2011-2017年孕妇生殖道无乳链球菌检出及其耐药性变化

目的了解某地区孕妇生殖道无乳链球菌的感染及其耐药状况，为临床诊断与治疗提供依据。方法收集2011年1月—2017年12月广东省人民医院产科病区及门诊孕妇送检的生殖道分泌物培养的结果，比较分析各年份无乳链球菌检出情况及耐药率变化趋势。结果共送检31 569份生殖道分泌物标本，检出病原菌1 940株，其中无乳链球菌591株，占30.46%。无乳链球菌在生殖道分泌物标本中的检出率为1.87%；2011—2017年无乳链球菌药敏结果中，未发现对青霉素、氨苄西林、奎奴普丁/达福普汀、利奈唑胺、替考拉宁、万古霉素耐药菌株；对环丙沙星、左氧氟沙星、克林霉素、红霉素的耐药率较高，分别为19.80%～28.97%、19.80%～28.95%、26.73%～39.29%、44.05%～66.34%；对四环素的耐药率最高，为80.37%～94.29%，但有逐年下降的趋势（P＜0.05）。结论无乳链球菌为孕妇生殖道感染的主要病原菌，分析其耐药性，合理、规范的使用抗菌药物，可减少孕妇及新生儿无乳链球菌感染的发生。

Isolation and change in antimicrobial resistance of Streptococcus agalactiae from genital tract of pregnant women from 2011 to 2017

ObjectiveTo understand the infection and antimicrobial resistance of Streptococcus agalactiae(S. agalactiae) isolated from genital tract of pregnant women in an area, and provide basis for clinical diagnosis and treatment.MethodsGenital tract secretion culture results of pregnant women in the obstetric wards and outpatient department of Guangdong General Hospital from January 2011 to December 2017 were collected, prevalence and changing trend of antimicrobial resistance of S. agalactiae in different years were compared and analyzed.ResultsA total of 31 569 genital tract specimens were detected, 1 940 strains of pathogens were isolated, 591 of which were S. agalactiae, accounting for 30.46%. Isolation rate of S. agalactiae in genital tract specimens was 1.87%; antimicrobial susceptibility testing results of S. agalactiae from 2011 to 2017 showed that no strains were resistant to penicillin, ampicillin, quinupristin/dalfopristin, linezolid, teicoplanin, and vancomycin; resistance rates of S. agalactiae to ciprofloxacin, levofloxacin, clindamycin, and erythromycin were 19.80%-28.97%, 19.80%-28.95%, 26.73%-39.29%, and 44.05%-66.34% respectively; resistance rate of S. agalactiae to tetracycline was the highest (80.37%-94.29%), but with a decreasing trend year by year (P<0.05).ConclusionS. agalactiae is the main pathogen of genital tract infection in pregnant women, analysis of antimicrobial resistance and rational use of antimicrobial agents can reduce the occurrence of S. agalactiae infection in pregnant women and newborns