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中国成都B族链球菌临床感染及耐药性特征分析

Characterization of clinical infection and drug resistance of group B streptococcus in Chengdu, China.

作者信息

Wang Qin, Huang Yuxia, Liu Xiaoli, Deng Lin, Xia Jingruo, Wen Feng, Liu Chenggui, Zhu Xuan, Zhang Jiajia

机构信息

Medical Laboratory Department , Sichuan Province Orthopedic Hospital, Chengdu 610041, China.

Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China.

出版信息

Indian J Med Microbiol. 2024 Nov-Dec;52:100742. doi: 10.1016/j.ijmmb.2024.100742. Epub 2024 Oct 9.

Abstract

OBJECTIVE

To investigate the clinical infection characteristics and antibiotic resistance of Group B Streptococcus (Streptococcus agalactiae, GBS) in Chengdu, China, from 2019 to 2021, as well as to provide data to support rational clinical drug use.

METHODS

This was a retrospective study to collect 203 culture-positive GBS strains isolated from January 2019 to December 2021 in Chengdu, China, all of which were identified by the VITEK 2 Compact automated microbial Bacterial identification instrument. Data were derived using WHONET 5.6 software. The sample type and ward distribution were counted. Pregnant women and newborns were screened from the original data and their pregnancy outcomes were calculated respectively.

RESULTS

GBS strains were mainly concentrated in obstetrics and neonatology departments, accounting for 40.9 % and 33.5 %. The types of specimens were mainly vaginal secretions, amniotic fluid and sputum, accounting for 25.6 %, 26.1 % and 18.7 %, respectively. Chorioamnionitis, premature rupture of membranes and preterm delivery occurred mainly in pregnant women after infection, accounting for 44.4 %, 31.5 % and 24.1 %. Neonates, on the other hand, were mainly diagnosed with neonatal pneumonia, neonatal sepsis, respiratory failure and septic meningitis, accounting for 91.8 %, 61.2 %, 44.9 % and 16.3 % of all positive neonates. 840 pregnant women were screened for GBS colonization from 2019 to 2021, and a total of 108 GBS positive pregnant women were identified, with a GBS colonization rate of 12.9 %. A total of 9 neonates from 108 GBS positive pregnant women developed early-onset disease. The morbidity in neonates was 8.3 %. No strains resistant to penicillin and ampicillin were found, while the resistance rates of tetracycline and clindamycin were higher than 50 %, respectively 60.1 % and 53.2 %.

CONCLUSION

GBS infection mainly affected pregnant women and newborns in Chengdu, China, which can lead to adverse maternal and infant outcomes. Attention should be paid to strengthening general screening of GBS in perinatal urogenital secretions and the prevention strategy of IAP (intrapartum antibiotic prophylaxis). Antimicrobial therapy should be administered with appropriate antibiotics. Penicillin was still the first line drug for the treatment of GBS. These initiatives were important to reduce mother-to-child transmission and neonatal infections.

摘要

目的

调查2019年至2021年中国成都地区B族链球菌(无乳链球菌,GBS)的临床感染特征及耐药情况,为临床合理用药提供依据。

方法

本研究为回顾性研究,收集2019年1月至2021年12月在中国成都分离出的203株GBS培养阳性菌株,均采用VITEK 2 Compact全自动微生物鉴定仪进行鉴定。使用WHONET 5.6软件进行数据分析。统计样本类型及科室分布情况。从原始数据中筛选出孕妇及新生儿,并分别计算其妊娠结局。

结果

GBS菌株主要集中在产科和新生儿科,分别占40.9%和33.5%。标本类型主要为阴道分泌物、羊水和痰液,分别占25.6%、26.1%和18.7%。绒毛膜羊膜炎、胎膜早破和早产主要发生在感染后的孕妇中,分别占44.4%、31.5%和24.1%。另一方面,新生儿主要诊断为新生儿肺炎、新生儿败血症、呼吸衰竭和化脓性脑膜炎,分别占所有阳性新生儿的91.8%、61.2%、44.9%和16.3%。2019年至2021年共筛查840例孕妇GBS定植情况,共鉴定出108例GBS阳性孕妇,GBS定植率为12.9%。108例GBS阳性孕妇中共9例新生儿发生早发型疾病,新生儿发病率为8.3%。未发现对青霉素和氨苄西林耐药的菌株,而四环素和克林霉素的耐药率均高于50%,分别为60.1%和53.2%。

结论

GBS感染主要影响中国成都地区的孕妇和新生儿,可导致母婴不良结局。应重视加强围产期泌尿生殖道分泌物GBS的普遍筛查及产时抗生素预防性应用(IAP)策略。抗菌治疗应选用合适的抗生素。青霉素仍是治疗GBS的一线用药。这些举措对于减少母婴传播和新生儿感染具有重要意义。

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