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基于一所大学医院24年临床数据的B族链球菌对青霉素不敏感性增加与分离率上升并存

Increase in Penicillin Non-Susceptibility in Group B Streptococci Alongside Rising Isolation Rates-Based on 24 Years of Clinical Data from a Single University Hospital.

作者信息

Shin Sunghwan, Whang Dong Hee, Um Tae-Hyun, Cho Chong Rae, Chang Jeonghyun

机构信息

Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang 10380, Republic of Korea.

出版信息

Antibiotics (Basel). 2025 Sep 13;14(9):928. doi: 10.3390/antibiotics14090928.

DOI:10.3390/antibiotics14090928
PMID:41009906
Abstract

: (Group B Streptococci, GBS) is Gram-positive, beta-hemolytic coccus known to be transmitted by vertical transmission in neonates during birth with neonatal sepsis, pneumonia, and meningitis. In adults, particularly the elderly and those with diabetes mellitus, GBS can also cause pneumonia and sepsis. Penicillin is the drug of choice, and GBS is generally susceptible to this antibiotic. This study investigates trends in GBS isolation rates and penicillin non-susceptibility over time at a university hospital. : We retrospectively analyzed 24 years (2000-2023) of microbiological data from Ilsan Paik Hospital to investigate trends in GBS isolation and penicillin susceptibility. Isolates were identified and tested using the Vitek 2 system, following CLSI guidelines. WHONET 2023 was used for data aggregation and analysis. Trends were analyzed by dividing the study period into three intervals: Period 1 (2000-2009), Period 2 (2010-2019), and Period 3 (2020-2023). Antimicrobial susceptibility rates for total GBS and PCN-NS GBS (penicillin non-susceptible group B Streptococcus) were compared using chi-square tests. : Among 257,884 total isolates, 3003 (1.16%) were GBS, and 29 (0.97%) were PCN-NS. GBS and PCN-NS isolation rates increased significantly across the three periods ( = 0.0001 and = 0.009, respectively). PCN-NS GBS showed reduced susceptibility to all tested antimicrobials, with no drug showing higher susceptibility compared to total GBS. : This study demonstrates a statistically significant rise in both GBS isolation rate and penicillin non-susceptibility over time. Given the emergence of multidrug-resistant GBS strains, susceptibility testing and interdisciplinary collaboration between microbiologists and clinicians are critical to guiding effective antimicrobial therapy and preventing neonatal and adult GBS infections.

摘要

B族链球菌(GBS)是革兰氏阳性、β溶血性球菌,已知在新生儿出生时通过垂直传播导致新生儿败血症、肺炎和脑膜炎。在成年人中,尤其是老年人和糖尿病患者,GBS也可引起肺炎和败血症。青霉素是首选药物,GBS通常对这种抗生素敏感。本研究调查了某大学医院GBS分离率和青霉素不敏感性随时间的变化趋势。我们回顾性分析了一山白医院24年(2000 - 2023年)的微生物学数据,以研究GBS分离情况和青霉素敏感性。按照临床和实验室标准协会(CLSI)指南,使用Vitek 2系统对分离株进行鉴定和检测。使用WHONET 2023进行数据汇总和分析。通过将研究期分为三个时间段来分析趋势:第1期(2000 - 2009年)、第2期(2010 - 2019年)和第3期(2020 - 2023年)。使用卡方检验比较总GBS和青霉素不敏感GBS(青霉素不敏感B族链球菌)的抗菌药物敏感性率。在总共257,884株分离株中,3003株(1.16%)为GBS,29株(0.97%)为青霉素不敏感GBS。在这三个时间段内,GBS和青霉素不敏感GBS的分离率均显著增加(分别为 = 0.0001和 = 0.009)。青霉素不敏感GBS对所有测试抗菌药物的敏感性均降低,与总GBS相比,没有一种药物显示出更高的敏感性。本研究表明,随着时间的推移,GBS分离率和青霉素不敏感性在统计学上均显著上升。鉴于多重耐药GBS菌株的出现,药敏试验以及微生物学家和临床医生之间的跨学科合作对于指导有效的抗菌治疗和预防新生儿及成人GBS感染至关重要。

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本文引用的文献

1
Characterization of Penicillin-Non-Susceptible, Multidrug-Resistant Streptococcus agalactiae Using Whole-Genome Sequencing.使用全基因组测序对青霉素不敏感、多重耐药无乳链球菌进行特征分析
Curr Microbiol. 2025 Jun 24;82(8):344. doi: 10.1007/s00284-025-04334-7.
2
Global patterns of antibiotic resistance in group B : a systematic review and meta-analysis.B组抗生素耐药性的全球模式:一项系统评价和荟萃分析。
Front Microbiol. 2025 Apr 16;16:1541524. doi: 10.3389/fmicb.2025.1541524. eCollection 2025.
3
The increasing burden of group B from 2013 to 2023: a retrospective cohort study in Beijing, China.
2013年至2023年B组负担的增加:中国北京的一项回顾性队列研究。
Microbiol Spectr. 2025 Jan 7;13(1):e0226624. doi: 10.1128/spectrum.02266-24. Epub 2024 Dec 10.
4
Incidence of invasive infections with Group B streptococcus in adults in Norway 1996-2019: a nationwide registry-based case-control study.挪威 1996-2019 年成人侵袭性 B 群链球菌感染的发生率:一项全国范围内基于登记的病例对照研究。
Infection. 2024 Oct;52(5):1745-1752. doi: 10.1007/s15010-024-02210-3. Epub 2024 Mar 14.
5
Detection of Penicillin Nonsusceptible Streptococcus agalactiae by Laboratories That Participate in the College of American Pathologist's Proficiency Testing Program.参与美国病理学家学会能力验证计划的实验室对青霉素不敏感无乳链球菌的检测
J Clin Microbiol. 2023 Aug 23;61(8):e0059523. doi: 10.1128/jcm.00595-23. Epub 2023 Jul 10.
6
Antimicrobial resistance in colonizing group B Streptococcus among pregnant women from a hospital in Vietnam.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。
Sci Rep. 2021 Oct 21;11(1):20845. doi: 10.1038/s41598-021-00468-3.
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