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产时女性B族细菌定植的患病率及危险因素:一项横断面研究。

Prevalence and risk factors of group B colonisation in intrapartum women: a cross-sectional study.

作者信息

Akkaneesermsaeng Wandee, Petpichetchian Chusana, Yingkachorn Mingkwan, Sasithorn Saranya

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University , Songkhla , Thailand.

Clinical Microbiology Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University , Songkhla , Thailand.

出版信息

J Obstet Gynaecol. 2019 Nov;39(8):1093-1097. doi: 10.1080/01443615.2019.1587597. Epub 2019 Jun 14.

Abstract

A cross-sectional study was conducted at a Thai university hospital between November 2016 and March 2017 to evaluate the prevalence and risk factors of group B (GBS) colonisation in pregnant women who were admitted to the labour room for delivery. Rectovaginal specimens were collected and processed for the identification of GBS. Univariate and multiple logistic regression analyses were conducted to evaluate factors associated with GBS colonisation. Statistical significance was set at  < .05. Fifty-seven of 505 pregnant women (11.3%, 95% confidence interval [CI] 9.0-15.0%) were found to have GBS colonisation. Teenage pregnancy (odds ratio [OR] 3.83, 95% CI 1.13-13.02,  < .05), multi-parity (OR 3.59, 95% CI 1.69-7.60,  < .01) and non-Buddhist religions (OR 1.87, 95% CI 1.01-3.48,  < .05) were significantly associated with GBS colonisation. Intrapartum risk factors were not associated with GBS colonisation. Impact statement The prevalence of GBS colonisation in pregnant women varies by geographic areas and ethnicities, ranging from 2.3 to 32.9%. Risk factors for GBS colonisation have been studied but the results were inconsistent. This study reports the prevalence of GBS colonisation in intrapartum women in Southern Thailand to be 11.3%. We also identified some independent risk factors for GBS colonisation which were teenage pregnancy, multi-parity and non-Buddhist religions. To our knowledge, the relationship between religious belief and identification of GBS has never been reported before. We also found that intrapartum risk factors that have been used as the indication for intrapartum antibiotics administration have no correlation with GBS colonisation. This study adds to the literature the prevalence and risk factors of GBS colonisation in the setting of a developing country. It also shows that intrapartum risk identification alone is not an optimal strategy to reduce infection associated with GBS. Instead, prenatal GBS screening should be encouraged to identify women with GBS colonisation to reduce the risk of infection and unnecessary antibiotics exposure.

摘要

2016年11月至2017年3月期间,在泰国一家大学医院开展了一项横断面研究,以评估入住产房待产的孕妇中B族链球菌(GBS)定植的患病率及危险因素。采集直肠阴道标本并进行处理以鉴定GBS。进行单因素和多因素逻辑回归分析,以评估与GBS定植相关的因素。设定统计学显著性为<0.05。505名孕妇中有57名(11.3%,95%置信区间[CI] 9.0 - 15.0%)被发现有GBS定植。青少年妊娠(优势比[OR] 3.83,95% CI 1.13 - 13.02,<0.05)、多产(OR 3.59,95% CI 1.69 - 7.60,<0.01)和非佛教宗教信仰(OR 1.87,95% CI 1.01 - 3.48,<0.05)与GBS定植显著相关。产时危险因素与GBS定植无关。影响声明GBS在孕妇中的定植患病率因地理区域和种族而异,范围为2.3%至32.9%。已对GBS定植的危险因素进行了研究,但结果并不一致。本研究报告泰国南部产时妇女中GBS定植的患病率为11.3%。我们还确定了一些GBS定植的独立危险因素,即青少年妊娠、多产和非佛教宗教信仰。据我们所知,宗教信仰与GBS鉴定之间的关系此前从未有过报道。我们还发现,一直用作产时抗生素给药指征的产时危险因素与GBS定植无关。本研究为发展中国家背景下GBS定植的患病率和危险因素增添了文献资料。它还表明,仅靠产时风险识别并非降低与GBS相关感染的最佳策略。相反,应鼓励进行产前GBS筛查,以识别GBS定植的妇女,从而降低感染风险和不必要的抗生素暴露。

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