Analysis of Infection Status,Antibiotic Resistance Status and Vaginal Micro-ecology of Late Pregnant Women with Group B Streptococcus Infection
Objective:To evaluate the current infection level and antibiotic resistance status of group B strepto-coccus(GBS)in late pregnant women in the third trimester of pregancy and the vaginal microecology of GBS in-fected pregnant women.Methods:The data of 37175 women in the third trimester of pregnancy who received prenatal examination in Tangshan Maternal and Child Health Hospital from January 2020 to December 2022 were retrospectively analyzed.We explored the infection status,trends of infection and antibiotic resistance of pregant women of different age groups for three consecutive years using resultss of GBS cultures and drug sensitivity tests.849 women in the third trimester of pregnancy who visited the hospital from January 2022 to December 2022 were specially selected(including 499 GBS positive women and 350 GBS negative women)to conduct both morphological tests and bacterial cultures to genital tract specimen,for the purpose of comparing cleanliness de-gree and microecology indicators between these two groups.Results:From January 2020 to December 2022,the positive rates of GBS were 4.30%,4.79%and 5.14%,respectively,which increased year by year(P<0.01).There was no statistical difference in infection rate between different age groups(P>0.05);For three consecutive years,no GBS strains resistant to penicillin,ampicillin,amoxicillin/clavulanate,ceftriaxone,cefotaxime,cefepime,meropenem,linezolid and vancomycin were found.The resistance rates to levofloxacin,erythromycin and clinda-mycin were high(all>50%),however showing a downward trend.The resistance rate to tetracycline was rather high and climbing year by year.In terms of vaginal microecology,the microbiota imbalance rates were 73.35%and 29.71%in GBS positive and negative groups respectively.The grade Ⅲ-Ⅳ cleanliness were 72.95%and 28.86%,respectively.In the GBS-positive group,11.62%exhibited a significant increase in leukocytes;72.95%had a pH>4.5.These findings showed a statistically significant difference when compared to the GBS-negative group(P<0.01).The differences in cleanliness,leukocyte count,bacterial density and diversity between GBS-positive and GBS-negative groups were all statistically significant(P<0.01).Conclusions:The positive rate of GBS increases year by year.Age is not a factor causing GBS infection.Penicillin can still be used as the first line prophylactic antibiotic during cildbirth in GBS positive pregant women.For those allergic to penicillin,antibiotics should be selected scientifically and reasonably according to the results of drug sensitivity test.Pregnant women had a higher vaginal microecological imbalance rate,but not all GBS infected women had vaginal microecological imbalance.
Late pregnancyGroup B streptococcusInfection rateDrug resistance rateVaginal microecology
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