Analysis of vaginal microecology and placental isolates and drug resistance in pregnant women with premature rupture of membranes
Objective To compare the vaginal microecology,placental swab bacterial distribution and drug resistance in pregnant women with premature rupture of membranes and normal rupture of mem-branes in late pregnancy(35-37 weeks of pregnancy),to provide etiological basis for clinical prevention and treatment. Methods The results of placental swab cultures at the Obstetrics Department of Gansu Provincial Maternity and Childcare Hospital from January 1,2020 to June 30,2022 were collected. Pregnant women with positive cultures were divided into two groups:those with premature rupture of membranes and those with normal rupture of membranes. The study analyzed the basic clinical characteristics ,vaginal microecology in late pregnancy,and the distribution and drug sensitivity results of the main isolates in placental swab cul-tures of the two groups. Results There were significant differences in gestational age ,bacterial vaginosis and normal microecology between the two groups(P<0.05). Multivariate logistic regression analysis showed that pregnancy week(b=-0.711,OR=0.491)and normal microecology(b=-1.412,OR=4.103)were negatively correlated with the occurrence of premature rupture of fetal membranes,while age(b=0.076,OR=1.079)was positively correlated. There was no significant difference in bacterial vaginosis (P>0.05). The main bacteria isolated from the placenta between the two groups were gram-negative bacteria ,with no significant difference (P>0.05),mainly Escherichia coli. The difference in detection rate was statistically significant(P<0.05). The proportion of ultra-broad spectrum β-lactamase production in the premature rupture group was higher ,and the resistance to ampicillin and cephalosporin was also higher ,with a statistically significant difference(P<0.05). The second most common bacteria were gram-positive cocci(E. faecalis and Streptococcus agalactis),with no statistically significant difference(P>0.05). Streptococcus agalactis is sensitive to penicillins and glycopep-tides,with a high resistance rate to quinolones. Enterococcus faecalis was sensitive to penicillins,glycopep-tides,and oxazolidinones,but had high resistance to erythromycin and clindamycin. Conclusion The prema-ture rupture of membranes group includes both older and younger individuals ,with vaginal microecological ab-normalities more likely to occur in late pregnancy. The detection rate of Escherichia coli in placenta swabs as well as resistance to penicillin and cephalosporin antibiotics ,is higher in this group.
Premature rupture of membranesVaginal microecologyPlacenta swabIsolated bacteriaDrug resistance
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维普
