女性泌尿生殖道支原体感染及耐药性分析

Analysis on mycoplasma infection and antimicrobial resistance among female patients

目的通过分析深圳市人民医院2009年9月至2010年4月女性泌尿生殖道支原体感染状况及耐药性变迁,指导临床合理用药。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,进行支原体检测及药敏分析。结果 2135例患者总检出率为54.6%(1166/2135),其中解脲脲支原体(Uu)阳性1017例(47.6%);人型支原体(Mh)阳性32例(1.5%);Uu+Mh阳性117例(5.5%)。1166例患者支原体对9种抗生素敏感性依次为原始霉素(99.8%)、交沙霉素(99.6%)、强力霉素(96.3%)、四环素(94.4%)、克拉霉素(85.6%)、阿奇霉素(77.6%)、红霉素(75.6%)、氧氟沙星(28.4%)和环丙沙星(22.8%)。结论支原体(尤其是Uu)感染已成为女性泌尿生殖系统炎症的主要病原体之一,治疗支原体感染应选择原始霉素、交沙霉素、强力霉素等敏感率高的药物及药敏试验显示敏感的药物,喹诺酮类药物耐药率较高,应引起临床重视。

Objective To analyze the infection and antimicrobial resistance of Ureaplasma urealyticum （Uu） and mycoplasma hominis （Mh） among female patients, and provide data of epidemiology and guidance for reasonable application of antibiotics. Method Cervical secretion was identified and the antibiotic susceptibility was detected with Mycoplasma IST 2 Reagent Box from France. Result Of the total 2 135 cases, 1166 were infected with Mycoplasma, the positive rate was 54.6%, among which 1 017 cases were Uu positive （47.6%）, 32 cases were Mh positive （ 1.5% ）, 117 cases were both Uu and Mh positive （5.5%） ; The susceptibility of the pathogens to all the 9 antimicrobial agents from high to low were Pristinamycin（99.8% ）, Josamycin （99.6%）, Doxycycline （96.3%）, Tetracycline （94.4%）, Clarithromycin （85.6%）, Azithromycin（77.6% ）, Erythromycin（75.6% ）, Ofloxacin（28.4% ） and Ciprofloxacin （22.8%）, respectively. Conclusion Mycoplasma （especially Uu） is the main pathogen of urogenital tract infections among women, and their susceptibility to antibiotics varies greatly. Antibiotics such as Pristinamycin, Josamycin and Doxycycline to which the pathogens are sensitive should be used to deal with the infection of Uu and Mh. Mycoplasma shows a high resistance to Quinolones, which should be paid highly attention in clinical practice.