某门诊非淋尿道炎患者支原体感染状况及耐药研究

Study on infection and drug sensitivity of a case of clinic non-gonococcal u-rethritis mycoplasma

目的了解本地区非淋球菌性尿道炎(non-gonococcal u-rethritis,NGU)患者的感染及耐药情况,为临床提供最新的流行病学资料及指导合理用药。方法采用支原体培养、鉴定、药敏一体化试剂盒进行支原体培养和药敏试验,观察结果并综合统计分析。结果 556例疑似NGU患者标本中支原体培养阳性242例、阳性率43.53%,单纯解脲脲原体(ureaplasma urealyticum,Uu)感染186例、占76.86%,单纯人型支原体(mycoplasma hominis,Mh)感染8例、占3.31%,Uu+Mh混合感染48例、占19.83%;556例患者中,男性占241例、女性占315例,阳性率分别占25.73%和56.86%,支原体检出率女性高于男性,差异有统计学意义(χ2=61.74,P<0.005)。Uu敏感性较高的有美满霉素、克拉霉素、强力霉素、交沙霉素,耐药性较高的有克林霉素、司帕沙星、甲砜霉素,Uu+Mh敏感性较高的有美满霉素、强力霉素、交沙霉素,耐药性较高的是阿齐霉素、罗红霉素、红霉素、克林霉素。结论支原体感染以单纯Uu感染最为常见,感染率女性高于男性,耐药率最高为阿齐霉素,临床医生应根据患者临床症状及药敏结果合理选用抗生素。

Objective To understand the mycoplasma infection and the drug sensitivity of non -gonococcal urethritis patients, so as to provide epidemiology data for clinical correct medication. Methods The results of drug sensitivity was tested by using culture, identification, drug sensitivity kit. The infectious states and drug resistances of mycoplasma were analyzed. Results In 556 cases, 242 were detected as mycoplasma positive, and the positive rate was 43.53% , including 186 positive cases for ureaplasma urealyticum （Uu） , accounting for 76. 86% , There were 8 positive cases for mycoplasma hominis （ Mh）, accounting for 3.31%, and 48 positive cases for Uu and Mh mixed infection, which accounted for 19. 83%. There were 241 male patients and 315 female patients in the 556 cases, and the positive rate was 25.73% and 56. 86% respectively. The mycoplasma detection rate of female was higher than that of male. There was statistical significant difference of the positive rate between male and female patients （X2 = 61.74, P 〈 0. 005 ） Uu was sensitive to minocycline, elarithromycin, doxyeyeline, josamycin, and resistant to clindamycin, sparfloxacin, thiamphenicol. Uu ＋ Mh was sensitive to minocycline, doxycycline, josamycin, and resistant to azithromycin, roxithromycin, erythromycin, clindamyein. Conclusions Mycoplasma infection is dominated by Uu. The mycoplasma infection rate of female is higher than that of male, and azithromycin＇s drug resistance rate is the highest. Thus clinician should choose antibiotics rationally based on clinical symptoms and the results of drug sensitivity test.