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目的：分析胎膜早破（ premature rupture of memberane， PROM）所致孕妇绒毛膜羊膜炎的细菌培养及药敏结果，探讨胎膜早破引起的绒毛膜羊膜炎主要致病菌的病原学特征，为围产期感染用药提供科学依据。方法：对 2011 年 6 月至 2013 年 9 月在我院分娩的 597 例破膜时间大于 24 小时的 PROM 孕妇的胎膜进行细菌培养及药敏试验。结果： 597 例破膜时间大于 24 小时的 PROM 孕妇的胎膜细菌培养中， 86 例培养阳性，阳性率为 1 4.41%；培养阳性病例中革兰氏阴性杆菌占 73.26%（ 63 /86），革兰氏阳性菌球菌占 34.88%（ 30/86），培养最多的菌种是大肠埃希菌，占 60.47%（ 52/86）。革兰氏阴性杆菌对亚胺培南、哌拉西林 / 他唑巴坦、头孢哌酮 / 舒巴坦、庆大霉素、头孢西丁、左氧氟沙星敏感；革兰氏阳性球菌对亚胺培南、丁胺卡那、哌拉西林 / 他唑巴坦、替考拉宁、万古霉素、利奈唑胺、庆大霉素、头孢西丁、左氧氟沙星敏感。结论：革兰氏阴性杆菌是 PROM 相关的绒毛膜羊膜炎的主要致病菌，应根据病原学特征合理应用抗生素。

英文摘要:

Objective:To analyze the bacterial clutrue and drug susceptibility of fetal membrane sample from women suffered chorioamnionitis with premature rupture of membranes （ PROM）, explore the feature of pathogenic bacteria induced chorioamnionitis and provide evidence for rational use of antibiotics.Methods:597 fetal membrane samples of women with premature rupture of membranes beyond 24 hours from maternity department of our hospital from June 201 1 to Sept 201 3 were cultured. Bacterial strains were isolated and identified, and drug-susceptibility tests were done.Results:Among the 597 fetal membrane samples, 86 were infected by bacteria. The total positive rate was 14.41%. The infection of gram-negative bacilli accounted for 73.26%（ 63/86）, whereas gram-positive cocci 34.88%（ 30/86）. The strain with the highest isolated rate was E.coli,60.47%(52/86). Gram-negative bacilli were sensitive to imipenem, piperacillin/tazobactam, cefoperazone / sulbactam, gentamicin, cefoxitin levofloxacin. Gram-positive cocci were sensitive to imipenem, amikacin, piperacillin/tazobactam, vancomycin, linezolid, gentamicin, teicoplanin, and cefoxitin levofloxacin.Conclusion:Gram-negative bacilli are the main pathogenic bacteria isolated in fetal membrane samples of women with premature rupture of membranes. It is important to use antibiotics rationally according to the feature of pathogenic bacteria.

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