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定植于越南某医院孕妇群体中的 B 型链球菌的抗微生物耐药性。

Antimicrobial resistance in colonizing group B Streptococcus among pregnant women from a hospital in Vietnam.

机构信息

National Hospital of Obstetrics and Gynecology, Hanoi, 100000, Vietnam.

Intensive Care Unit, 103 Military Hospital, Hanoi, 100000, Vietnam.

出版信息

Sci Rep. 2021 Oct 21;11(1):20845. doi: 10.1038/s41598-021-00468-3.

Abstract

Few studies have been conducted on group B Streptococcus (GBS) in Vietnam. We determined the GBS colonization and antimicrobial resistance vaginal-rectal profile of 3863 Vietnamese pregnant women over 5 years. Maternal GBS colonization was characterized by antibiotic susceptibility. Overall, the GBS colonization rate was 8.02% (95% CI: 7.20-8.94%). Compared to sampling ≥ 35 weeks of gestation, the GBS colonization rate was statistically higher (p = 0.004) with sampling < 35 weeks. Among 272 antimicrobial susceptibility testing isolates, all were susceptible to ampicillin, penicillin, ceftriaxone, cefotaxime, vancomycin, and quinupristin/dalfopristin. Resistance was highest for tetracycline (89.66%), followed by erythromycin (76.23%) and clindamycin (58.21%). Multidrug resistance and resistance to ≥ 6 different antibiotics were 60.66% and 8.82%, respectively. Resistance to clindamycin but not erythromycin (L phenotype) was 2.2%. The clindamycin resistance rate was significantly increased (p = 0.005) during the study period. These data demonstrate a low rate of maternal GBS colonization. The high rate of erythromycin, clindamycin, and multidrug resistance to GBS that can be transmitted to neonates is an important risk factor to consider. β-lactams continue to be appropriate for first-line treatment and prophylaxis in the study area. Ongoing monitoring should be considered in the future.

摘要

少有研究针对越南的 B 型链球菌(GBS)展开。我们对 3863 名越南孕妇进行了为期 5 年的阴道直肠 GBS 定植和抗菌药物耐药性检测。通过药敏试验对母体 GBS 定植情况进行分析。结果显示,GBS 定植率为 8.02%(95%CI:7.20-8.94%)。相较于≥35 孕周采样,<35 孕周采样的 GBS 定植率更高(p=0.004)。272 株药敏试验分离株均对氨苄西林、青霉素、头孢曲松、头孢噻肟、万古霉素和奎奴普丁/达福普汀敏感。耐药率最高的是四环素(89.66%),其次是红霉素(76.23%)和克林霉素(58.21%)。多重耐药和耐药≥6 种不同抗生素的比例分别为 60.66%和 8.82%。克林霉素耐药但红霉素耐药(L 表型)的比例为 2.2%。研究期间,克林霉素耐药率显著升高(p=0.005)。这些数据表明母体 GBS 定植率较低。但由于 GBS 对红霉素、克林霉素耐药率高且可传播给新生儿,耐药率高仍是一个重要的危险因素。在研究地区,β-内酰胺类药物仍适合作为一线治疗和预防用药。未来应考虑进行持续监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0680/8531308/4ca927f48992/41598_2021_468_Fig1_HTML.jpg

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