霉素及左氧氟沙星耐药率分别为76.7%、73.5%和58.0%,且红霉素的耐药率呈逐年上升趋势。表型为结构型耐药(cMLSB)的GBS菌株占红霉素耐药菌株的首位(88.2%),而诱导型耐药(iMLSB)和M型耐药菌株仅占耐药株的5.5%和6.3%。最常见的血清型为Ⅲ型,其次为Ⅰa 型、Ⅴ型、Ⅰb 型、Ⅱ型和Ⅵ型。结论:①西安地区孕产妇生殖道GBS定植率与我国其他地区相似或略低;②血清型Ⅲ占主要地位;③红霉素、克林霉素、左氧氟沙星耐药率高于其他地区,且红霉素耐药率呈逐年上升趋势。

关键词: 无乳链球菌, 孕妇, 血清分型, 抗药性, 细菌

Abstract: Objective:To investigate the distribution characteristics of group B Streptococcus(GBS) serotypes isolated from pregnant women in Xi′an and the resistance spectrum of GBS to conventional antibiotics. Methods:A total of 498 GBS strains were collected from cultures of vaginal swabs of pregnant women in late pregnancy who received prenatal GBS screening in obstetrics department of Northwest Women′s and Children′s Hospital from January 2015 to December 2017. The serotype of GBS was determined by multiple PCR and the antibiotics sensitivity test and phenotype screening test were carried out. Results:All GBS isolates were sensitive to penicillin, ceftriaxone, vancomycin and linezolid. The resistance rates of GBS to erythromycin, clindamycin and levofloxacin were 76.7%, 73.5% and 58.0% respectively, and the resistance rate of erythromycin was increasing year by year. The predominant resistance phenotype was cMLSB(88.2%) among erythromycin-resistant strains, while iMLSB and M type strains accounted for only 5.5% and 6.3%. The most common serotypes were serotype Ⅲ, followed by Ⅰa, Ⅴ, type Ⅰb, Ⅱ and Ⅵ. Conclusions:(1) The vaginal colonization prevalence of GBS of pregnant women in Xi′an was similar to or slightly lower than that in other areas of China; (2) Six serotypes were identified with type Ⅲ being predominant; (3) The resistance rates of erythromycin, clindamycin and levofloxacin were higher than those of other areas, and the resistance rates of erythromycin were increasing year by year.

Key words: Streptococcus agalactiae, Pregnant women, Serotyping, Drug resistance, bacterial

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