[1]杨 柳,付 欣,张小飞.胎膜早破孕妇生殖道无乳链球菌血清型分型和耐药基因分析[J].现代检验医学杂志,2023,38(03):123-127.[doi:10.3969/j.issn.1671-7414.2023.03.022]
　YANG Liu,FU Xin,ZHANG Xiao-fei.Serotyping and Resistance Gene Analysis of Reproductive Streptococcus Agalactiae in Women with Premature Rupture of Membranes[J].Journal of Modern Laboratory Medicine,2023,38(03):123-127.[doi:10.3969/j.issn.1671-7414.2023.03.022]
点击复制

胎膜早破孕妇生殖道无乳链球菌血清型分型和耐药基因分析()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年03期
页码:
123-127
栏目:
论著
出版日期:
2023-05-15

文章信息/Info

Title:
Serotyping and Resistance Gene Analysis of Reproductive Streptococcus Agalactiae in Women with Premature Rupture of Membranes
文章编号:
1671-7414（2023）03-123-05
作者:
杨 柳; 付 欣; 张小飞
（西北妇女儿童医院医学检验中心，西安 710061）
Author(s):
YANG Liu;  FU Xin ;  ZHANG Xiao-fei
（Department of Clinical Laboratory, Northwest Women’s and Children’s Hospital, Xi’an 710061，China）
关键词:
胎膜早破; 无乳链球菌; 血清型; 耐药基因
分类号:
R714.433；Q781
DOI:
10.3969/j.issn.1671-7414.2023.03.022
文献标志码:
A
摘要:
目的 了解胎膜早破孕妇生殖道B 族链球菌（group B Streptococcus，GBS）的血清型分型和耐药基因分布。方法 收集2020 年1 月～ 2021 年12 月西北妇女儿童医院产科分娩的胎膜早破孕妇生殖道的50 株GBS，使用全自动微生物分析系统对分离株进行鉴定和药敏实验，通过聚合酶链反应（polymerase chain reaction, PCR）检测血清型和耐药基因。结果 50 株GBS 以血清型Ⅲ型（24 株，48.0%）为主，其次为Ⅰ b 型（12 株，24.0%）和Ⅰ a 型（10 株，20.0%）；对青霉素、头孢曲松、万古霉素和利奈唑胺全部敏感；对红霉素、克林霉素和左氧氟沙星的耐药率分别为80.0%，74.0% 和56.0%；在红霉素耐药分离株中，85.0% 为大环内酯类- 林可酰胺结构型耐药，且ermB 基因携带率高达75%；对左氧氟沙星耐药表现为gyrA，partC 和 artE 的三种基因突变引起的DNA 解螺旋酶和拓扑异构酶的双改变。结论 西安地区胎膜早破孕妇生殖道GBS 以血清型Ⅲ型为主，对大环内酯类、林可酰胺类和喹诺酮类药物具有高水平的耐药性，青霉素仍为分娩时GBS 感染预防和治疗的首选药物。
Abstract:
Objective To investigate the serotype and drug resistance gene distribution of group B Streptococcus (GBS) isolated from the reproductive tract of pregnant women with premature rupture of membranes. Methods 50 strains of GBS were collected and isolated from the reproductive tract of pregnant women with premature rupture of membranes delivered in the department of obstetrics of Northwest Women’s and Children’s Hospital from January 2020 to December 2021. Automatic microbial analysis system analyzer was used to identify the isolates and drug sensitivity test, serotype and drug resistance genes were analyzed by PCR amplification. Results The majority serum were type Ⅲ (24 strains, 48.0%), followed by type Ⅰb (12 strains, 24.0%) and type Ⅰa (10 strains, 20.0%). It was sensitive to penicillin, ceftriaxone, vancomycin and linezolid, and resistant to erythromycin, clindamycin and levofloxacin were 80.0%, 74.0% and 56.0%, respectively. 85.0% erythromycin resistant isolates were macrolide lincoamido structural resistance, and the ermB gene carrying rate was as high as 75%. The resistance to levofloxacin was manifested by gyrA, partC and artE gene mutations causing double changes in DNA helicase and topoisomerase. Conclusion In Xi’an area, the GBS isolated from reproductive tract of pregnant women with premature membranes were mainly type III, which showed high resistance to macrolides, lincoimides and quinolones. Penicillin is still the first choice for the prevention and treatment of GBS infection during childbirth.

