| Objective: To investigate the negative rate of treating group B streptococcus(GBS)by intrapartum antimicrobial prophylaxis in pregnant women.It includes the negative rate of vaginal GBS after the treatment of antibiotics during labor,whether there are differences in the efficacy of different antibiotics during labor,and whether there are differences in the efficacy of different doses of the same antibiotics during labor.Methods: A prospective study was conducted to analyze the clinical data of 148 pregnant women with positive vaginal GBS screening results at 35 to 37 weeks of gestation in Shenzhen Peking University Shenzhen Hospital from January 2018 to February 2019.The patients with positive GBS screening in the third trimester of pregnancy and vaginal delivery were treated with antibiotic prophylaxis(intrapartum antimicrobial prophylaxis,IAP).According to the type of antibiotics used during labor,they were divided into penicillin group,cefazolin group and clindamycin group.The patients who were positive for GBS screening in the third trimester of pregnancy and delivered by cesarean section chose cefmetazole as the perioperative antibiotic and the cefmetazole group.After delivery,without vaginal voyeur and vulva disinfection,sterile swabs were placed under the vagina and rotated for 1 week and cultured immediately.The swabs were inoculated into the GBS enrichment tube and cultured at 35 ℃ for 24 hours in the 5%CO2 concentration incubator and then transferred to the blood plate.After 24 hours of continuous culture,the colonies with milky white,smooth surface,milky,round and β hemolysis on the blood plate were selected for purification(the suspected individual colonies were inoculated to the new blood plate for 24 hours)and identified.The results of GBS reexamination of postpartum vaginal secretions and the therapeutic effects of different antibiotic groups and different doses of the same antibiotics were statistically analyzed.Postpartum GBS was negative in 127 cases,the total negative rate was 85.81%,93 cases in cefazolin group,88.17%(82 cases)in cefazolin group,11 cases in penicillin group,13 cases in clindamycin group.The negative rate of re-examination was 61.54%(8 cases),and that of cefmetazole group was 31 cases,and the negative rate was 83.87%(26 cases).Fisher test was performed between penicillin group and cefazolin group(P < 0.05),Fisher test between penicillin group and clindamycin group(P < 0.05),and chi-square test between cefazolin group and clindamycin group(P < 0.05).Chi-square test was performed at different doses of the same antibiotics(P > 0.05).In penicillin group,the negative rate of 4.8-million-unit dose was 100%(2 cases),and the negative rate of 9.6-million-unit dose was 100%(9 cases).In cefazolin group,the negative rates of 2 g,3 g and 4 g were 85.11%(40 cases),91.43%(32 cases)and 90.91%(10 cases),respectively.in the cefazolin group,the negative rates of 2g,3G and 4G were 85.11%(40 cases),91.43%(32 cases)and 90.91%(10 cases),respectively.The negative rate of 1.8 g clindamycin and 6.9 g clindamycin was 66.67%(2 cases)and 60%(6 cases),respectively.the negative rate of clindamycin was 66.67%(2 cases)and 60%(6 cases),respectively.In cefmetazole group,the negative rate of dosage 6 g and 8 g were 84.62%(22 cases)and 80%(4 cases),respectively.Chi-square test was performed between different doses of the same antibiotics(P > 0.05).Results: In this study,we collected 148 cases of vaginal GBS colonization in our hospital,including 97 cases of vaginal delivery,of which 97 cases were delivered through vagina,and the negative rate was 89.69%(87 cases).51 cases were delivered by cesarean section.The negative rate of reexamination was 78.43%(40 cases).The results of postpartum GBS and the mode of delivery were tested by Chi-square test(χ 2 = 3.480,P > 0.05.The negative rate of reexamination was 78.43%(40 cases).Conclusion: The total negative rate of GBS was high.The effectiveness was different among groups treated with different antibiotics,penicillin had the highest negative rate,while cefazolin ranked the second. |
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