Reinhard J, Sänger N, Hanker L C, Peiffer S, Yuan J, Kempf V A J, Louwen F
Obstetrics and Gynaecology Department, St. Marienkrankenhaus Frankfurt, Frankfurt am Main.
Johann Wolfgang Goethe University Frankfurt, Frankfurt am Main.
Geburtshilfe Frauenheilkd. 2013 Jan;73(1):59-62. doi: 10.1055/s-0032-1328132.
The aim of this study was to evaluate the prevalence, spectrum and antibiotic susceptibility of bacterial and Candida colonization of the vagina between the 21st and the 33rd week of gestation in women who had preterm premature rupture of membranes (PPROM). High vaginal swabs from 245 subjects with PPROM were analyzed in a retrospective cohort study using cultivation-dependent methods. Patients were additionally divided into two groups: women with PPROM between the 21st and 27th week of gestation (group A) and women with PPROM between the 28th and 33rd week of gestation (group B). A subgroup analysis comparing the two groups was done. The prevalence of pathological bacterial colonization was similar in both study groups (40.8 vs. 41.4 %; p > 0.05), however, a difference in antibiotic susceptibility was noted, which did not reach statistical significance (resistance to ampicillin 71.4 vs. 52.5 %; cefuroxime 9.5 vs. 11.7 %; gentamicin 28.6 vs. 16.4 %; ciprofloxacin 5.0 vs. 5.4 %). In group A there was a statistically significant lower rate of Candida colonization (11.1 vs. 24.3 %; p = 0.04). In patients with early PPROM, the rate of Candida colonization (group A) is lower and there are indications of a difference in antibiotic susceptibility of the colonizing bacteria depending on gestational age. Larger study groups are required to confirm these preliminary results.
本研究的目的是评估胎膜早破(PPROM)孕妇在妊娠21至33周期间阴道细菌和念珠菌定植的患病率、谱型及抗生素敏感性。在一项回顾性队列研究中,采用培养依赖性方法对245例PPROM患者的高阴道拭子进行了分析。患者还被分为两组:妊娠21至27周的PPROM孕妇(A组)和妊娠28至33周的PPROM孕妇(B组)。对两组进行了亚组分析比较。两个研究组的病理性细菌定植患病率相似(40.8%对41.4%;p>0.05),然而,注意到抗生素敏感性存在差异,但未达到统计学显著性(氨苄西林耐药率71.4%对52.5%;头孢呋辛9.5%对11.7%;庆大霉素28.6%对16.4%;环丙沙星5.0%对5.4%)。A组念珠菌定植率在统计学上显著较低(11.1%对24.3%;p=0.04)。在早期PPROM患者中,念珠菌定植率(A组)较低,并且有迹象表明定植细菌的抗生素敏感性因孕周而异。需要更大的研究组来证实这些初步结果。