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目的探讨无乳链球菌(GBS)致新生儿血流感染的血清型及耐药性,为早期诊治提供依据。方法回顾性分析2008年2月-2016年11月本院收治的GBS致新生儿血流感染者的临床资料,比较分析早发型和晚发型病例的临床表现、危险因素,并对GBS进行血清学分型和药敏试验。结果共纳入84例病例,其中早发型占34.5%,早发型以呼吸系统症状为主,晚发型以发热为首发症状,两者的危险因素比较,除母亲绒毛膜羊膜炎外差异均无统计学意义(P>0.05);GBS的血清型以Ⅲ型为主,占60.7%,对多数药物敏感,对四环素、红霉素、克林霉素高度耐药,耐药率分别为100.0%、72.6%、60.7%,D试验阳性率为27.6%。结论新生儿GBS血流感染临床症状明显,以Ⅲ型为主,青霉素类抗生素仍是治疗GBS感染的首选药物。
Objective To investigate the serotypes and drug resistance of neonates with bloodstream infections caused by Streptococcus agalactiae (GBS), and to provide evidence for early diagnosis and treatment. Methods The clinical data of neonates with GBS admitted to our hospital from February 2008 to November 2016 were retrospectively analyzed. The clinical manifestations and risk factors of early-onset and late-onset cases were compared. Serum scores of GBS Type and drug sensitivity test. Results A total of 84 cases were enrolled, of which 34.5% were early-onset, early-onset respiratory symptoms, late-onset fever as the first symptom, the risk factors were compared, except for the mother chorion amniotic differences were not statistically significant (P> 0.05). The serotypes of GBS were predominantly type Ⅲ, accounting for 60.7%, sensitive to most of the drugs and highly resistant to tetracycline, erythromycin and clindamycin with resistance rates of 100.0% and 72.6 %, 60.7%, D test positive rate was 27.6%. Conclusion The clinical manifestations of neonatal GBS bloodstream infection are obvious. The main type Ⅲ is penicillin antibiotic, which is still the first choice of treatment for GBS infection.