2000-2003年上海地区性病就诊者支原体感染及耐药监测的结果分析

The analysis the results of surveillance of mycoplasma infection and drug resistance among outpatients at STD clinics in Shanghai from 2000 to 2003

目的了解上海地区2000～2003年性病就诊者支原体感染及对多种抗生素耐药的发生率、流行情况和耐药特征.方法采用生物梅里埃IST试剂盒.对结果分别计算男女阳性检测率和耐药率等,并进行统计分析.结果共检测11566人次,支原体阳性率42.9%.主要由解脲脲原体(Uu)构成(89.4%),Uu+人型支原体(Mh)混合感染所占比例在逐年下降.受检者的男女性别比例为0.93:1.男性阳性率26.2%,女性阳性率58.6%(x2=1 233.96,P＜0.001).有4 722人次感染的支原体出现对1种或1种以上药物耐药,4.1%感染的支原体对所有9种药物全部敏感,其中单一感染菌株占95.5%(Uu/Mh).总体上单一感染较混合感染的耐药率要低(x2=5.049,P=0.025).各抗生素平均耐药率由高向低依次为:氧氟沙星(Ofl)87.4%,红霉素(Ery)59.2%,环丙沙星(Cip)39.0%,阿奇霉素(Azi)17.2%,四环索(Tet)13.6%,克拉霉素(Cla)7.8%,强力霉素(Dox)6.1%,交沙霉素(Jos)1.6%和原始霉素(PRI)0.6%.多重耐药菌株占76.9%.对Dox、Tet和Cip抗生素,有随着年龄上升而耐药率下降的趋势(P＜0.05).结论近年来,支原体感染和对多种药物的耐药率逐年提高,Pri、Dox、Jos和Tet有较好的抗菌活性.建议上海地区对女性应首选Dox进行抗感染治疗.

Objectives To study Mycoplasma infection and drug resistance from the urogenital tract samples of STD clinics from 2000 to 2003 in Shanghai. Methods The specimens were tested by the bioMerieux IST kit. The results of positive rate and resistance rate were analyzed respectively. Results There were 42.9 % positive rate of Mycoplasma in a total of 11,566 samples. The positive rate was mostly due to Uu（89.9 % ）. The co-infected scale of Uu ＋ Mh saw a slow drop yearly. The gender scale of male to female＇ s was 0.93 ： 1. The positive rate of male was 26.2 % , and the resisted rate of female was 58.6 % （X^2=1 233.96, P〈0. 001 ） . There were 4 772 samples of Mycoplasma which were resistant to drugs, and 4.1% of Mycoplasma were susceptive to 9 kind of antibiotics,of which 98.95 % were infected either by Uu or Mh. The resistant rate of single infection was lower than that of co-infection on the whole（X^2=5. 049, P=0. 025）. The average resistant raters for respective antibiotics were Ofl （ 87.4 % ）, Ery （ 59.2 % ）, Cip （ 39.0 % ）, Azi （ 17.2 % ）, Tet （ 13.6 % ）, , Cla（ 7.8 % ）, Dox （ 6.1% ）, Jos（ 1.6 % ） and PRI （0.6 % ）. The multiple-resistant strains were 76.9 % . The resistant rates to Dox,Tet and Cip tended to drop along with the rise of age groups（ P≤0.05）. Conclusion Infection and drug resistant rates of Mycoplsma increased yearly at present. Pri, Dox,Jos and Tet had preferable antimicrobial activities. The results indicated that Dox is the drug of choice for the treatment of Mycoplasma in fernales.