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目的对围产期孕妇B族链球菌(GBS)携带株的血清型及药敏结果进行分析。方法收集妊娠35~37周孕妇的阴道和直肠分泌物标本,进行细菌培养和鉴定,并统计其阳性率。采用凝集法进行血清学分型,用纸片扩散法进行药敏试验,参照2009版CLSI标准判定药敏结果,采用WHONET 5.6软件进行统计分析。结果 2 533例围产期孕妇进行GBS的检测,检出GBS 264株,阳性率10.4%(264/2 533)。并对153株菌进行了血清分型,其中Ⅲ型占54.9%(84/153)、Ⅰa型占17.6%(27/153)、Ⅰb型占13.1%(20/153);药敏试验显示:该菌对青霉素、头孢曲松、万古霉素均敏感,对左氧氟沙星、红霉素和克林霉素的耐药率分别是32.9%、68.1%和62.1%;对不同血清型的耐药情况分析发现,Ⅲ型菌株对以上3种药物的耐药率明显高于其他血清型菌株。结论孕妇阴道和直肠均为GBS的定植部位,建议应对孕妇的阴道和直肠分泌物同时送检以提高其检出率;Ⅲ型是GBS主要的血清型;青霉素仍可作为孕产妇及新生儿治疗GBS感染的首选药物,GBS阳性的孕产妇应立即进行干预治疗,以保证围产儿健康。
Objective To analyze the serotypes and susceptibility of streptococcus pneumoniae (GBS) carrier in pregnant women during perinatal period. Methods Samples of vaginal and rectal secretions of pregnant women from 35 to 37 weeks of pregnancy were collected for bacterial culture and identification, and the positive rate was calculated. The serological typing was performed by agglutination method. Drug susceptibility test was conducted by disk diffusion method. The drug susceptibility results were determined by reference to the 2009 CLSI standard and analyzed by WHONET 5.6 software. Results A total of 2 533 pregnant women of perinatal period were tested for GBS, and 264 strains of GBS were detected. The positive rate was 10.4% (264/2 533). Fifty-three isolates were serotyped, including 54.9% (84/153) of type III, 17.6% (27/153) of type Ia and 13.1% (Ib / 15) of type Ib. The bacterium was sensitive to penicillin, ceftriaxone and vancomycin. The resistance rates to levofloxacin, erythromycin and clindamycin were 32.9%, 68.1% and 62.1%, respectively. The resistance to different serotypes It was found that the drug resistance rate of type III strains to the above three drugs was significantly higher than that of other serotype strains. Conclusions The vagina and rectum of pregnant women are the colonized sites of GBS. It is suggested that the vaginal and rectal secretions of pregnant women should be examined simultaneously to improve their detection rate. Type Ⅲ is the major serotype of GBS. Penicillin can still be used as maternal and newborn treatment GBS infection of the drug of choice, GBS-positive pregnant women should immediately intervention to ensure that the perinatal health.