围产期孕妇生殖道B群链球菌感染临床特征

目的：探讨B群链球菌（GBS）在围产期孕妇生殖道的定植情况，及其对围产期孕妇妊娠结局的影响。方法：纳入2018年5月至2019年3月在温州医科大学附属第二医院建卡定期产检的3 619例孕妇，检查GBS感染情况，分为GBS阳性组和GBS阴性组。分析围产期孕妇高危因素，根据临床诊断判断妊娠结局，根据白带常规检查判断阴道微环境情况。结果：与GBS阴性组比，GBS阳性组阴道pH值升高，清洁度更差，且真菌和线索细胞检出率更高（均P＜0.05）。GBS阳性组霉菌感染史或细菌性阴道炎史显著高于GBS阴性组（均P＜0.05）；霉菌感染史、细菌性阴道炎史为GBS感染的危险因素（均P＜0.05）。GBS阳性组中胎膜早破、宫内感染、新生儿感染的发生率，显著高于GBS阴性孕妇（P＜0.05）。结论：霉菌感染史或细菌性阴道炎史是GBS感染的高危因素，而GBS感染对围产期孕妇阴道微环境有负面影响，而且对产妇以及新生儿的结局产生不良影响。

Clinical characteristics of group B streptococci infection in genital tract of puerperae

Objective: To investigate the colonization of obstetric group B streptococcus (GBS) in pregnant women in the late pregnancy and its effect on the pregnancy outcome of perinatal pregnant women. Methods: A total of 3 619 pregnant women who underwent regular check-up in the Second Affiliated Hospital of Wenzhou Medical University from May 2018 to March 2019 were enrolled to be indentified for GBS infection. Query electronic medical records were set up to understand the high maternal risk factors to judge the pregnancy outcome according to clinical diagnosis and routine examination of leucorrhea. Data were analyzed by statistical methods. Results: A comparison between the two groups showed that the history of fungal infection or bacterial vaginitis in GBS-positive group was significantly higher than that in negative group. The results of vaginal secretion test showed that GBS positive maternal vaginal pH increased, cleanliness was worse, and the detection rate of fungi and clue cells was higher (P<0.05, respectively). History of fungal infection and history of bacterial vaginitis were risk factors for GBS infection (P<0.05). According to pregnancy outcome, the incidence of premature rupture of membranes, intrauterine infection and neonatal infection was significantly higher in GBS-positive group (P<0.05). Conclusion: The history of fungal infection or bacterial vaginitis is a high risk factor for GBS infection, which can have adverse effects on maternal and neonatal outcomes and can also have a negative impact on maternal vaginal microenvironment.