上海闸北区性病门诊生殖道支原体检出率及药敏分析

The detection and analysis of drug sensitivity of gential tract Mycoplasma in outpatients from Zhaibei region in Shanghai

目的了解上海闸北地区性病门诊患者人型支原体(Mycoplasma hominis,Mh)与解脲脲原体(Ureaplasma urealyticum,Uu)感染及药敏情况,为临床生殖道支原体感染的诊治提供依据。方法采用支原体诊断试剂盒,对性病门诊患者进行支原体培养、鉴定和药敏试验。结果 248例性病门诊患者支原体培养结果阳性(39.12%),其中男性145例,女性103例。单纯Mh感染男性38例(9.09%),女性12例(5.56%);单纯Uu感染男性61例(14.59%),女性69例(31.94%);混合感染男性46例(11.00%),女性22例(10.19%)。男性与女性单纯Mh感染和Mh+Uu混合感染的检出率差异无统计学意义(P>0.05);女性单纯Uu感染检出率高于男性,差别有统计学意义(P<0.001)。药敏试验结果显示,13种抗生素治疗Mh/Uu感染时,各类抗生素之间总体耐药性有差别(P<0.001)。支原体对美满霉素、强力霉素、交沙霉素、左氧氟沙星和氧氟沙星有较高的敏感性。结论本地区治疗支原体感染时应尽量避免使用大环内酯类抗生素(交沙霉素除外),(左)氧氟沙星可作为耐红霉素类和四环素类支原体感染的备选治疗药物。

Objective To detect and analyze the drug sensitivity of Mycoplasma hominis （Mh）and Ureaplasma urealyticum（Uu） in gential tract infection outpatients from Zhaibei region in Shanghai and to provide evidences for the etiological diagnosis and treatment of Mycoplasma infection. Methods The Mycoplasma diagnostic kit was used for culture, identification and antibiotics sensitivity test of Mycoplasma in the samples from the outpatients. Results Out of 648 patients, 248 patients were found to be positive for Mycoplasma infection （145 males and 103 females） , in which 38 male patients （9.09%） and 12 female patients（5.56% ） were infected with Mh and 61 male patients（ 14.59% ） and 69 female patients（31.94% ） were with Uu, and 68 patients（46 males and 22 females） had combined infections. The detection rate for simple Uu infection in female was higher than that in male （P 〈 0.001）. Furthermore, Mh and Uu showed different sensitivity to different antibiotics （P 〈 0.001 ）. Higher sensitivities to Minomycin, Doxycycline, Josamycin, Levofloxacin and Ofloxacin were found for both Mh and Uu. Conclusion Macrolides （excluding Josamycin） should be avoided as much as possible in the treatment of Mycoplasma infection in this region. Levofloxacin and Ofloxacin could be chosen if Mycoplasma was not sensitive to macrolides（Josamycin） or tetracyclines.