深圳地区女性泌尿生殖道解脲脲原体基因分型与耐药初探

A Study on Genotyping and Drug Resistant of Ureaplasma Urealyticum in Female Genitourinary Tract in Shenzhen

目的:了解深圳地区女性泌尿生殖道解脲脲原体(Uu)基因分型情况,初步探讨Uu基因型与多重耐药性的关系。方法:采用PCR方法对无症状Uu携带者(对照组)与Uu感染者(病例组)的Uu基因进行分群和分型,对随机抽取的阳性产物进行双向DNA测序,最后采用SPSS11.5统计软件包进行统计学分析。结果:①病例组394例标本检出Uu阳性214例,占总受检例数的54.3%(214/394),其中单纯Uu阳性标本171例,占总阳性例数的79.9%(171/214);对171例单纯Uu阳性标本分群共发现:Uu生物二群40例(23.4%,40/171);混合感染10例(5.8%,10/171);生物一群121例(70.8%,121/171),其中1型32例(26.4%,32/121)、3型22例(18.2%,22/121)、6型28例(23.1%,28/121)、14型11例(9.1%,11/121)、其它型28例(23.1%,28/121)。对照组213例标本共检出Uu阳性99例,占总受检例数的46.5%(99/213),单纯Uu阳性标本61例,占总阳性例数的61.6%(61/99)。61例单纯Uu阳性标本共分离出:Uu生物二群11例(18.0%,11/61);混合感染4例(8.6%,4/61);Uu生物一群46例(75.4%,46/61),其中1型24例(52.2%,24/46)、3型10例(21.7%,10/46)、6型9例(19.6%,9/46)、14型2例(4.3%,2/46)、其它型1例(2.2%,1/46)。②对照组以Uu生物一群1、3、6基因型单型别感染为主,其中生物一群1型感染率明显高于病例组(P<0.05);病例组则以Uu生物二群与生物一群中各基因型的合并感染为主;③病例组的各类抗生素耐药率明显高于对照组(P<0.01)。结论:①深圳地区女性泌尿生殖道Uu感染以生物一群单型别感染为主,混合感染的比例较低。②对抗生素的滥用导致Uu的耐药情况严重,抗生素合理应用问题亟待进一步规范解决。

Objective To investigate the distribution of genotypes of Ureaplasma urealyticum（Uu） in female genitourinary tract and clarify the relationship between the genotypes and multiple drug resistance in Patients with Uu in Shenzhen city. Methods The Uu patients were indevided into two groups： the patient group with symptoms and the control group without symptoms. Gene amplification, model typing and two-way sequencing process for DNA of the positive PCR products were carried out; Statistical analysis was done by adopting the statistical software SPSS 11.5. Results ①In 394 samples of patient group, 214 samples showed positive results of Uu DNA with a total positive rate of 54.3% （214/394） in the patient group. A single infection of Uu was detected in 171 cases of 214 positive samples including 40 cases for biologic group Ⅱ, 10 cases for mixed infection groups, 121 cases for biologic group Ⅰ （32 cases for type 1, 22 cases for type 3, 28 cases for type 6, 11 cases for type 14, 28 cases for other types）. In 213 cases of control group, 99 samples showed positive results of Uu DNA with a total positive rate of 46.5% （99/213）. A single infection of Uu was detected in 61 cases of 99 positive samples including 11 cases for biologic group Ⅱ, 4 cases for mixed infection groups, 46 cases for biologic group Ⅰ （24 cases for type 1, 10 cases for type 3, 9 cases for type 6, 2 cases for type 14, 1 case for other type）. ②The type 1, type 3 and type 6 in biologic group I of Uu were the main pathogens of Uu in the control group while the mixed infection of genotypes of Uu accounted for the prevalent status of Uu in the patient group. The infection rate of the single Uu genotype in the control group was apparently higher than that in the patient group （P 〈 0.05）. ③The drug resistance rate in patient group was significantly higher than that in the control group （P 〈 0.01）. Conclusion ①In fection with Uu in Shenzhen was commonly seen belonging chiefly to the single type infection, while rate of mixed infection was relatively lower. ②Abused application of antibiotics led to serious drug endurance of Uu. Therefore, the problem related to reasonable application of antibiotics needed to be schematized and solved to a further step.