妇科门诊患者支原体属感染的现状及耐药性分析

Current status of Mycoplasmainfections in patients of gynecology department and analysis of drug resistance

目的了解妇科门诊女性患者支原体属感染及其耐药性现状,为有效预防和治疗支原体属感染提供依据。方法 2010年1月-2011年12月在医院妇科门诊就诊的885例疑似患者,用Mycoplasma IST 2鉴定、药敏一体化试剂盒检测解脲脲支原体(Uu)和人支原体(Mh)。结果共402例患者送检标本支原体属培养阳性,总阳性率45.4%;其中87.3%为单一病原体阳性,12.7%为两种支原体同时阳性;累计Uu阳性385例次(占85.0%),Mh阳性68例次(占15.0%);Uu和Mh的耐药率基本相近,但混合感染时其耐药率则有上升趋势;对多西环素、克拉霉素和普那霉素敏感率最高,分别为96.9%～80.8%和97.1%～76.5%;而对喹诺酮类药物耐药率最高,分别达78.7%～83.4%和75.0%～89.7%;对交沙霉素、阿奇霉素的耐药率均>51.7%。结论 Uu是主要感染菌种,Mh多与Uu以混合感染形式存在;常用抗支原体属药物耐药性变化较快,应根据培养和药敏试验结果加以选择,尤其是混合感染患者,治疗用药应兼顾两种支原体的效果;对于有生殖泌尿道感染症状的女性患者,宜及时检测支原体属,以保证用药的科学性。

OBJECTIVE To study the current status of Mycoplasma infections in the patients of gynecology department and analyze the drug resistance so as to effectively prevent and control the Mycoplasma infections.METHODS A total of 885 patients suspected with Mycoplasma infections who enrolled the hospital from Jan 2010 to Dec 2011 were selected as the study objects,the Ureaplasma urealyticum（Uu） and Mycoplasma hominis（Mh） were identified with Mycoplasma IST 2 kit and the susceptibility integration kit.RESULTS The results suggested that there were 402 cases tested positive with the total positive rate was 45.4%,among which the patients with single Mycoplasma infections accounted for 87.3%,and the patients with the mixed Mycoplasma infections accounted for 12.7%.There were totally 385（85.0%） case-times of patients with the Uu infections and 68（15.0%） case-times of patients with Mh infections.The drug resistance rate of the Uu was as basically same as the Mh,however,the drug resistance rate kept an upward trend as the Uu and Mh caused the mixed infections.The drug susceptibility rate of Uu to doxycycline,clarithromycin and pristinamycin varied between 96.9% and 80.8%,the Mh varying between 97.1% and 76.5%,which were the highest.The drug resistance rate of the Uu to quinolones varied between 78.7% and 84.3%,the Mh varying between 75.0% and 89.7%,which were the highest.The drug resistance rates to both josamycin and azithromycin were higher than 51.7%.CONCLUSION The Uu is the main species of infectious pathogens,but more common in the mixed infections caused by the Uu and Mh.The drug resistance to the commonly used antibiotics changes rapidly,thus it is necessary to choose antibiotics based on the results of bacterial culture and drug susceptibility testing.The treatment effect of the two species of pathogens should be taken into account,especially for the patients with the mixed infections.For the female patients with the genitourinary tract infections,it is necessary to take the test of Mycoplasma so as to ensure the scientific use of antibiotics.