妊娠晚期妇女阴道病原菌及耐药性情况分析

Drug Resistance Analysis and Distribution of Vaginal Pathogens in Late Pregnancy

摘要: 为了掌握本地区妊娠晚期妇女阴道病原菌的分布与耐药情况，给临床提供用药依据和警示，收集本地区2017年6月至2019年6月198例妊娠晚期妇女阴道分泌物，对其病原菌进行分离鉴定、药敏结果分析。198例阴道分泌物中分离出166例革兰阳性球菌，占83.83%；25例革兰阴性杆菌，占12.62%；7例真菌，占3.55%。其中革兰阳性球菌中主要以凝固酶阴性(CNS)的葡萄球菌为主，占73.49%，对青霉素、红霉素、氨苄西林的耐药性均高达75%以上，对万古霉素，呋喃妥因，替考拉宁，吗啉噁酮均100%敏感，凝固酶阳性的葡萄球菌主要以金黄色葡萄球菌为主，其对青霉素、氨苄西林、妥布霉素、耐药性大于75%。革兰阴性杆菌主要以大肠埃希菌和奇异变形杆菌为主，其对氨苄西林普遍耐药，对复方新诺明、哌拉西林耐药率都高于30%，对碳青霉烯类，三代、四代头孢菌素有较高的敏感性，真菌均对氟胞嘧啶敏感，对伊曲康唑均耐药。本地区妊娠晚期妇女阴道病原菌主要以凝固酶阴性的葡萄球菌、大肠埃希菌为主，临床应该根据实际药敏结果合理选择抗生素治疗，降低妊娠期和新生儿的感染。

Abstract: To investigate the distribution and antibiotics resistance of vaginal pathogens in late pregnancy women and to provide evidence for clinical treatment, we collected 198 cases of late pregnant woman from June 2017 to June 2019, then vaginal pathogens were isolated and their resistance to antibiotics was detected. A total of 166 Gram-positive strains (83.83%), 25 Gram-negative strains (12.62%) and 7 strains of fungi (3.55%) were isolated from 198 vaginal secretions. The most common vaginal pathogens of Gram-positive strains were Coagulase-negative Staphylococcus (73.49%), which were resistant to Penicillin, Erythromycin and Ampicillin up to 75%, while they were sensitive to Vancomycin, Furantoin, Teicoplanin and Morpholine completely. Staphylococcus aureus was the main Coagulase-positive Staphylococcus, the resistance rate of Staphylococcus aureus to Penicillin, Ampicillin, Tobramycin was more than 75%. The resistance rate of Gram-negative Escherichia coli and Mycobacterium to Ampicillin was 100% and more than 30% to Sulfamethoxazole/Trimethoprim and Piperacilin, and their susceptibility to Carbapenems and three-four generations Cephalosporin was evident. Fungi showed highly sensitivity to Fluorocytosine and resistance to Itraconazole. Coagulase-negative Staphylococcus and Escherichia coli were mainly pathogens in vaginal microorganisms in late pregnancy women. Clinical antibiotics should be reasonably selected according to the actual drug sensitivity results to reduce the infection in pregnancy and neonates.