埃塞俄比亚东南部吉吉加产前诊所就诊孕妇中B族链球菌定植的抗菌药物耐药性概况及相关因素
Antimicrobial Resistance Profile and Associated Factors of Group B Streptococci Colonization among Pregnant Women Attending Antenatal Clinics in Jigjiga, Southeast Ethiopia.
作者信息
Tesfaye Addisu, Melese Addisu, Derbie Awoke
机构信息
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia.
Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
出版信息
Int J Microbiol. 2022 Mar 31;2022:9910842. doi: 10.1155/2022/9910842. eCollection 2022.
BACKGROUND
(group B , GBS) is one of the causes of maternal and neonatal morbidity and mortality in many parts of the world. It is associated with severe maternal and neonatal outcomes. The colonization rate, associated factors, and antimicrobial sensitivity (AST) profile of GBS among pregnant women in Eastern Ethiopia is less studied.
METHODS
A cross-sectional study was conducted from 1 March to 30 May, 2021 in Jigjiga. A total of 182 pregnant women with a gestational period of ≥36 weeks were included. A structured questionnaire was used to collect data on the participants' demographic and clinical history. Vaginal-rectal samples were collected by brushing the lower vagina and rectum with a sterile cotton swab for bacteriological culture. An antimicrobial sensitivity test (AST) was performed using the Kary-Bauer disk diffusion method. Data were entered and analyzed using SPSS version 25. The logistic regression model was used to find out factors associated with GBS colonization.
RESULTS
GBS colonization among pregnant women attending antenatal care was at 15.9% (29/182). The AST result showed that the majority of the isolates were sensitive to vancomycin (96.6%), chloramphenicol (96.6%), ampicillin (93.1%) azithromycin (89.7%), and penicillin (86.2%). In contrast, the isolates were found to be resistant to ceftriaxone, erythromycin, ciprofloxacin, clindamycin, and tetracycline at 17.2%, 20.7%, 27.6%, 27.6%, and 34.5%, respectively. Multidrug resistance (MDR) was noted in 4 isolates (13.79%). GBS colonization was significantly associated a with history of preterm labor (<37 weeks of gestation) (AOR = 3.87, 95% CI = 1.36-10.9) and a history of prolonged ruptured membrane (>18 hr.) (AOR = 3.44, 95% CI = 1.34-8.83).
CONCLUSIONS
The colonization rate of GBS was considerably high among pregnant women attending antenatal care in the present study area. The observed antimicrobial resistance for the common drugs and the reported MDR level calls for routine screening of pregnant women for GBS and actions to minimize antimicrobial resistance (AMR) should be strengthened.
背景
B族链球菌（GBS）是世界许多地区孕产妇和新生儿发病及死亡的原因之一。它与严重的孕产妇和新生儿结局相关。埃塞俄比亚东部孕妇中GBS的定植率、相关因素及抗菌药物敏感性（AST）情况研究较少。
方法
2021年3月1日至5月30日在吉吉加进行了一项横断面研究。共纳入182名孕周≥36周的孕妇。使用结构化问卷收集参与者的人口统计学和临床病史数据。通过用无菌棉拭子擦拭阴道下段和直肠收集阴道-直肠样本进行细菌培养。采用Kary-Bauer纸片扩散法进行抗菌药物敏感性试验（AST）。数据录入并使用SPSS 25版进行分析。采用逻辑回归模型找出与GBS定植相关的因素。
结果
接受产前检查的孕妇中GBS定植率为15.9%（29/182）。AST结果显示，大多数分离株对万古霉素（96.6%）、氯霉素（96.6%）、氨苄西林（93.1%）、阿奇霉素（89.7%）和青霉素（86.2%）敏感。相比之下，分离株对头孢曲松、红霉素、环丙沙星、克林霉素和四环素的耐药率分别为17.2%、20.7%、27.6%、27.6%和34.5%。4株分离株（13.79%）存在多重耐药（MDR）。GBS定植与早产史（孕周<37周）（比值比[AOR]=3.87，95%置信区间[CI]=1.36 - 10.9）和胎膜早破史（>18小时）（AOR = 3.44，95% CI = 1.34 - 8.83）显著相关。
结论
在本研究地区，接受产前检查的孕妇中GBS定植率相当高。观察到的常见药物抗菌耐药性及报告的MDR水平表明，应对孕妇进行GBS常规筛查，并应加强采取措施以尽量减少抗菌药物耐药性（AMR）。
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