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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

37

期数:

2020年5

页码:

462-464

栏目:

临床研究

出版日期:

2020-05-05

文章信息/Info

Title:

Influence of Streptococcus Group B infection on the maternal and infant outcomes in pregnant women

作者:

李金霞

（开封市中心医院妇产科，河南　开封　475000)

Author(s):

LI Jinxia

(Department of Obstetrics and Gynecology,Kaifeng Central Hospital,Kaifeng 475000,Henan Province,China)

关键词:

妊娠女性; B族链球菌; 药物敏感性; 母婴结局

Keywords:

pregnant women; Streptococcus Group B; drug sensitivity; maternal and infant outcomes

分类号:

R714.7

DOI:

10.7683/xxyxyxb.2020.05.015

文献标志码:

A

摘要:

目的　探讨妊娠期B族链球菌感染对母婴结局的影响。方法　选择2015年1月至2018年1月于开封市中心医院进行完整产前检查的108例孕妇为研究对象，所有孕妇于28孕周时应用无菌棉拭子采集阴道分泌物和肛周分泌物，使用革兰阳性球菌鉴定板和全自动微生物鉴定仪检测B族链球菌，采用纸片扩散法分析B族链球菌的药物敏感性，分析妊娠期B族链球菌感染对母婴结局的影响。结果　108例孕妇中， B族链球菌感染14例（感染组），无B族链球菌感染94例（非感染组）。药物敏感性试验结果显示，B族链球菌对头孢吡肟、头孢曲松、万古霉素及青霉素的敏感率均为100.0%（32/32），对头孢唑林、庆大霉素、环丙沙星、红霉素、四环素的敏感率分别为96.9%（31/32）、84.4%（27/32）、81.3%（26/32）、34.4%（11/32）、31.3%（10/32）。感染组孕妇胎膜早破、宫内感染、胎儿窘迫、早产、产后出血发生率分别为21.4%（3/14）、21.4%（3/14）、14.3%（2/14）、14.3%（2/14）、7.1%（1/14），不良妊娠结局发生率为78.6%（11/14）；非感染组胎膜早破、宫内感染、胎儿窘迫、早产、产后出血发生率分别为7.4%（7/94）、6.4%（6/94）、5.3%（5/94）、6.4%（6/94）、2.1%（2/94），不良妊娠结局发生率为27.7%（26/94）；感染组孕妇不良妊娠结局发生率显著高于非感染组（χ²=14.024，P＜0.05），感染组孕妇胎膜早破、宫内感染、胎儿窘迫和早产发生率显著高于非感染组（χ²=5.021、5.129、4.856、4.847，P＜0.05），2组孕妇产后出血发生率比较差异无统计学意义（χ²=1.185，P＞0.05）。感染组和非感染组新生儿出生体质量分别为（3.06±0.27）、（3.96±0.31）kg，感染组新生儿出生体质量小于非感染组（t=2.241，P＜0.05）。感染组新生儿窒息、新生儿感染发生率分别为7.1%（1/14）、21.4%（3/14），非感染组新生儿窒息、新生儿感染发生率分别为7.4%（7/94）、5.3%（5/94）；感染组新生儿感染发生率显著高于非感染组（χ²=5.723，P＜0.05），2组新生儿窒息发生率比较差异无统计学意义（χ²=0.893，P＞0.05）。结论　妊娠期B族链球菌感染具有一定的发生率，对母婴结局有不良影响；妊娠女性应进行B族链球菌检查，并根据药物敏感性试验结果选择合适的、敏感的抗生素进行治疗。

Abstract:

Objective　To investigate the influence of Streptococcus Group B infection on the maternal and infant outcomes in pregnant women.Methods　A total of 108 pregnant women who underwent complete prenatal care in Kaifeng Central Hospital from January 2015 to January 2018 were selected as the subjects.The vaginal and perianal secretions of all pregnant women were collected with sterile cotton swabs at the 28^th week of gestation,The Streptococcus Group B were detected by Gram-positive cocci identification plate and automatic microbial identification instrument,the drug sensitivity of Streptococcus Group B was analyzed by disk diffusion test,and the influence of Streptococcus Group B infection on the maternal and infant outcome was analyzed.Results　Among the 108 pregnant women,14 cases were infected with Streptococcus Group B (infection group),and 94 cases were not infected with Streptococcus Group B (non-infection group).The results of drug sensitivity test showed that the sensitivity of Streptococcus Group B to cefepime,ceftriaxone,vancomycin and penicillin was 100.0% (32/32),and the sensitivity of Streptococcus Group B to cefazolin,gentamycin,ciprofloxacin,erythromycin and tetracycline was 96.9% (31/32),84.4% (27/32),81.3% (26/32),34.4% (11/32) and 31.3% (10/32),respectively.In the infection group,the incidence of premature rupture of membranes,intrauterine infection,fetal distress,premature delivery and postpartum hemorrhage was 21.4% (3/14),21.4% (3/14),14.3% (2/14),14.3% (2/14) and 7.1% (1/14),respectively;and the incidence of adverse pregnancy outcome was 78.6% (11/14).In the non-infection group,the incidence of premature rupture of membranes,intrauterine infection,fetal distress,premature delivery and postpartum hemorrhage was 7.4% (7/94),6.4% (6/94),5.3% (5/94),6.4% (6/94) and 2.1% (2/94),respectively;and the incidence of adverse pregnancy outcome was 27.7% (26/94).The incidence of adverse pregnancy outcome in the infection group was significantly higher than that in the non-infection group (χ²　=14.024,P＜0.05).The incidences of premature rupture of membranes,intrauterine infection,fetal distress and premature delivery in the infection group were significantly higher than those in the non-infection group (χ²　=5.021,5.129,4.856,4.847;P＜0.05).There was no significant difference in the incidence of postpartum hemorrhage between the two groups (χ²　=1.185,P>0.05).The birth weight of the neonatus in the infection group and the non-infection group was (3.06±0.27), (3.96±0.31) kg,respectively.The birth weight of the neonatus in the infection group was lower than that in the non-infection group (t=2.241,P＜0.05).The incidence of asphyxia and infection of the neonatus in the infection group was 7.1% (1/14) and 21.4% (3/14),respectively;and the incidence of asphyxia and infection of the neonatus in the non-infection group was 7.4% (7/94) and 5.3% (5/94),respectively.The incidence of infection of newborn in the infection group was significantly higher than that in the non-infection group (χ²　=5.723,P＜0.05).There was no significant difference in the incidence of neonatal asphyxia between the two groups (χ²　=0.893,P>0.05).Conclusion　Streptococcus Group B infections in pregnancy has a certain incidence,which has adverse effects on the maternal and infant outcomes.The detection of Streptococcus Group B should be carried out in pregnant women,and the appropriate and sensitive antibiotics should be selected for treatment according to the results of the drug sensitivity test.

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更新日期/Last Update: 2020-05-05