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Journal of Zhejiang University-SCIENCE B

, Volume 19, Issue 12, pp 973–978 | Cite as

Risk factors and drug resistance in early-onset neonatal group B streptococcal disease

  • Ying-wei Wang
  • Yao-qiang Du
  • Xiao-lin Miao
  • Guang-yong Ye
  • Yi-yun Wang
  • Ai-bo Xu
  • Yun-zhong Jing
  • Yu Tong
  • Kai Xu
  • Mei-qin Zheng
  • Dong Chen
  • Zhen Wang
Correspondence

新生儿早发型无乳链球菌感染的风险因素及耐药分析

摘要

目的

新生儿早发型无乳链球菌(GBS)是一种可致婴儿脑、肺和眼部发生感染甚至死亡的细菌。筛查其感染风险因素并建立概率预测模型有助于疾病的预防和控制,进一步分析GBS 菌株的耐药类 型和耐药基因,为疾病的临床诊断和治疗提供指 导意见。

创新点

首次归类了新生儿感染GBS 的众多因素,按照孕妇、分娩过程、胎儿因素分为三类,统计筛选出重要风险因素并建立Logistic 回归的概率预测模型,并通过聚合酶链式反应(PCR)筛查到了相 关耐药基因。

方法

收集2007 年1 月至2015 年12 月,浙江大学医学院附属妇产科医院、温州医科大学附属眼视光医院和温州市人民医院的实验组135例早发型GBS感染和对照组234 例无感染的新生儿及其母亲的 临床资料和标本,进行数据统计分析并构建概率 预测模型,采用传统的药敏实验对所有GBS 阳性标本进行耐药分析,同时PCR 筛查耐药基因并测定序列。

结论

这9年间新生儿早发型GBS 感染率呈上升趋势。孕妇泌尿系统感染、胎膜早破、胎龄这三项因素与感染GBS的结局存在显著关联,由此得出的Logistic 回归模型可用于预测感染GBS 的概率。 135 株GBS 对克林霉素、红霉素、四环素的耐药 菌株比例分别为51.11%、80.00%、91.11%,同时未发现对万古霉素、青霉素、呋喃妥因、力奈唑 胺的耐药性。PCR 筛查发现aac6、ant6-I、aph3-III 和TEM四个耐药基因,其中aph3-III 仅存在于耐 药株中,而测序发现aac6 基因在非耐药株中相比耐药株存在一个缺失突变。临床上尽早对患者分离的GBS药敏试验,有助于合理用药和有效治疗。

关键词

新生儿 无乳链球菌 风险因素 耐药性 

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Supplementary material

11585_2018_165_MOESM1_ESM.pdf (121 kb)
Risk factors and drug resistance in early-onset neonatal group B streptococcal disease

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Copyright information

© Zhejiang University and Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Laboratory MedicineTiantai People’s HospitalTaizhouChina
  2. 2.Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhouChina
  3. 3.Department of Infectious DiseasesEye Hospital of Wenzhou Medical UniversityWenzhouChina
  4. 4.Department of Laboratory Medicine, Women’s HospitalZhejiang University School of MedicineHangzhouChina
  5. 5.Department of Laboratory MedicineWenzhou People’s HospitalWenzhouChina
  6. 6.Department of Laboratory MedicineThe Sixth People Hospital of WenzhouWenzhouChina

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