308例非淋菌性宫颈炎单纯解脲支原体感染的耐药趋势分析

Drug Resistance Analysis in 308 Cases With Non-gonococcal Cervicitis of Simple Ureaplasma Urealyticum Infection

目的探讨本地区非淋菌性宫颈炎单纯解脲支原体(Uu)感染的耐药趋势。方法对308例单纯Uu感染所致的非淋菌性宫颈炎患者的宫颈管分泌物进行支原体培养及药物敏感试验。结果Uu对环丙沙星、四环素及螺旋霉素的耐药率居12种常用抗生素之首,其耐药率分别为51.3%、46.75%及43.18%;对强力霉素、交沙霉素及美满霉素敏感率较高,其敏感率分别为80.19%、71.43%及68.83%;在耐药菌珠中,14株对四环素、强力霉素、美满霉素同时耐药;19株对红霉素、螺旋霉素、罗红霉素、阿奇霉素同时耐药。结论Uu对环丙沙星、四环素及螺旋霉素的耐药率高,而对强力霉素、交沙霉素及美满霉素的敏感率高,提示Uu若对某种抗生素耐药时,则对其同类抗生素的耐药率增加,故临床上治疗单纯Uu感染所致的非淋菌性宫颈炎,治疗前应进行药物敏感试验,如果某种药物难于清除Uu或临床症状持续存在时,原则上不应选用同类药物继续治疗,在试验结果出来前或无条件进行药物敏感试验时,可选用强力霉素、交沙霉素及美满霉素作为经验性用药。

Objective To study the drug resistance status of simple ureaplasma urealyticum（Uu） infection in the nongonococcal cervicitis. Methods The Uu culture and drug sensitivity test were done on cervix secreta in 308 patients with non - gonococcal cervicitis of simple ureaplasma urealyticum（Uu） infection. Results The drug resistant rates of Uu to ciprofloxacin, tetracycline and acetylspiramycin were 51.3 %, 46.7 % and 43.18 % respectively, which were the highest among the twelve antibiotics; while the drug resistant rates to doxycycline, josamycin and minocycline were low, and the susceptabilities were 80.19 %, 71.43 % and 68.83 % respectively. Conclusion The drug resistan rates of Uu to ciprofloxacin, tetracycline and acetylspiramycin were high; while the drug susceptabilities to doxycycline, josamycin and minocycline were high. The test showed that drug sensitivity test should be done before initiating the treatment of non - gonococcal cervicitis due to simple ureaplasma urealyticum（Uu） infection. If symptoms persist.after therapy, agents like doxycycline, iosamycin and minocycline can be considered as the empiric choices before getting the drug sensitivity test result.