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Objective:To investigate the phenotypes, molecular types and drug-resistance genes of erythromycin (ERY)-resistant group B Streptococcus (GBS) in pregnant women in late pregnancy in Zhengzhou and provide basic data for the prevention, control and treatment of GBS infection. Methods:This study retrospectively collected 86 GBS strains isolated from the vaginal secretions of pregnant women in late pregnancy at Maternal and Child Health Hospital of Henan Province from 2021 to 2022. ERY-resistant GBS strains were selected using the ERY disk diffusion method, and their susceptibility to 10 different antibiotics was tested. Whole-genome sequencing was performed to analyze their molecular features including molecular types, clonal complex groups and drug-resistance genes. Drug-resistance genes carried by GBS strains belonging to different clonal complex groups were compared.Results:There were 70 ERY-resistant GBS strains. Among them, 7.14%(5/70) exhibited an inducible resistance phenotype to macrolide-lincosamide-streptogramin B (MLSB) antibiotics; 84.29%(59/70) showed constitutive resistance to MLSB antibiotics; 8.57%(6/70) were resistant to macrolides but susceptible to lincosamides. The resistance rates of these strains to clindamycin (CLI), tetracycline (TE) and levofloxacin (LEV) were 91.43%(64/70), 54.29%(38/70) and 60.00%(42/70), respectively. These ERY-resistant strains exhibited multidrug resistance patterns with 40.00%(28/70) showing ERY-CLI-LEV resistance phenotype and 30.00%(21/70) showing ERY-CLI-TE resistance phenotype. The major drug-resistance genes carried by the 70 GBS strains were macrolide/lincosamide resistance genes mreA (100.00%) and ermB (53/70, 75.71%), aminoglycoside resistance genes ant (6)-Ⅰ a (22/70, 31.43%) and aph(3′)-Ⅲ (18/70, 25.71%), and tetracycline resistance genes tetM (22/70, 31.43%) and tetO (13/70, 18.57%). These strains belonged to 12 sequence types derived from seven clonal complexes (CCs) and 48.57%(34/70) of them were clustered into CC12. All CC12 strains harbored ermB, but none carried ermA. The positive rates of lsaE, lunB, and aac (6′)- aph(2" ) in CC19 and CC651 strains, ant (6)-Ⅰ a in CC651 and CC452 strains, and mefA and msrD in CC19 and CC23 strains were significantly higher than those in CC12 strains ( P<0.001). Conclusions:ERY-resistant GBS in Zhengzhou exhibited diverse drug resistance phenotypes and molecular types. CC12 was the most prevalent clonal complex in this region. The constitutive MLSB resistance phenotype and ermB gene were the most common ERY resistance phenotype and genotype, respectively, and tetM gene was related to tetracycline resistance. Furthermore, the drug-resistance genes varied in GBS strains of different clonal complexes. This study suggested that close attention should be paid to the epidemiological situation of GBS in this region and the effectiveness of antibiotics used for clinical prevention and treatment of GBS infection should be carefully evaluated.
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TORCH, which is considered as a series of pathogens, including the Toxoplasma gondii, Rubella virus, Cytomegalovirus or Herpes simplex virus, often infects the pregnant women to induce the the fetus or newborn infection by transplacental infection or exposure to contaminated genital tract secretions at delivery. Increasing evidence have been confirmed that the infection of TORCH may cause the miscarriage, premature birth, malformed fetus, stillbirth, intrauterine growth retardation, neonatal multiple organ dysfunction and other adverse pregnancy outcomes. For most TORCH-infections cases may lacking the effective treatments during pregnancy, and it is important to achieve the effacing monitoring of TORCH infections before and during pregnancy. The laboratory testing of TORCH has the great significance. However, the consensus opinions still need to improve the the standardization of TORCH testing process and the correct interpretation. Based on the characteristics of the TORCH detection method, this article gives a consensus opinion on the standardized detection and clinical application of TORCH from the laboratory perspective according to the characteristics and types of infection of different pathogens.
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Objective To investigate serum interferon-inducible protein 16 (IFI16) level in the patients with preeclampsia (PE) and its correlation with PE pathogenesis.Methods Forty-five PE pregnant women in the Third Affiliated Hospital of Zhengzhou University from August 2015 to March 2016 were selected as the PE group and contemporaneous 30 healthy pregnant women undergoing the routine pregnant examination were selected as the control group.The biochemical indexes of serum urea,uric acid,creatinine,etc.were detected by using the automatic biochemical analyzer.The serum levels of IFI16 and ET-1 were measured by ELISA.Then the correlations between serum IFI16 level with these detected indicators were analyzed.The receiver operating characteristic (ROC) curve analysis was performed to evaluate the value of serum IFI16 for predicting PE disease.Results The serum IFI16 and ET-1 levels in the PE group were significantly higher than those in the control group (P<0.01).Furthermore the serum IFI16 level in severe PE was significantly higher than that in mild PE (P<0.01).Serum IFI16 level in PE was positively correlated with systolic blood pressure,diastolic blood pressure,24-h urine protein quantitation and serum ET-1 level,and negatively correlated with serum albumin.Serum IFI16 levels 14.47 ng/mL and 17.09 ng/mL as the critical values for predicting preeclampsia and discriminating between mild preeclampsia and severe preeclampsia has a higher sensitivity and specificity.Conclusion The high level of serum IFI16 in pregnant women has a certain correlation with PE pathogenesis and may be a novel biomarker for predicting PE occurrence.