解脲支原体及人型支原体感染与盆腔炎的关系

Analysis of relationship between Ureaplasma urealyticum and Mycoplasma hominis infections and pelvic inflammatory disease

目的探究解脲支原体(Uu)及人型支原体(Mh)感染与盆腔炎的关系,为盆腔炎诊治提供参考。方法选择2019年1月-2022年1月在南京市江宁医院就诊的90例盆腔炎患者为研究组,另选择同期进行体检的健康女性60名为对照组,均采集宫颈管分泌物行Uu、Mh感染检查和药敏试验,比较两组研究对象临床资料、不同支原体检出情况、药敏试验结果。结果研究组患者性伴侣>2个、性生活频率>3次/周、流产>2次、有阴道炎症疾病史、阴道清洁度分布高分度的占比均显著高于对照组,差异均有统计学意义(P均<0.05)。共84例支原体感染者,其中对照组20例,研究组64例。研究组Uu(40.00%vs.23.33%)、Mh(18.89%vs.6.67%)及总支原体(71.11%vs.35.00%)感染率均显著高于对照组,差异均有统计学意义(χ^(2)=4.500、4.467、20.851,P均<0.05);Uu+Mh感染率与对照组比较差异无统计学意义(χ^(2)=2.219,P>0.05)。支原体感染者中,阴道清洁度Ⅳ度者支原体阳性率显著高于Ⅱ、Ⅲ度者,Ⅲ度者支原体阳性率显著高于Ⅱ度者,差异均有统计学意义(P均<0.05)。Uu对强力霉素、美满霉素耐药率均为0%,对环丙沙星耐药率较高为78.00%;Mh对四环素、强力霉素、美满霉素、交沙霉素耐药率均为0%,对罗红霉素、克拉霉素、阿奇霉素耐药率较高,均高于85.00%;Uu+Mh对四环素、强力霉素、交沙霉素耐药率最低,均为7.14%,对罗红霉素100.00%耐药,对克拉霉素、阿奇霉素、环丙沙星耐药率均为78.57%。结论Uu、Mh是盆腔炎感染的主要病原体,与该病发病密切相关,四环素、强力霉素、美满霉素、交沙霉素对支原体感染耐药率低,适合本地区用药。

Objective To explore the relationship between Ureaplasma urealyticum(Uu)and Mycoplasma hominis(Mh)infections and pelvic inflammatory disease.Methods A total of 90 patients with pelvic inflammatory disease treated in the hospital between January 2019 and January 2022 were selected as the study group,and 60 healthy women who underwent physical examination in the hospital during the same period were included in the control group.Cervical secretions were collected for examination of Uu and Mh infections and drug sensitivity test.The clinical data,detection status of different mycoplasmas and results of drug sensitivity test results were compared between the two groups of subjects.Results The proportions of patients with sexual partners>2,frequency of sexual life>3 times/week,abortion>twice,history of vaginal inflammation and high degree of vaginal cleanliness distribution were significantly higher in the study group than those in the control group(P<0.05).There were 20 cases of mycoplasma infection in the control group and 64 cases in the study group,and the Uu(40.00%vs.23.33%),Mh(18.89%vs.6.67%)and total mycoplasma(71.11%vs.35.00%)infection rate in the study group were significantly higher than those in the control group(χ^(2)=4.500,4.467,20.851,all P<0.05),and the Uu+Mh infection rate was not statistically different from that in the control group(χ^(2)=2.219,P>0.05).Among the patients with mycoplasma infection,the positive rate of mycoplasma in patients with vaginal cleanliness degree Ⅳ was significantly higher than that in patients with degree Ⅱ or Ⅲ(P<0.05),and the positive rate of mycoplasma in patients with degree Ⅲ was significantly higher than that in patients with degree Ⅱ(P<0.05).The drug resistance rates of Uu to doxycycline and minocycline were both 0%,and the drug resistance rate to ciprofloxacin was 78.00%.The drug resistance rates of Mh to tetracycline,doxycycline,minocycline and josamycin were all 0%,and the drug resistance rates to roxithromycin,clarithromycin and azithromycin were higher than 85.00%.Uu+Mh had the lowest resistance rate to tetracycline,doxycycline,and josamycin,all of which were 7.14%;the resistance rates to clarithromycin,azithromycin and ciprofloxacin were all 78.57%,and the drug resistance rate to roxithromycin was 100.00%.Conclusions Uu and Mh were the main pathogens of pelvic inflammatory disease infection,which were closely related to the incidence of the disease.Mycoplasma infection was low resistance to tetracycline,doxycycline,minocycline and josamycin;these drugs should be suitable for treating pelvic inflammatory disease.