在埃塞俄比亚亚的斯亚贝巴的一些选定的公立产前保健中心，孕妇阴道带菌的 B 组链球菌定植情况和药敏模式。
Group B streptococci vaginal colonization and drug susceptibility pattern among pregnant women attending in selected public antenatal care centers in Addis Ababa, Ethiopia.
机构信息
Ethiopian Public Health Institute, P.O. Box 1242, Arbegnoch Street, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
出版信息
BMC Pregnancy Childbirth. 2018 May 4;18(1):135. doi: 10.1186/s12884-018-1791-4.
BACKGROUND
Group B Streptococcus (GBS) is the leading cause of septicemia, meningitis, and pneumonia in neonates. Maternal colonization with GBS is the principal risk factor for early-onset disease in infants. Group B Streptococcus is now an important cause of maternal and neonatal morbidity and mortality in many parts of the world. In Ethiopia, few studies have been done on GBS colonization among pregnant women. The aim of this study was to determine the prevalence of GBS colonization, antimicrobial susceptibility patterns and assess risk factors among pregnant women.
METHODS
A prospective cross-sectional study was conducted from May to August 2014 at selected public antenatal care (ANC) centers in Addis Ababa, Ethiopia. Clinical and socio-demographical data were collected using structured questionnaire after obtaining written informed consent. A total of 281 lower vaginal swabs were collected and inoculated into 1 ml Todd Hewitt Broth supplemented with gentamicin and nalidixic acid to prevent the growth of contaminants. After overnight incubation, all broths were subcultured on 5% sheep blood agar for isolation of GBS. Antimicrobial susceptibility testing was performed according to the criteria of the Clinical and Laboratory Standard Institute (CLSI) guidelines 2013 by disk diffusion method. Data were entered and analysed using SPSS version 20.0 software. Chi-square test and binary logistic regression analysis were used. P-value < 0.05 was considered statistically significant.
RESULTS
The overall prevalence of GBS colonization among pregnant women was 14.6% (41/281). Group B Streptococcus colonization was significantly associated with health institutions (P < 0.05). All GBS isolates were susceptible to chloramphenicol. Resistance to tetracycline, cefotaxime, clindamycin, penicillin, vancomycin, ampicillin and erythromycin was 90.2%, 34.1, 26.8%, 19.5, 17%, 14.6 and 7.5% respectively. Multidrug resistance (MDR) (≥ 2 drugs) was detected in 43.9% (18/41) of the isolates.
CONCLUSION
There was a high frequency of GBS colonization (14.6%) and resistance to the commonly used antibiotics which suggests the importance of the screening of GBS colonization in pregnant women at 35-37 weeks of gestation and testing their antimicrobial susceptibilities in order to provide antibiotic prophylaxis and minimize newborn infection and co-morbidity.
背景
B 群链球菌（GBS）是导致新生儿败血症、脑膜炎和肺炎的主要原因。孕妇带菌是导致婴儿早发性疾病的主要危险因素。GBS 现在是世界上许多地区产妇和新生儿发病率和死亡率的重要原因。在埃塞俄比亚，很少有研究针对孕妇的 GBS 定植情况进行研究。本研究旨在确定 GBS 定植率、抗生素药敏模式并评估孕妇的危险因素。
方法
本前瞻性横断面研究于 2014 年 5 月至 8 月在埃塞俄比亚亚的斯亚贝巴选定的公共产前护理（ANC）中心进行。在获得书面知情同意后，使用结构化问卷收集临床和社会人口统计学数据。共采集 281 份下生殖道拭子，接种于 1ml 含庆大霉素和萘啶酸的 Todd-Hewitt 肉汤中，以防止污染物生长。过夜孵育后，所有肉汤均在 5%绵羊血琼脂上进行培养，以分离 GBS。根据临床和实验室标准协会（CLSI）指南 2013 年的标准，采用纸片扩散法进行抗生素药敏试验。数据采用 SPSS 20.0 软件录入和分析。采用卡方检验和二项逻辑回归分析。P 值<0.05 为统计学显著。
结果
孕妇中 GBS 定植率总体为 14.6%（41/281）。GBS 定植与医疗机构显著相关（P<0.05）。所有 GBS 分离株均对氯霉素敏感。对四环素、头孢噻肟、克林霉素、青霉素、万古霉素、氨苄西林和红霉素的耐药率分别为 90.2%、34.1%、26.8%、19.5%、17%、14.6%和 7.5%。41 株分离株中 43.9%（18/41）为多重耐药（MDR）（≥2 种药物）。
结论
GBS 定植率较高（14.6%），对常用抗生素耐药，提示在妊娠 35-37 周时对孕妇进行 GBS 定植筛查，并检测其抗生素药敏性，以提供抗生素预防，尽量减少新生儿感染和并发症的重要性。
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