产时万古霉素对阴道群链球菌菌落计数的影响。

The Effect of Intrapartum Vancomycin on Vaginal Group B Streptococcus Colony Counts.

机构信息

Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.

出版信息

Am J Perinatol. 2019 May;36(6):555-560. doi: 10.1055/s-0038-1675622. Epub 2018 Nov 16.

DOI:10.1055/s-0038-1675622

PMID:30452069

Abstract

OBJECTIVE

To define the temporal relationship between intrapartum intravenous vancomycin administration and vaginal group B streptococcus (GBS) colony counts.

STUDY DESIGN

Prospective cohort study conducted from October 2014 to February 2017. Women with antenatal cultures demonstrating GBS colonization and a plan for vancomycin administration were eligible. Intrapartum vaginal cultures were collected prior to the first vancomycin infusion and every 2 hours up to five collections or delivery. Results were analyzed in two groups: participants with at least one positive intrapartum culture and those without any positive intrapartum cultures.

RESULTS

A total of 63 women were enrolled. Among consented women, a total of 8 were excluded and 3 participants' cultures were never plated, thus leaving a total of 52 women for analysis. The degree of vaginal GBS colonization varied between subjects and was not normally distributed. Colony counts dropped rapidly from hour 0 to hour 2 (median: 6.0 × 10 vs. 1.0 × 10, < 0.01). Standardizing hour 0 colony counts to 100%, the percent decline in colony counts from hour 0 to hour 2 was significant ( = 0.03), and at each subsequent time point fell further.

CONCLUSION

GBS vaginal colony counts fall rapidly after intrapartum vancomycin administration.

摘要

目的

定义产时静脉万古霉素给药与阴道型 B 组链球菌（GBS）菌落计数之间的时间关系。

研究设计

前瞻性队列研究，于 2014 年 10 月至 2017 年 2 月进行。符合条件的孕妇为产前培养显示 GBS 定植且计划给予万古霉素的患者。在首次万古霉素输注前和每 2 小时采集一次阴道培养物，最多采集 5 次或分娩。结果分析分为两组：至少有一次产时培养阳性的参与者和没有任何产时培养阳性的参与者。

结果

共纳入 63 名女性。在同意的女性中，共有 8 人被排除在外，3 名参与者的培养物从未进行平板培养，因此共有 52 名女性进行分析。受试者之间的阴道 GBS 定植程度不同，且呈非正态分布。从 0 小时到 2 小时，菌落计数迅速下降（中位数：6.0×10 对 1.0×10 ， < 0.01）。将 0 小时的菌落计数标准化为 100%，从 0 小时到 2 小时的菌落计数下降具有统计学意义（ = 0.03），且在随后的每个时间点进一步下降。