2004～2007年泌尿生殖道支原体感染率及耐药分析

Analysis of infection rate and drug resistance of urinogenital mycoplasma during a period of 2004-2007

目的分析2004～2007年来本院就诊泌尿生殖道感染者支原体检出及耐药性变异,了解瑞安地区支原体流行病学情况,为临床的诊断及治疗提供帮助。方法采用珠海丽珠试剂有限公司生产的解脲支原体(Uu)和人型支原体(Mh)分离、鉴定、计数、药敏试剂盒检测患者的泌尿生殖道分泌物,然后分析就诊患者的支原体培养及药敏试验结果。结果4年中检测疑似泌尿生殖道感染患者5092例,支原体阳性率为50.8%～54.6%;Uu检出率为42.5%～45.4%,Mh为2.1%～2.4%、混合型(Mh+Uu)为6.0%～7.5%。药敏试验结果表明:Uu对四环素类(强力霉素、美满霉素)耐药性没有明显变化,大环内酯类(罗红霉素、阿奇霉素)变化非常显著,耐药性都呈现上升趋势,喹诺酮类(氧氟沙星、左氧氟沙星)保持高度耐药。结论支原体感染已成为泌尿生殖道感染的主要病原体之一,其中Uu感染占较大比例,同时支原体耐药性变化也十分明显,尤其是大环内酯类、喹诺酮类,应提醒临床应谨慎用药,防止耐药株增加。

Objective To analyze the infection rate and drug resistance of urinogenital myeoplasma in patients in our hospital from 2004 to 2007, investigate the epidemiological situation of mycoplasma in Ruian area, so as to provide aid for clinical diagnosis and treatment. Methods The urogenital tract secretions were detected by ureaplasma urealytium （Uu） and macoplasma hominics （Mh） susceptibility test kits produced by Zhuhai Lizhu Reagent Co. , Ltd. The rnycoplasma culture and drug susceptibility test results were analyzed. Results The positive rate of mycoplasma was within 50.8%-54.6% in a total of 5 092 doubtful genitourinary infection samples during the four years, in which 42. 5%-45. 40% was ureaplasma urealytium （Uu）, 2. 1%-2. 4% was macoplasma hominics （Mh）, and 6.0%-7.5% was mixed infection （Uu and Mh）. Susceptibility test showed： Ureaplasma urealytium （Uu） was still sensitive to tetracyclines （deoxycycline, minocycline）, highly resistant to macrolides （roxithromycin, azithromycin）, and the drug resistance displayed increasing tendency. Ureaplasma urealytium （Uu） kept highly resistant to quinolones （ofloxacin, levofloxacin）. Conclusion Mycoplasma has become one of the main pathogens of urinogenital infection, most of which is ureaplasma urealytium （Uu）. Meanwhile, drug resistance of mycoplasma has changed a lot, especially against quinolones and macrolides. Antibiotics should be used cautiously to prevent the accrescence of persisters.