Antibiotic Therapy Increases the Risk of Preterm Birth in Preterm Labor without Intra-Amniotic Microbes, but may Prolong the Gestation Period in Preterm Labor with Microbes, Evaluated by Rapid and High-Sensitive PCR System
Antibiotic Therapy Increases the Risk of Preterm Birth in Preterm Labor without Intra-Amniotic Microbes, but may Prolong the Gestation Period in Preterm Labor with Microbes, Evaluated by Rapid and High-Sensitive PCR System
复制标题
通过快速高灵敏 PCR 系统评估，抗生素治疗会增加羊膜内无微生物早产的早产风险，但可能会延长有微生物早产的妊娠期
DOI：
10.1111/aji.12484
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发表时间：
2016
影响因子：
3.6
通讯作者：
Saito S
中科院分区：
文献类型：
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作者：
Yoneda S;Shiozaki A;Yoneda N;Ito M;Shima T;Fukuda K;Ueno T;Niimi H;Kitajima I;Kigawa M;Saito S
目的应用快速无细菌聚合酶链反应（PCR）系统对羊膜完好早产儿（PTL）的羊膜内微生物进行检测，探讨抗生素在早产儿（PTL）中的应用效果。材料与方法招募孕32周前PTL患者104例。直到2012年，抗生素都是根据PTL的临床严重程度经验性地处方的。随后用我们新建立的PCR系统对储存样品中的羊膜内微生物进行了评估，并对PTL中抗生素的使用效果进行了评估。结果羊水（AF）微生物阴性患者（n= 67），抗生素治疗显著缩短妊娠期（P< 0.0001），而微生物阳性患者（n= 37），适当的抗生素治疗（针对鉴定的AF微生物选择合适的抗生素）与妊娠期延长显著相关（P< 0.0001）。结论胎膜完好的PTL适当的抗生素治疗可延长妊娠期。
ObjectivesTo examine the efficacy of the use of antibiotics in preterm labor (PTL) with intact membranes, after evaluating intra‐amniotic microbes by our rapid and bacteria‐free polymerase chain reaction (PCR) system.Materials and methodsOne hundred and four PTL patients before 32 weeks of gestation were recruited. Until 2012, antibiotics were empirically prescribed based on the clinical severity of PTL. Intra‐amniotic microbes in stored samples were evaluated later by our newly established PCR system, and the efficacy of the use of antibiotics in PTL was evaluated.ResultsIn the amniotic fluid (AF) microbe‐negative patients (n= 67), antibiotic therapy significantly shortened the gestation period (P< 0.0001), whereas in the microbe‐positive patients (n= 37), appropriate antibiotic therapy (proper antibiotic selection against identified AF microbes) was significantly associated with an increase in gestation period (P< 0.0001).ConclusionAppropriate antibiotic therapy in PTL with intact membranes prolonged the gestation period.