参考文献/References:

[1] WANG Xiaoyan, ZHANG Xiaoyan , LIU Yiran , et al. Effect of premature rupture of membranes on time to delivery and outcomes in full-term pregnancies with vaginal dinoprostone-induced labour[J]. Arch Gynecol Obstet, 2020, 301(2)：369-374..
[2] 刘茹凤, 王欣茹, 李红, 等. 检测人血清中肺炎球菌 10A 型荚膜多糖IgG 抗体的包被抗原适用性研究[J]. 微生物学免疫学进展, 2019, 47(5)：16-21. LIU Rufeng, WANG Xinru, LI Hong, et al. Confirmation coated antigen of serotype 10A polysaccharide for ELISA in quantitation of Streptococcus pneumoniae serotype-specific IgG antibody [J]. Progress in Microbiology and Immunology, 2019, 47 (5): 16-21.
[3] 中华医学会妇产科学分会产科学组. 胎膜早 破的诊断与处理指南(2015)[J]. 中华妇产科杂 志,2015,50(1):3-8. Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. Guidelines for the diagnosis and management of premature rupture of membranes (2015) [J]. Chinese Journal of Perinatal Medicine, 2015,50 (1): 3-8.
[4] 中华医学会围产医学分会, 中华医学会妇产科学分 会产科学组. 预防围产期B 族链球菌病（中国） 专家共识 [J]. 中华围产医学杂志, 2021, 24(8) : 561- 566. Society of Perinatal Medicine, Chinese Medical Association, Obstetrics Subgroup, Society of Obstetrics and Gynecology, Chinese Medical Association. Chinese experts consensus on prevention of perinatal group B Streptococcal disease [J]. Chinese Journal of Perinatal Medicine, 2021,24 (8): 561-566.
[5] LEE H T, KIM S Y, PARK P W, et al. Detection and genomic analysis of genital group B Streptococcus in pregnant Korean women [J]. J Obstet Gynaecol Res,2019, 45(1)：69-77.
[6] GUO Huiwu, FU Maozhang, PENG Qing,etal. Antimicrobial resistance and molecular characterization of Streptococcus agalactiae from pregnant women in Southern China [J]. J Infect Dev Ctries,2019,13(9):802-809.
[7] 徐守宁, 王仁存. 胎膜早破孕妇感染常见病原菌类 型及耐药性分析[J].国际医药卫生导报, 2018, 24 (2): 262-264. XU Shouning, WANG Rencun. Common pathogenic bacteria types in pregnant women with premature rupture of membranes and the drug resistance [J]. International Medicine and Health Guidance News,2018,24 (2): 262-264.
[8] 马靖杰, 唐丽, 郭瑶珊. 孕妇生殖道B 族链球菌感 染与胎膜早破的关系及对母婴预后的影响[J]. 国际 医药卫生导报,2021,27(12):1845-1847. MA Jingjie, TANG Li, GUO Yaoshan. The relationship between genital tract group B Streptococcus infection and premature rupture of membranes in pregnant women and its effect on maternal and infant prognosis [J]. International Medicine and Health Guidance News,2021, 27(12) : 1845-1847.
[9] 林雅茵, 林新祝. 围产期B 族链球菌感染血清型研 究进展[J]. 中华围产医学杂志,2018,21(12):836-839. LIN Yayin, LIN Xinzhu. Advances in serotypes of perinatal group B Streptococcus infection [J]. Chinese Journal of Perinatal Medicine, 2018,21(12):836-839.
[10] PERME T, GOLPARIAN D, IHAN M B, et al. Genomic and phenotypic characterisation of invasive neonatal and colonising group B Streptococcus isolates from Slovenia, 2001-2018[J]. BMC Infectious Diseases, 2020, 20(1):958.
[11] 林新祝, 吴佳音, 祝垚, 等. 孕晚期阴道定植B 族链 球菌的血清型特点及其与新生儿早发型感染的相关 性[J]. 中华围产医学杂志, 2020, 23(4)：232-238. LIN Xinzhu, WU Jiayin, ZHU Yao, et al. Serotype features of group B Streptococcus vaginal colonization in late pregnant women and their correlation with early-onset neonatal infection [J]. Chinese Journal of Perinatal Medicine, 2020,23 (4): 232-238.
[12] SHABAYEK S,SPELLERBERG B. Group B Streptococcal colonization, molecular characteristics,and epidemiology[J]. Frontiers in Microbiology, 2018,9：437.
[13] DO NASCIMENTO C S, DOS SANTOS N F B,FERREIRA R C C, et al. Streptococcus agalactiae in pregnant women in Brazil: prevalence, serotypes,and antibiotic resistance[J]. Brazilian Journal of Microbiology, 2019, 50(4)：943-952.
[14] FURFARO L L, CHANG B J, PAYNE M S. Perinatal Streptococcus agalactiae epidemiology and surveillance targets[J]. Clinical Microbiology Reviews,2018,31(4) - e00049-18.
[15] WANG Jing, ZHANG Yan, LIN Miao, et al. Maternal colonization with group B Streptococcus and antibiotic resistance in China: systematic review and meta-analyses [J]. Ann Clin Microbiol Antimicrob, 2023, 22(1)：5.
[16] HAYES K, O’HALLORAN F, COTTER L. A review of antibiotic resistance in group B Streptococcus: the story so far [J]. Crit Rev Microbiol, 2020, 46(3)：253-269.
[17] MOTALLEBIRAD T, FAZELI H, AZADI D, et al. Determination of capsular serotypes, antibiotic susceptibility pattern, and molecular mechanism of erythromycin resistance among clinical isolates of group B Streptococcus in Isfahan, Iran [J]. Adv Biomed Res, 2021, 10: 27.
[18] ZHU Dekang, ZHENG Mingyu, XU Jinge, et al. Prevalence of fluoroquinolone resistance and mutations in the gyrA, parC and parE genes of Riemerella anatipestifer isolated from ducks in China [J]. BMC Microbiol,2019,19(1):271.

