摘要
目的 探究孕晚期产前抗生素治疗B族链球菌(GBS)感染对新生儿结局、血清炎症因子及GBS药物敏感试验结果的影响.方法 选取2020年1月至2022年12月期间成都市新都区人民医院收治的60例GBS阳性孕妇所生的新生儿作为研究对象,依据孕母产前是否采用抗生素治疗分为对照组(n=29)和观察组(n=31).对照组未给予预防性抗生素治疗,观察组根据药物敏感试验结果给予抗生素治疗.比较两组孕妇妊娠结局、新生儿结局以及新生儿出生6、24 h血清白细胞介素-6(IL-6)、降钙素原、C反应蛋白(CRP)水平,并分析新生儿GBS药物敏感试验结果.结果 31例孕妇经药物敏感试验检查,对青霉素敏感度最高,故选择27例GBS感染孕妇进行青霉素治疗;对于青霉素过敏者有3例,2例应用克林霉素,1例应用头孢唑林.观察组孕妇不良妊娠结局总发生率为9.66％,低于对照组(31.03％),差异有统计学意义(P＜0.05).观察组新生儿不良结局总发生率、早发型GBS疾病(EOGBS)发生率分别为6.45％、6.45％,均低于对照组(27.59％、24.14％),差异均有统计学意义(P＜0.05).观察组新生儿出生后6 h血清IL-6、降钙素原、CRP 水平分别为(76.21±7.96)pg/mL、(0.82±0.12)μg/L、(5.36±0.85)mg/L,24 h 血清 IL-6、降钙素原、CRP 水平分别为(62.35±6.47)pg/mL、(0.61±0.09)µg/L、(3.15±0.64)mg/L,均低于对照组[6 h:(88.25±9.15)pg/mL、(0.92±0.15)µg/L、(8.25±1.63)mg/L;24 h:(66.21±7.11)pg/mL、(0.72±0.11)μg/L、(4.22±0.71)mg/L],差异均有统计学意义(P＜0.05).60例新生儿经药物敏感试验检查,对青霉素敏感度均大于90％.结论 孕晚期产前抗生素治疗GBS感染,不仅可改善产妇妊娠结局,还可改善新生儿结局,降低EOGBS发生率,缓解炎症反应状态,且不影响新生儿药物敏感试验结果.
Abstract
Objective To investigate the effect of prenatal antibiotic treatment of group B streptococcus(GBS)infection in late pregnancy on neonatal outcome,serum inflammatory factors and drug sensitivity test results of GBS.Methods A total of 60 GBS positive pregnant women who were admitted to Xindu District People's Hospital of Chengdu from January 2020 to December 2022 were selected as the study subjects.They were assigned to the control group(n=29)and the observation group(n=31)according to whether they were treated with antibiotics before de-livery.The control group did not receive prophylactic antibiotic treatment,while the observation group received antibiotic treatment based on the results of the drug sensitivity test.Pregnancy outcome,neonatal outcome,the levels of serum interleukin-6(IL-6),procalcitonin and C-reac-tive protein(CRP)of neonatal at 6 and 24 h after birth were compared between the groups.Drug sensitivity test results of GBS were analyzed.Results Drug sensitivity test results showed that 31 pregnant women were highly sensitive to penicillin,and 27 pregnant women infected with GBS were treated with penicillin.Three women were allergic to penicillin,including 2 treated with clindamycin and 1 treated with cefazolin.The total incidence of adverse pregnancy outcomes in the observation group was 9.66％,which was lower than that in the control group(31.03％),and the difference was statistically significant(P＜0.05).The total incidence of adverse neonatal outcomes and the incidence of early onset GBS of newborn(EOGBS)in the observation group were 6.45％,6.45％,respectively,which were lower than those in the control group(27.59％and 24.14％),the differences were statistically significant(P＜0.05).The levels of serum IL-6,procalcitonin,and CRP of newborns in the observation group at 6 hours after birth were(76.21±7.96)pg/mL,(0.82±0.12)μg/L,(5.36±0.85)mg/L,respectively,the levels of serum IL-6,pro-calcitonin,and CRP of newborns at 24 hours after birth were(62.35±6.47)pg/mL,(0.61±0.09)µg/L,(3.15±0.64)mg/L,respective-ly,which were all lower than those in the control group[6 hours:(88.25±9.15)pg/mL,(0.92±0.15)μg/L,(8.25±1.63)mg/L;24 hours:(66.21±7.11)pg/mL,(0.72±0.11)μg/L,(4.22±0.71)mg/L,the differences were statistically significant(P＜0.05).Drug sensitivity test results showed that the sensitivity rates of 60 neonates to penicillin were higher than 90％.Conclusion Prenatal antibiotic treat-ment of GBS infection in late pregnancy can improve maternal and neonatal outcomes,reduce the incidence of EOGBS and alleviate inflammatory reactions,without influencing neonatal drug sensitivity test results.
维普
万方数据