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目的探讨抗生素治疗晚期流产及早产孕妇阴道肺炎克雷伯菌感染对母婴结局的影响。方法选择2011年1月至2013年12月因晚期流产或早产于孙逸仙纪念医院住院,并在住院期间发现阴道肺炎克雷伯菌感染的孕妇36例。根据抗生素治疗情况分为两组,其中按药敏试验选择敏感抗生素治疗的孕妇19例为研究组,未使用抗生素治疗的17例为对照组。分析抗生素治疗肺炎克雷伯菌感染对妊娠结局及新生儿感染的影响。结果研究组最终发生流产3例,早产12例,足月产4例,终止妊娠孕龄为190 d;对照组最终发生流产4例,早产10例,足月产3例,终止妊娠孕龄为209 d。对比两组孕妇胎膜早破发生率、终止妊娠孕龄、妊娠结局、分娩方式差异均无统计学意义(P>0.05)。研究组孕妇阴道分泌物检查距终止妊娠时间间距50 d,比对照组的60 d长,差异有统计学意义(P=0.044)。两组中共27例(75%)出现下生殖道多重感染,以解脲支原体(19株)与人型支原体(15株)最常见,两组孕妇出现多重感染情况差异无统计学意义。两组新生儿感染情况差异无统计学意义。结论抗生素治疗阴道肺炎克雷伯菌感染未能改善晚期先兆流产及先兆早产孕妇的妊娠结局。
Objective To investigate the antibiotic treatment of late abortion and premature delivery of vaginal Klebsiella pneumoniae infection on maternal and infant outcomes. Methods From January 2011 to December 2013, 36 pregnant women with late-stage miscarriage or premature delivery at Memorial Hospital of Sun Yat-sen and vaginal Klebsiella pneumoniae infection during hospitalization were selected. According to the antibiotic treatment, the patients were divided into two groups. Among them, 19 pregnant women treated with sensitive antibiotics according to the drug susceptibility test were the study group, and 17 cases without the antibiotic treatment were the control group. Analysis of antibiotic treatment of Klebsiella pneumoniae infection on pregnancy outcome and neonatal infection. Results In the study group, 3 cases of abortion eventually occurred, 12 cases of preterm delivery, 4 cases of full-term pregnancy and 190 days of termination of pregnancy. In the control group, 4 cases of abortion eventually occurred, 10 cases of preterm birth, 3 cases of full-term pregnancy, 209 d. Comparing the incidence of premature rupture of membranes, termination of pregnancy gestational age, pregnancy outcome, mode of delivery between two groups of pregnant women had no statistical significance (P> 0.05). The study group vaginal discharge of pregnant women to check the interval from the termination of pregnancy 50 d, 60 d longer than the control group, the difference was statistically significant (P = 0.044). In the two groups, 27 cases (75%) had lower genital tract multiple infections. Ureaplasma urealyticum (19 strains) and Mycoplasma hominis (15 strains) were the most common. There was no significant difference in the incidence of multiple infections between the two groups. There was no significant difference in neonatal infection between the two groups. Conclusion Antibiotic treatment of Klebsiella pneumoniae in vaginal pneumonia failed to improve the outcome of pregnancy in threatened threatened abortion and threatened abortion.