581例泌尿生殖道支原体、衣原体感染耐药性分析及对策

Mycoplasma and Chlamydia trachomatis Infection in Reproductive Tract:Resistance Analysis and Countermeasures in 581 Cases

目的观察581例泌尿生殖道支原体、衣原体感染情况,分析其对抗菌药物的耐药性并提出治疗对策。方法采用单克隆抗体胶体金法检测衣原体抗原,采用培养法检测支原体及其药物敏感试验。结果581例标本检出沙眼衣原体(Ct)阳性42例,阳性率为7.2%;检出支原体阳性239例,阳性率为41.1%,其中解脲脲支原体(Uu)阳性率为28.4%(165例),人支原体(Mh)阳性率为3.1%(18例),Uu+Mh混合感染阳性率为6.7%(39例),Uu+Ct混合感染阳性率为2.9%(17例);支原体药敏试验结果显示,Uu对红霉素、罗红霉素耐药率分别为64.8%、62.6%,Mh也呈同样趋势,两种支原体合并感染的耐药率升高;多西环素、米诺环素、交沙霉素有较高的抑菌能力。结论随着支原体感染病例不断增多,出现多重耐药现象,临床应参照药敏试验结果选用抗菌药物,并进行足量、足疗程治疗,以减少耐药菌株的产生,多西环素、米诺环素、交沙霉素可作为临床支原体感染首选药。

OBJECTIVE To observe the situation of Mycoplasma and Chlamydia trachornatis （Ct） infection in the patients with reproductive tract infection （RTI） ,and their antibiotic resistance analysis and therapeutic strategies. METHODS To analyze Ct an/ibody with monoclonal antibody immunogold filtration assay, and to detect Mycoplasma and their drug sensitivity with culture method. RESULTS From 581 specimens there were 42 cases who had Ct （7. 2%）, and 239 cases who had Mycoplasma （41. 1%）. The single infection of Ureaplasma urealyticum（Uu） was in 165 cases （28.4%） and of Mycoplasrna horninis（Mh） in 18 cases （3.1%） ,respectively, Uu＋Mh were in 39 cases （6.7%）. Uu＋Ct were in 17 cases （2.9%）. The result of drug sensitivity showed that the drug resistance of Uu to erythromycin was 64.8 %, to roxithromgcin was 62.6 %. Mh was also with the similar tendency. The mixed infections rate was elevated. Doxycycline, minocycline, and josamyein had the higher bacteriostatic ability. CONCLUSIONS With the growing number of mycoplasma infections, and large-scale application of antibiotics the multidrug-resistance was occurred, so it is important to clinical reference to the selection of antibiotic susceptibility test results, and sufficient and adequate course of therapy to reduce the selection of resistant strains. Experimental evidence showed doxycycline, minocycline and josamycin can be used as the first choice for clinical medicine in mycoplasma infection.