2004～2008年泌尿生殖道支原体感染流行病学及耐药性变异分析

The epidemiology of mycoplasma infection and variance of resistance from 2004 to 2008 Year

目的分析本院2004～2008年泌尿生殖道炎性反应患者支原体感染及耐药性变异状况,为临床提供最新的流行病学资料和用药指导。方法采用法国生物梅里埃公司Mycoplasma IST2支原体鉴定及药敏试剂盒,检测本院妇产科和皮肤科送检的泌尿生殖道分泌物,回顾性分析支原体培养和药敏试验结果等资料。结果 5年检测疑似支原体感染患者5 175例,支原体总检出率为43.2%～50.1%;其中解脲脲原体(Uu)、人型支原体(Mh)、混合型(Mh+Uu)检出率分别为35.0%～40.7%、0.6%～1.1%、5.6%～8.9%。Uu在5年间对DOT、JOS、CLA和PRI敏感率非常高且稳定;对TET敏感率较高且呈上升趋势;对ERY和AZI敏感性较弱且呈减弱趋势;对OFL和CIP敏感率最低。Mh在5年间对DOT、JOS和PRI敏感率最高;对TET敏感性较高;对OFL和CIP敏感性较低;对ERY、AZI和CLA敏感率最差。结论近5年,支原体在本地的流行病学变化较小,女性较男性更易感染,且Uu感染维持在1个较高的水平,应引起有关监控部门重视;泌尿道支原体感染经验治疗应使用DOT、JOS和PRI,使用其他药物时应有药敏试验结果作依据。

Abstract：Objective To analyze urogenital Mycoplasma infection and its antibiotic susceptibility from 2004 to 2008,and provide the datum of epidemiology and instruct reasonable application of antibiotics.Methods The secretion specimen was identified and their antibiotic susceptibility was detected with Mycoplasma IST2 Reagent Box from France,analyze the result of mycoplasma cultivation and the sensitivities to antibiotics.Results The positive rates of mycoplasma in 5 175 suspicious patients were from 43.2%-50.1% during 2004 to 2008 year,among them,the Uu,Mh,Uu＋Mh were 35.0%-40.7%,0.6%-1.1%,5.6%-8.9% respectively.DOT,JOS,CLA and PRI showed the most sensitive and stable to Uu during 5 years;the next was TET,it seemed increasing sensitivity trend for TET; the third was ERY and AZI,it seemed decreasing sensitivity trend for ERY and AZI; the lowest rate of sensitivity was to OFL and CIP.DOT,JOS and PRI showed the most sensitive and stable to Mh; the next was TET; the third was OFL and CIP; the lowest rate of sensitivity was ERY,AZI and CLA.Conclusion The variance of epidemiology of mycoplasma is very little during the latest 5 years,female was liable to infect mycoplasma than male,the infection rate of Uu keeping in a higher level,it should be paid high attention for control department.For experiential therapy to Mycoplasma infection,DOT,JOS and PRI are good choices,the other antibiotic should be used on guideline of antibiotic susceptibility test.