2018-2020年琼海地区女性社区获得性生殖道支原体感染情况及影响因素分析

Analysis of female community-acquired genital Mycoplasma infection and its influencing factors in Qionghai area from 2018 to 2020

目的分析琼海地区2018-2020年女性社区获得性生殖道支原体感染情况、相关危险因素及对常用抗菌药物的耐药性,探讨对应策略及预防措施。方法选取2018年1月至2020年12月琼海市中医院妇科疑似生殖道支原体感染的4500例女性患者为研究对象,均行支原体培养及药敏鉴定,并整理所有患者的临床资料,统计分析女性泌尿生殖道支原体感染的相关危险因素。结果4500例疑似生殖道支原体感染的女性患者中,检出支原体感染患者2164例,占48.09%。生殖道支原体感染的2164例患者中共分离支原体2352株。2018年检出支原体阳性498例,占50.02%,其中人型支原体、解脲支原体及混合感染分别为66例(6.63%)、356例(35.76%)和76例(7.63%)。2019年检出支原体阳性707例,占47.83%,其中人型支原体、解脲支原体及混合感染分别为92例(6.22%)、498例(33.69%)和117例(7.92%)。2020年检出支原体阳性959例,占46.87%,其中人型支原体、解脲支原体及混合感染分别为144例(7.04%)、662例(32.36%)和153例(7.48%)。药敏试验结果显示,人型支原体对红霉素和克拉霉素的耐药率较高,均超过80.00%;解脲支原体对红霉素和阿奇霉素的耐药率较高,均超过80.00%;混合感染对红霉素和罗红霉素的耐药率较高,超过90.00%。支原体属的3种感染类型均对强力霉素和交沙霉素的耐药率较低,在20.00%以下。调查结果显示,女性生殖道支原体感染与文化程度、支原体感染知晓情况、不洁性接触史、泌尿生殖系统感染史以及宫颈糜烂等因素相关(均P<0.05),而在年龄、孕产史上差异无统计学意义(均P>0.05)。结论琼海地区女性生殖道支原体感染率呈逐年升高趋势,临床医师应加强病原菌及耐药性检测,合理使用抗生素。女性生殖道支原体感染与文化程度、支原体感染知晓情况、不洁性接触史、泌尿生殖系统感染史以及宫颈糜烂等因素相关,临床应积极开展女性生殖道支原体感染健康知识宣教,针对危险因素进行防控。

Objective To analyze the situation of female community-acquired Mycoplasma genitalium infection(MGI),related risk factors and drug resistance to common antibiotics in Qionghai region from 2018 to 2020,and explore corresponding strategies and preventive measures to reduce the incidence of female MGI.Methods A total of 4,500 female patients with suspected genital Mycoplasma infection in our hospital from January 2018 to December 2020 were selected for Mycoplasma culturing and drug sensitivity identification.The relevant risk factors of female urogenital Mycoplasma infection were statistically analyzed by sorting out the clinical data of all patients.Results Among the 4,500 female patients with suspected genital Mycoplasma infection,2,164(48.09%)were detected as genital Mycoplasma infection.2,352 strains of Mycoplasma were isolated from them.In 2018,498 cases(50.02%)were positive for Mycoplasma,including 66 cases(6.76%)of Mycoplasma hominis,356 cases(36.48%)of Ureaplasma urealyticum and 76 cases(7.63%)of mixed infection.In 2019,707 Mycoplasma positive cases(47.83%)were detected,including 92 cases(6.22%)of Mycoplasma hominis,498cases(33.69%)of Ureaplasma urealyticum and 117 cases(7.92%)of mixed infection.In 2020,959 cases(46.87%)of Mycoplasma were detected,including 144 cases(7.04%)of Mycoplasma hominis,662 cases(32.36%)of Ureaplasma urealyticum and 153 cases(7.48%)of mixed infection.The results of drug sensitivity test showed that the resistance rate of Mycoplasma hominis to Erythromycin and Clarithromycin were high,more than 80.00%;that of Ureaplasma urealyticum to Erythromycin and Azithromycin were higher,more than 80.00%.The drug resistance rates to Erythromycin and Roxithromycin in patients with mixed infection were higher,more than 90.00%.The drug resistance rates of the three infection types of Mycoplasma to Doxycycline and Josamycin were low,less than 20.00%.The results showed that female genital tract Mycoplasma infection was related to educational level,awareness of Mycoplasma infection,history of unclean sexual contact,history of urogenital system infection and cervical erosion(all P<0.05).There were no significant differences in age and pregnancy history(all P>0.05).Conclusion In recent years,the Mycoplasma infection rate in Qionghai has been increasing year by year.Clinicians should strengthen the detection of pathogens and drug resistance,and rationally use antibiotics.Female genital tract mycoplasma infection is related to multiple factors.Clinically,we should actively carry out health knowledge education on female genital tract mycoplasma infection and prevent and control the risk factors.