摘要目的 探讨孕晚期孕妇B族链球菌(group BStreptococcus,GBS)的定植率及耐药性,评估开展孕晚期GBS筛查及分娩期给予产时抗生素预防(intrapartum antibiotic prophylaxis,IAP)对预防新生儿早发型GBS疾病(early-onset GBS disease,EOGBS)的效果. 方法 回顾性分析2016年3月至201 8年3月在香港大学深圳医院、孕35～37周行GBS筛查的14 204例孕妇GBS定植情况、GBS菌株耐药情况,分析开展筛查及给予IAP前后新生儿EOGBS的发生率.采用x2检验或Fisher精确概率法对数据进行统计学分析. 结果 14 204例孕妇中,2 027例GBS培养阳性,GBS定植率为14.27％.开展GBS筛查及产时干预前后新生儿EOGBS的发生率分别为0.6‰(4/6 356)及0.07‰(1/14 403),差异有统计学意义(Fisher精确概率法,P=0.033).2 027株GBS菌株对青霉素及万古霉素100％敏感,对克林霉素及红霉素的耐药率分别达到67.2％和65.7％. 结论 孕晚期常规GBS筛查及分娩期预防性抗生素治疗能显著降低新生儿EOGBS的发生率.青霉素是预防及治疗GBS感染的首选药物.

abstractsObjective To study the colonization rate and antibiotic resistance of group B Streptococcus (GBS) in gravidas during late pregnancy,and to evaluate the effectiveness of GBS screening in late pregnancy and intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal early-onset GBS disease (EOGBS).Methods A retrospective study was conducted to analyze the colonization rate and antibiotic resistance pattern of GBS in 14 204 gravidas who were screened for GBS at 35-37 gestational weeks during March 2016 to March 2018 in the University of Hongkong-Shenzhen Hospital (HKU-SZH).Differences in the incidence of EOGBS before and after GBS screening and IAP were analyzed using Chi-square or Fisher's exact test.Results Among the 14 204 gravidas,2 027 cases were GBS positive with a colonization rate of 14.27％.Incidence rates of EOGBS before and after GBS screening were 0.6‰ (4/6 356) and 0.07‰ (1/14 403),respectively (Fisher's exact test,P=0.033).GBS isolates were 100％ (2 027/2 027) sensitive to penicillin and vancomycin.Resistance rates to clindamycin and erythromycin were 67.2％(1 363/2 027) and 65.7％ (1 332/2 027),respectively.Conclusions Routine GBS screening in late pregnancy and IAP can significantly decrease the incidence of EOGBS.Penicillin is the optimal choice for prevention and treatment of GBS infection.