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胎膜早破时阴道高位拭子中的阴道微生物群:一项描述性横断面研究。

Vaginal Microflora in High Vaginal Swab in Prelabour Rupture of Membrane: A Descriptive Cross-sectional Study.

机构信息

Department of Obstetrics and Gynaecology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.

Department of General Practice and Emergency Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2024 Jul 31;62(276):532-535. doi: 10.31729/jnma.8737.

Abstract

INTRODUCTION

Premature rupture of membrane (PROM) refers to the disruption of the fetal membrane before the beginning of labor, resulting in spontaneous leakage of amniotic fluid. Cervicovaginal infection is an important risk factor of PROM and can lead to complications to mother and the child. This study aimed to delineate the bacterial patterns found in PROM so that the ideal appropriate responsive antibiotics can be chosen.

METHODS

A descriptive cross-sectional was done during the period of 6 months from December of 2023 to May 2023, to characterize the microorganisms in the vaginal fluid found in antenatal women presenting with premature rupture of membraneafter obtaining ethical approval (IRC number: 20102023/02). A total of 117 antenatal women diagnosed with premature rupture of membrane were included in the study. High vaginal swabs were collected for microbial culture and sensitivity. Data were entered using Microsoft Excel 2000 (v9.0) and Statistical Package for the Social Sciences (SPSS) software version 26.0 was used for analysis.

RESULTS

Out of 117 samples, culture growth was present in the culture of high vaginal swabs of 23 (19.66%) women. The high vaginal swab cultures from the samples collected in women presenting with PROM reported 9 different types of pathogens E. coli in 12 (52.17%), Klebsiella in 4 (17.39%) and Pseudomonas in 2 (8.70%) cultures.

CONCLUSIONS

This study reveals diverse microorganisms in premature rupture of membrane cases, with E. coli being the most common. Identifying these bacterial patterns is essential for selecting effective antibiotics, improving maternal and neonatal outcomes, and reducing morbidity and mortality by early detection and treatment of vaginal infections.

摘要

引言

胎膜早破(PROM)是指分娩开始前胎儿膜的破裂,导致羊水自发泄漏。宫颈阴道感染是 PROM 的一个重要危险因素,并可能导致母婴并发症。本研究旨在描绘 PROM 中发现的细菌模式,以便选择理想的适当反应性抗生素。

方法

在 2023 年 12 月至 2023 年 5 月的 6 个月期间进行了一项描述性的横断面研究,以描述在获得伦理批准后(IRC 编号:20102023/02)出现胎膜早破的产前妇女阴道液中发现的微生物。共有 117 名被诊断为胎膜早破的产前妇女纳入研究。采集阴道拭子进行微生物培养和药敏试验。使用 Microsoft Excel 2000(v9.0)输入数据,并使用统计软件包(SPSS)版本 26.0 进行分析。

结果

在 117 个样本中,有 23 名(19.66%)妇女的阴道拭子培养有生长。从出现 PROM 的妇女采集的阴道拭子培养报告了 9 种不同类型的病原体:大肠埃希菌 12 例(52.17%)、克雷伯菌 4 例(17.39%)和铜绿假单胞菌 2 例(8.70%)。

结论

本研究揭示了胎膜早破病例中存在多种微生物,其中大肠埃希菌最为常见。识别这些细菌模式对于选择有效的抗生素、改善母婴结局以及通过早期发现和治疗阴道感染来降低发病率和死亡率至关重要。

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本文引用的文献

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Antibiotics in the management of PROM and preterm labor.抗生素在胎膜早破和早产管理中的应用。
Obstet Gynecol Clin North Am. 2012 Mar;39(1):65-76. doi: 10.1016/j.ogc.2011.12.007. Epub 2012 Jan 28.
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Antibiotic therapy in preterm premature rupture of the membranes.胎膜早破早产的抗生素治疗
J Obstet Gynaecol Can. 2009 Sep;31(9):863-867. doi: 10.1016/S1701-2163(16)34305-5.
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Premature rupture of the fetal membranes.胎膜早破
N Engl J Med. 1998 Mar 5;338(10):663-70. doi: 10.1056/NEJM199803053381006.
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Vaginal infection and preterm labour.阴道感染与早产
Br J Obstet Gynaecol. 1991 May;98(5):427-35. doi: 10.1111/j.1471-0528.1991.tb10335.x.

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