相似文献/References:

[1]张 赟,李 娅,郭旭昌,等.胎膜早破孕妇生殖道感染病原菌的分布及耐药性分析[J].现代检验医学杂志,2015,30(03):98.[doi:10.3969/j.issn.1671-7414.2015.03.028]
　ZHANG Yun,LI Ya,GUO Xu-chang,et al.Distribution and Drug Resistance of Genital Tract Pathogenic Bacteria in Pregnant Women with Premature Rupture of Membrane[J].Journal of Modern Laboratory Medicine,2015,30(03):98.[doi:10.3969/j.issn.1671-7414.2015.03.028]
[2]李小侠a,解 娟a,詹 颉a,等.围产期胎膜早破与生殖道病原菌感染的分析[J].现代检验医学杂志,2016,31(04):90.[doi:10.3969/j.issn.16717-414.2016.04.024]
　LI Xiao-xiaa,XIE Juana,ZHAN Jiea,et al.Analysis of Perinatal Premature Rupture of Membranes and Reproductive Tract Pathogen Infection[J].Journal of Modern Laboratory Medicine,2016,31(03):90.[doi:10.3969/j.issn.16717-414.2016.04.024]
[3]刘家玲,袁 军,胡方芳.贵州地区孕晚期妇女生殖道无乳链球菌定植筛查及CAMP试验阴性的GBS菌株基因测序分析研究[J].现代检验医学杂志,2018,33(01):14.[doi:10.3969/j.issn.1671-7414.2018.01.001]
　LIU Jia-ling,YUAN Jun,HU Fang-fang.Screening of Streptococcus Agalactiae of Genitourinary Tractin the Late Pregnant Women in Guizhou Province and the Genetic Sequencing Analysis[J].Journal of Modern Laboratory Medicine,2018,33(03):14.[doi:10.3969/j.issn.1671-7414.2018.01.001]
[4]吴 慧a,韩文龙b,柏 蕾,等.胎膜早破产妇血清SFRP5，TIMP-1 和HMGB1 水平与并发组织学绒毛膜羊膜炎的相关性研究[J].现代检验医学杂志,2022,37(05):112.[doi:10.3969/j.issn.1671-7414.2022.05.022]
　WU Huia,HAN Wen-longb,BO Lei,et al.Correlation of Serum SFRP5, TIMP-1 and HMGB1 Levels with Histological Chorioamnitis in Pregnant Women with Premature Rupture of Membranes[J].Journal of Modern Laboratory Medicine,2022,37(03):112.[doi:10.3969/j.issn.1671-7414.2022.05.022]

备注/Memo

备注/Memo:
作者简介：杨柳（1989-），女，硕士，检验师，研究方向：微生物与感染，E-mail：419739292@qq.com。
通讯作者：张小飞（1987-），男，本科，主管检验师，研究方向：临床检验诊断学，E-mail：413779079@qq.com。
更新日期/Last Update: 2023-05-15