2003-2007年沈阳地区泌尿生殖道支原体感染流行病学及耐药性变异

The epidemiology of mycoplasma infection and variance of resistance from 2003 to 2006 year

目的通过分析我院2003-2007年度非淋球菌性泌尿生殖系炎症(NGU)患者支原体感染及耐药性变迁情况,为临床提供最新的流行病学资料及用药指导。方法采用支原体培养、药敏一体化方法检测我院妇科、皮肤科送检的泌尿生殖道分泌物,回顾性分析就诊患者的性别、年龄、支原体培养药敏试验结果等临床资料。结果5年检测疑似NGU患者5944例,支原体阳性率为47.4-64.6%;其中解脲脲原体(Ureaplasma urealyticum,Uu)、人型支原体(Ma-coplasma hominics,Mh)、混合型(Mh+Uu)检出率分别为42.1%-56.6%、0.76%-2.5%、2.6%-6.7%;患者年龄主要分布于20-40岁之间,女性患者尤以20-30岁发病为主。耐药监测结果表明,Uu对四环素类敏感性没有明显的变化,大环内酯类、喹诺酮类变化非常显著。具体如阿奇霉素、交沙霉素、克拉霉素,Uu对它们的敏感性从2003年到2004年下降显著,2005年稳定且开始回升,到2006、2007年趋于稳定,但罗红霉素则一直呈下降趋势,从2003年的37.0%下降到2006年的5.3%,直至2007年时敏感性才略有回升(为17%)。喹诺酮类药物中,总体上Uu对其敏感性在5年中呈下降趋势。单纯Mh感染患者主要对四环素类药物、交沙霉素敏感。结论支原体(尤其是Uu)感染已成为NGU的主要病原体之一,且耐药性变异十分明显,临床治疗中应严格按照药敏试验结果合理用药以提高疗效、减少耐药菌株产生。

Objective To analyze the variance of mycoplasma infecting in genitourinary tract and the resistance characteristics in order to provide the datum of epidemiology and instruct reasonable applieation of antibiotics.Methods The secretion specimen collected from patients with the non-gonoccocal urethritis （NGU） was tested by the method of incubating and drug susceptibility all-in one. Results The positive rates of mycoplasma in 5 944 suspicious NGU patients were from 47.4% to 64.6% during 2003 - 2007 year, of the total, the Uu, Mh, Uu and Mh were 42.1% - 56.6% ,0.6 % - 2.5 % ,2.6% - 6.7 % respectively. The ages distributing of the patients with mycoplasma infection concentrated on 20-40 years,especially the majority female patients were be.tween 20- 30 years.The resistant of Uu to the Tetracyeline was no obvious variance from 2003 to 2007 year,but to the Quinolones,the changes increased significantly, to macrolides, there were significant difference, to Roxithromycin, the susceptibility decreased continually before 2007,but to the other of macrolides,the susceptibility increased significantly in 2006 and 2007 compared to 2005year. Conclusion Mycoplasma （especially Uu） was the main pathogen of NGU. There were great changes of Uu susceptibility to antibiotics during the 2003 - 2007 year.It＇s urgent to strengthen reasonable use of drug for avoiding the produce of drug-resistance mycoplasma individual.