2010-2011年泌尿生殖道感染性病原体分布状况及支原体体外药物敏感性调查

Distribution of pathogens in urogenital tract and analysis of Mycoplasma drug resistance in 2010-2011

目的分析2010-2011年绍兴人民医院暨浙江大学绍兴医院泌尿生殖道感染患者病原体(细菌、真菌、支原体)分布状况及支原体药物敏感性分析,为临床准确诊断和合理地进行抗感染治疗提供参考依据。方法采用法国生物梅里埃公司产VTYEK-AMS全自动微生物鉴定仪及配套鉴定卡对病原菌进行鉴定,其中支原体鉴定用Myco-plasma IST2支原体鉴定及药敏试剂盒进行检测。结果 2010-2011年共3 779例标本中病原体培养阳性株数1 128株(520株、608株),总检出率为24.0%;病原体以支原体检出为首,占总检出病原体的80.7%(75.2%、85.4%),以解脲(Uu)、人型(Mh)及Uu+Mh混合支原体感染为主;其次革兰阴性细菌占9.0%,以淋病奈瑟球菌为主;再次为真菌占5.9%,以白色假丝酵母菌为主。支原体感染男、女患者阳性率分别为38.3%和70.8%;淋病奈瑟球菌感染男、女患者阳性率分别为18.1%和11.1%,两种病原体男女比较差异均有统计学意义(P<0.01);患者主要集中在20～40岁年龄段。药敏结果显示,不同类型支原体的药物敏感性不同,单纯Uu阳性对原始霉素敏感率最高为99.2%,对强力霉素、四环素、交沙霉素和克拉霉素敏感率分别为96.8%、91.3%、85.5%和68.7%。单纯Mh阳性、Uu合并Mh阳性对抗生素的耐药率要高于单纯Uu阳性。结论泌尿生殖道感染以支原体为主,次为淋病奈瑟球菌,女性支原体感染率明显高于男性,而淋病奈瑟球菌感染男性明显高于女性,支原体对各种抗菌药物已产生一定的耐药性,对泌尿生殖道感染患者应及时进行病原体培养及药敏试验,指导临床对不同病原体合理用药,以有效提高治愈率和控制耐药菌株的产生。

Objective To analyze the distribution and drug resistance of pathogens in urogenital tract infection during 2010-2011 and provide evidence for clinical treatment.Methods The secretion specimens were identified by VTYEK-AMS and antibiotic susceptibility of Mycoplasma was detected with drug susceptibility kit 1ST2.Results Of the total of 3,779 cases,the positive rate of pathogens was 24.0%（1128 cases）;Mycoplasmas（Uu,Mh and Uu＋Mh） were the predominant pathogens,accounting for 80.7% in total,followed by Gram-negative bacteria which accounted for 9.0%（mainly Neisseria gonorrhoeae） and Fungi which accounted for 5.9%（Candida albicans predominantly）.The infection rates of Mycoplasma in male and female were 38.3% and 70.8% respectively,and those of gonorrhea coccus were 18.1% and 11.1% respectively（P0.01）.Drug sensitivity test showed that different types of Mycoplasmas had different sensitivities;the susceptibility rate of Uu to Pyostacin was 99.2%,while those to DOX,TET,JOS and CIA were 96.8%,91.3%,85.5% and 68.7%,respectively.Conclusion The urogenital tract infection is mainly caused by Mycoplasmas,followed by Gonorrhea coccus.Women are infected by Mycoplasmas more frequently than men,while men are more often infected by Gonorrhea coccus.The isolated Mycoplasmas have developed multiple drug resistance to antibiotics,so it is important to test the resistance of Mycoplasma for guiding clinical medication in order to improve the cure rate and reduce the generation of drug-resistant strains effectively.