泌尿生殖道支原体感染趋势及耐药性分析

Study on nongonococcal genitourinary tract infections and drug resistance of Mycoplasma to antibiotics

目的比较不同性别患者标本中支原体和衣原体分离率及支原体对抗生素的耐药性。方法采用生物梅里埃公司试剂盒,对1059份疑为非淋菌性尿道(宫颈)炎患者的泌尿生殖道标本进行了支原体和衣原体检测,同时对支原体检测阳性标本进行了菌落计数和抗生素敏感性检测。结果1059份标本中支原体和衣原体分离率为36.3%和5.6%。其中男性标本中支原体和衣原体分离率为14.8%和3.7%,女性标本中支原体和衣原体分离率为52.6%和7.2%。解脲脲原体菌落计数结果,≥104CFU/ML女性占73.2%,高于男性的60.3%。人型支原体菌落计数结果,≥104CFU/ML女性占30.5%,高于男性的25.0%。药敏结果显示支原体对原始霉素保持敏感(耐药率为0.9%),对强力霉素、交沙霉素、四环素的耐药率较低(4.1%、5.0%、13.1%),但对氧氟沙星、红霉素的耐药率较高(37.8%、27.9%)。结论非淋菌性尿道(宫颈)炎患者中支原体和衣原体是主要的病原,监测支原体的耐药性对指导临床治疗具有重要意义,原始霉素和强力霉素可作为治疗支原体感染非淋菌性尿道(宫颈)炎的首选药物。

Objective To compare the isolation rate of Ureaplasma urcalyticum（ Uu）, Mycoplasma hominis（Mh） and Chlamydia traehomatis（CT）, and to analyze the resistance of Mh and Uu to 6 kinds of antibiotics. Methods CT in genitourinary tract of 1 059 NGU patients was detected by kit of VIDAS. Uu and Mh in genitourinary tract was detected by kit of IST. Results From 1 059 tested samples, the total positive percentage for Mycoplasma and Chlamydia was 36. 3% and 5.6% respectively, 14. 8% and 3.7% for Mycoplasma and Chlamydia from male samples, 52. 6% and 7.2% for Mycoplasma and Chlamydia from female samples. The colony counting result showed that the number of female samples with colonies more than 10^4 cfu/ml was greater than that of male samples, 73.2% versus 60. 3% for Uu and 30. 5% versus 25% for Mh. The sensitivity of Mycoplasma to antimicrobial agents was as follows from high to low： Pristinamycine, Doxycycline, Josamycin, Tetracycline, Ofloxacin, Erythromycin. Conclusions The isolation of Mycoplasma was more than that of Chlamydia from patients with genitourinary tract infection. Resistance monitoring of Mycoplasma periodically played an important role in clinical drug treatment.