泌尿生殖道支原体属与衣原体属感染及药敏结果分析

Mycoplasma and chlamydia infections in urogenital tract and drug susceptibility test

目的探讨运城地区疑似非淋菌性尿道炎(NGU)患者,支原体属和沙眼衣原体(Ct)的感染及支原体属的耐药率,为临床医师抗感染治疗提供依据。方法用支原体属试剂盒培养法对解脲脲支原体(Uu)和人支原体(Mh)进行分离鉴定和药敏试验,用胶体金标法测沙眼衣原体(Ct)。结果 1012例标本中分离出解脲脲支原体471株占46.5%,高于人支原体28株占2.8%及解脲脲支原体和人支原体混合感染75株占7.4%(P<0.01),沙眼衣原体134株占13.2%;支原体属对常用药物有不同程度的耐药,Uu感染对红霉素、氧氟沙星的耐药率最高,分别为76.7%、80.0%;对多西环素、米诺环素的敏感率较高,分别为75.5%、73.3%;Mh感染中,交沙霉素、米诺环素、多西环素、甲砜霉素敏感性较高,分别为81.4%、69.9%、67.3%、51.2%;在Uu与Mh混合感染中,耐药率普遍增加,对多西环素、米诺环素、交沙霉素的耐药率较低,分别为18.7%、23.6%、31.8%。结论可以将多西环素、米诺环素、交沙霉素、甲砜霉素作为运城地区临床初步治疗支原体属感染的首选药物,以后根据药敏试验调整抗菌药物;解脲脲支原体是非淋菌性尿道炎的主要病原菌,支原体属和衣原体属可以引起混合感染,监测支原体属的耐药性对指导合理用药有重要意义。

OBJECTIVE To investigate the infection and drug resistance of urogenital mycoplasma and chlamydia in the patients with suspected nongonocoeeal urethritis（NGU）.METHODS Ureaplasma urealytieum（Uu） and Mycoplasma hominis（Mh） as well as their drug susceptibilities were tested by using the mycoplasma detection kits.Chlamydia antigen Was detected by the Colloidal gold method.RESULTS The total infection rate of mycoplasma was 56.76%in 1012 patients with suspected NGU.Only Uu positive rate（46.5%） was higher than Uu and Mh positive rate（7.4%） and only Mh positive rate（2.49%）（P0.01）.Ct positive rate（13.2%）.The highest resistant rates to erythromycin and Ofloxacin were 76.7% and 80.0%;the sensitive rates to doxycycline and minocycline were 75.5%,and 73.3% respectively.In Mh infections,sensitivity rates to josamylin,minocycline,doxycycline and thiamphenicol were 81.4%,69.9%,67.3% and 51.2%,respectively.CONCLUSIONS Vibramycin,josamycin,minocycline and thiamphenicol can be used as initial therapy in the region for mycoplasma infection.And antimicrobial agents should be chosen according to antimicrobial susceptibility test results.The infection of Uu is common in the patients of NGU.Mornitoring the drug resistance play an important guide role in the clinical treatment.