抗生素治疗阴道克雷伯菌感染对晚期先兆流产及先兆早产孕妇妊娠结局的影响

目的探讨抗生素治疗晚期流产及早产孕妇阴道肺炎克雷伯菌感染对母婴结局的影响。方法选择2011年1月至2013年12月因晚期流产或早产于孙逸仙纪念医院住院,并在住院期间发现阴道肺炎克雷伯菌感染的孕妇36例。根据抗生素治疗情况分为两组,其中按药敏试验选择敏感抗生素治疗的孕妇19例为研究组,未使用抗生素治疗的17例为对照组。分析抗生素治疗肺炎克雷伯菌感染对妊娠结局及新生儿感染的影响。结果研究组最终发生流产3例,早产12例,足月产4例,终止妊娠孕龄为190 d;对照组最终发生流产4例,早产10例,足月产3例,终止妊娠孕龄为209 d。对比两组孕妇胎膜早破发生率、终止妊娠孕龄、妊娠结局、分娩方式差异均无统计学意义(P0.05)。研究组孕妇阴道分泌物检查距终止妊娠时间间距50 d,比对照组的60 d长,差异有统计学意义(P=0.044)。两组中共27例(75%)出现下生殖道多重感染,以解脲支原体(19株)与人型支原体(15株)最常见,两组孕妇出现多重感染情况差异无统计学意义。两组新生儿感染情况差异无统计学意义。结论抗生素治疗阴道肺炎克雷伯菌感染未能改善晚期先兆流产及先兆早产孕妇的妊娠结局。

Impact of antibiotics treatment for vaginal infection with Klebsiella pneumoniae on pregnancy outcome in women at risk for premature delivery or late abortion

Objective To explore the influence of lower genital tract infection with Klebsiella pneumonia on the maternal and neonatal outcomes in women at risk for premature delivery or late abortion. Methods A total of 36 patients with vaginal Klebsiella pneumonia infection who were at risk for premature delivery or late abortion between January 2011 and December 2013 were enrolled in this study.Patients were divided into two groups based on whether to treat with antibiotics.The impact of antibiotics treatment for Klebsiella pneumoniae infection on pregnancy outcome and neonatal infection was analyzed. Results There were 3 abortions, 12 preterm deliveries and 4 term deliveries in the study group and there were 4 abortions,10 preterm deliveries and 3 term deliveries in the control group. The incidences of premature rupture of membranes,gestational age at termination of pregnancy,pregnancy outcome and mode of delivery had no significant differences between two groups（P〉0.05）. The interval of detection to termination of pregnancy in study group was longer（P =0.044）.27 patients in the study group were found to have multi-infection,mainly with Ureaplasma urealyticum（19 strains） and Mycoplasma hominis（15 strains）. The neonatal infection was similar between two groups.Conclusion Administration of antibiotics in vaginal infection caused by Klebsiella pneumonia in women at risk for premature delivery or late abortion demonstrated no benefit on improving pregnancy outcome.