目的：了解孕晚期妇女产道定植B群链球菌(GBS)的检出率、耐药率及耐药表型。方法纳入2014年1月至2015年12月167例产道定植筛查GBS阳性的样本，用美国国家临床实验室标准化委员会(CLSI)推荐的纸片扩散法检测GBS耐药性，用红霉素、克林霉素双纸片法(D试验)检测GBS耐药表型。结果 GBS检出率为12.8%(167/1300)；对红霉素耐药率为63.5%(106/167)，克林霉素为51.5%(86/167)，左氧氟沙星为38.9%(65/167)，四环素为88.0%(147/167)，并呈现耐药性上升趋势；对万古霉素、头孢噻肟、青霉素G、氨苄西林、利奈唑胺均未出现耐药。D试验检测GBS耐药表型，结构型占51.5%(86/167)，诱导性型占5.4%(9/167)，泵出型占6.6%(11/167)。结论青霉素和氨苄西林仍可作为围产期孕妇预防和治疗B群链球菌感染的首选用药；应加强GBS诱导型克林霉素耐药的检测，以指导围产期孕妇青霉素高危过敏时临床医生合理使用大环内酯类、林可酰胺类抗生素。%Objective To understand the detection rate, the rate of drug resistance, and resistance phenotypes of group B Streptococcus (GBS) for vaginal colonization. Methods A total of 167 samples found positive for GBS in vaginal colonization screened from January 2014 to December 2015 were collected. Disk diffusion method recommend-ed by Clinical and Laboratory Standards Institute (CLSI) was used to detect the drug resistance of GBS. Double disk diffu-sion (D test) for erythromycin and clindamycin was used to detect resistant phenotype of GBS. Results The detection rate of GBS was 12.8%(167/1 300). GBS were resistant to erythromycin (63.5%, 106/167), clindamycin (51.5%, 86/167), le-vofloxacin (38.9%, 65/167) and tetracycline (88.0%, 147/167), showing a rising trend of drug resistance. There was no re-sistance to vancomycin, cefotaxime, penicillin G, ampicillin and linezolid. D test showed the resistant phenotypes of GBS included structure type (51.5%, 86/167), induced type (5.4%, 9/167), pump out type (6.6%, 11/167). Conclusion Penicil-lin and ampicillin can be used as the first choice for the prevention and treatment of group B streptococcal infection. We should strengthen the detection of resistance to clindamycin in GBS, in order to guide the rational use of antibiotics in pregnant women with penicillin allergy, such as macrolides and lincosamides.
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