894例支原体感染的检测及药物敏感性分析

Detection and susceptibility analysis on 894 mycoplasma infection cases of Yabei Area, Beijing

目的以北京亚北地区为例分析解脲脲原体(Uu)和人型支原体(Mh)在泌尿生殖系统感染中的变化趋势及其对药物的敏感性,为临床合理使用抗生素提供参考。方法对2005-01～2007-06在笔者所在医院皮肤性病科就诊的2109例患者的泌尿生殖道标本做支原体培养及体外药敏试验,分析Uu和Mh的阳性检出率及其变化趋势、性别差异,并对其药物敏感情况进行综合性分析。结果支原体的总阳性检出率为42.4%(894/2109),Uu的阳性检出率为30.3%(639/2109),Mh的阳性检出率为2.9%(62/2109),Uu伴Mh混合感染的阳性检出率为9.2%(193/2109)。Uu的感染率最高,是引起支原体感染的主要病原菌(χ2=715.15,P<0.01)。其中女性阳性检出率为51.4%(639/1244)明显高于男性的29.5%(255/865)(χ2=100.08,P<0.01)。Mh感染与Uu伴Mh混合感染对四环素类、大环内酯类及喹诺酮类(除司帕沙星外)的药物敏感性无明显的差别(P>0.05);而且两者均与Uu感染者在四环素类和大环内酯类的药物敏感性上存在差异(P<0.05)。结论北京亚北地区近期由支原体引发的非淋菌性尿道炎的检出率有显著的下降趋势。虽然不同的病原体感染,对药物的敏感性存在一定的差异,但均对强力霉素、美满霉素和交沙霉素有着较高的敏感性,故在临床经验用药中,可作为首选。

Objective To detect and analyze the Ureaplasma urealyticum and the Mycoplasma hominis infection rates and antibiotic resistances, so as to guide the usage of the antibiotics. Methods Through the Mycoplasma cultivations and the antibiotic susceptibility tests on 2 109 outpatient specimens from Jan. 2005 to Jun. 2007 in Aviation Industry Central Hospital, the detection rates on Ureaplasma urealyticum and the Mcoplasmay hominis as well as their changing trends were analyzed. The gender differences and the antibiotic resistances were also investigated in the paper. Results The total positive rate was 42.4% （894/2109）. The positive rate of Uu was 30.3%（639/2109） , Mh was 2.9%（62/2109） and Uu＋Mh was 9.2%（193/2109）. The highest rate of Uu showed it was the main pathogen contributing to the Mycoplasma affection （χ^2=715.15, P〈0.01）. Females showed a higher positive rate, 51.4%（639/1244）, than that of males, 29.5%（255/865）, which indicated the obvious gender differences （χ^2=100.08, P〈0.01）. There were no obvious differences on susceptibility to tetracyclines, macrolides and quinolones （except sparfloxacin） between the infections of Mh and Mh＋Uu （P〉0.05）; however, the infections of Uu showed the obvious differences on susceptibility to tetraeyclines, macrolides compared to those of Mh and Mh＋ U （P〈0.05）. Comclusion It seemed to have a decreasing trend on the positive rate of the mycoplasma infections in Yabei Area of Beijing. Although the different pathogens had different antibiotic susceptibility, they are all sensitive to Doxycyciine, Minocin and Josanmyein that can be used, therefore, as the first choice for clinical medicine in mycoplasma infection.