中部某區域醫院以LIM Broth培養方式分析孕婦篩檢B群鏈球菌陽性率及抗藥性

Analysis of Antimicrobial Susceptibility and Positive rate in Group B Streptococcus Screening During Pregnancy by Using LIM Broth at a Regional Hospital in Central Taiwan

目的：B群鏈球菌（Group B Streptococcus, GBS）是威脅新生兒生命的主要致病菌之一，具有發病率高，致死率高的特點。新生兒感染B群鏈球菌的途徑，通常是在分娩的時候經由母體感染。因此，我們收集2012年-2016年懷孕婦女GBS篩檢結果，分析陽性率，並針對分離的703株B群鏈球菌之藥物敏感性及流行病學作近一步探討分析。方法：本研究以中部某區域醫院於2012年1月-2016年12月分離的703株B群鏈球菌的之流行病學資料為基礎，再以瓊脂紙錠擴散法（agar disk diffusionmethod）測試來判讀這703株菌株的抗生素藥物敏感性。結果：2012年-2016年約有4,111位懷孕婦女進行GBS篩檢：分析GBS篩檢孕婦年齡層以31-40歲最多，有2,414位（58.7％），其次是21-30歲，有1,535位（37.3％）。703株B群鏈球菌之孕婦資料分析：分析陽性孕婦年齡層以31-40歲最多，有435位（61.9％），其次是21-30歲，有245位（34.9％）。2012年-2016年陽性率為15.4-18.2％：以31-40歲孕婦，陽性率最高，有18.0％，其次是>40歲，有17.9％。結論：2012年-2016年在本院GBS篩檢平均陽性率約有17.1％。統計2012年-2016年B群鏈球菌對抗生素的感受性結果中發現，B群鏈球菌對Ampicillin（98.2％-1 0 0 . 0 ％ ）、P e n i c i l l i n （ 9 7 . 5 ％ - 9 8 . 7 ％ ）、Va n c omy c i n（100.0％ ）幾乎都有效， 而將近一半菌株對C l i n d a m y c i n（55.1％ -62.4％）、Erythromycin（57.8％-64.4％）具抗藥性。另外我們發現B群鏈球菌對Clindamycin及Erythromycin抗藥性有逐漸增加的趨勢。

Purposes: Group B Streptococcus (GBS) is one of the major pathogens that threaten neonatal life and is characterized by high morbidity and mortality rates. The route by which newborns acquire GBS infection is usually through the vaginal tract during childbirth. Therefore, we collected the GBS screening results of pregnant women from 2012 to 2016, analyzed the positivity rate, and further investigated the antimicrobial susceptibility and epidemiology of 703 isolated GBS strains. Methods: Based on the epidemiological data of the 703 GBS strains isolated from January 2012 to December 2016 at a regional hospital in central Taiwan, the antimicrobial susceptibility of these strains was further evaluated by using the agar disk diffusion method. Results: From 2012 to 2016, 4,111 pregnant women underwent GBS screening. Among these women, the highest proportion of pregnant women were in the age range of 31-40 years (58.7%; equivalent to 2,414 women), followed by 21-30 years (37.3%; equivalent to 1,535 women). Among the pregnant women from whom the 703 GBS strains were isolated, those who showed positive results were mostly in the age range of 31-40 years (61.9%; equivalent to 435 women), followed by 21-30 years (34.9%; equivalent to 245 women). The positivity rates for 2012-2016 ranged from 15.4-18.2%, with the women in the age range of 31-40 years showing the highest positivity rate (18.0%), followed by those >40 years old (17.9%). Conclusions: The mean positivity rate for GBS screening in this hospital from 2012 to 2016 was approximately 17.1%. Based on the statistical data of the antimicrobial susceptibility studies of GBS from 2012 to 2016, GBS bacteria were susceptible to Ampicillin (98.2%- 100.0%), Penicillin (97.5%-98.7%), and Vancomycin (100.0%). Nearly half of the strains were resistant to Clindamycin (55.1%-62.4%) and Erythromycin (57.8%-64.4%). In addition, we found that GBS bacteria showed an increasing resistance to Clindamycin and Erythromycin.