Cervical bacterial colonization in women with preterm labor or premature rupture of membranes
Cervical bacterial colonization in women with preterm labor or premature rupture of membranes
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DOI：
10.1590/s0100-72032008000800004
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发表时间：
2008-08-01
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影响因子：
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通讯作者：
Parpinelli, Mary Ângela
中科院分区：
文献类型：
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作者：
Lajos, Giuliane Jesus;Passini Junior, Renato;Parpinelli, Mary Ângela
目的：研究早产或胎膜早破妇女宫颈定植。方法：对212例早产或胎膜早破孕妇进行研究。从每名妇女收集两份宫颈样本，进行细菌镜检查和培养。评估宫颈微生物与尿路感染、绒毛膜炎、胎儿应激、抗生素使用、早产、新生儿感染和新生儿死亡的关系。研究结果：宫颈内定植的患病率为14.2%（CI 95%= 9.5-18.9%），在早产或胎膜早破中的结果相似。B群链球菌是最常见的微生物（9.4%）。其他微生物分离念珠菌属，链球菌属，肺炎链球菌，大肠杆菌和肠球菌属。细菌镜检最常见的结果是乳酸杆菌数量减少和大量白细胞。与宫颈粘液培养阴性的妇女相比，宫颈内定植与尿路感染（23.8%对5.4%; p< 0.01）、早发性新生儿感染（25.0%对7.3%; p< 0.01）和新生儿死亡率（定植妇女中有2例; p< 0.02）的发生率较高相关。结论：本研究显示，尽管使用了非选择性培养基，但宫颈内定植的患病率仍很高。分离的主要微生物是B组链球菌，但在三分之一的研究群体中存在其他微生物。需要更多的研究来评估宫颈内定植对产科结局和新生儿感染及死亡率的影响。
PURPOSE: to study cervical colonization in women with preterm labor or premature rupture of membranes. METHODS: two hundred and twelve pregnant women with preterm labor or premature rupture of membranes were studied. Two cervical samples from each woman were collected and bacterioscopy and culture were performed. Association of cervical microorganisms and urinary tract infection, chorioamnionitis, fetal stress, antibiotic use, prematurity, neonatal infection, and neonatal death were evaluated. RESULTS: the prevalence of endocervical colonization was 14.2% (CI95%= 9.5-18.9%), with similar results in preterm labor or premature rupture of membranes. Group B streptococcus was the most prevalent organism (9.4%). Other organisms isolated were Candida sp, Streptococcus sp, Streptococcus pneumoniae, Escherichia coli and Enterococcus sp. The most common findings of bacterioscopy were a reduced number of lactobacilli and a great number of leukocytes. Endocervical colonization was associated with a higher occurrence of urinary tract infection (23.8 versus 5.4%; p< 0.01), early-onset neonatal infection (25.0 versus 7.3%; p< 0.01) and neonatal mortality (two cases in colonized women; p< 0.02) when compared with a negative culture of endocervical mucus. CONCLUSIONS: this study showed high prevalence of endocervical colonization despite the use of a nonselective culture media. The main microorganism isolated was group B streptococcus, but other organisms were present in one third of the studied population. More studies are needed to evaluate the influence of endocervical colonization on obstetrical outcome and on neonatal infection and mortality.