胎膜早破待产妇下生殖道支原体和衣原体感染及支原体耐药性分析

Analysis on the lower genital duct infection of mycoplasma and chlamydia and mycoplasma antimicrobial susceptibility in 626 pregnant women with premature rupture of membrane

目的了解瑞安市胎膜早破患者生殖道的支原体、衣原体的感染状况及支原体的耐药状况。方法对626例胎膜早破晚孕患者的宫颈分泌物进行支原体培养及药敏和衣原体快速检测。结果626例胎膜早破病例中,支原体培养阳性为516例,总感染率为82.4%;其中单独解脲支原体(Uu)阳性348例(55.6%),对交沙霉素、米诺环素、强力霉素、阿奇霉素、红霉素、罗红霉素、氧氟沙星、诺氟沙星、林可霉素耐药率分别为1.1%、6.3%、6.6%、10.6%、14.7%、17.8%、27.3%、63.1%、94.6%;Uu与人型支原体(Mh)混合感染158例(25.2%),对上述药物耐药率分别为4.4%、8.6%、9.2%、90.0%、94.8%、95.6%、42.5%、69.9%、95.1%;单独Mh感染10例(1.6%),对交沙霉素、强力霉素、米诺环素高敏感,耐药率均为0,对林可霉素耐药率为10.0%;衣原体阳性34例(5.43%)。结论胎膜早破患者中支原体的高检出率提示其与胎膜早破密切相关;支原体体外药敏试验对交沙霉素、米诺环素、强力霉素敏感率较高。

Objective To investigate the lower genital duct infection of mycoplasma and chlamydia and mycoplasma antimicrobial susceptibility in 626 pregnant women with premature rupture of membrane （PROM） in our area. Methods 626 cases of cervical secretions samples from pregnant women in the late phase with PROM were collected for mycoplasma culture, antimicrobial susceptibility test and rapid detection of chlamydia. Results In 626 patients with premature rupture of membrane, 516 cases were mycoplasma positive, and the total infection ratio was 82.43% ;348 cases （55.59%） were only infected by Ureaplasma urealytium （Uu）, the resistance rates to josamycine, minocycline, doxycycline, azithromycin, erythromycin, roxithromycin, ofloxacin, norfloxacin and lincomycin were 1. 1%, 6. 3%, 6. 6%, 10. 6%, 14. 7%, 17. 8%, 27. 3%, 63. 1% and 94. 6% respectively; 158 cases （25.2%） underwent mixed infection of Uu and Mycoplasma hominis （Mh）, the resistance rates of Uu＋Mh to the above antibiotics were 4.4%, 8. 6%, 9.2%, 90.0%, 94.8%, 95.6%, 42.5%, 69.9% and 95.1% respectively; 10 cases were only infected by Mh （1.60%）, highly sensitive to josamycin, minocycline and doxycycline; and the resistant rate was 10.0% to lincomycin. 34 cases were chlamydia positive （5.43%）. Conclusion The high detection rate of mycoplasma in patients with premature rupture of membrane displays the close relationship between mycoplasma and premature rupture of membrane. Antimicrobial susceptibility test shows that mycoplasma is sensitive to josamycin, minocycline and doxycycline.