不同生物群解脲脲原体的耐药性差异及临床症状相关性分析

Comparative Anal Features betw ysis of Antibiotic Resistance and Clinical een Ureaplasma Urealyticum Biovars

目的 比较解脲脲原体（ureaplasma urealyticum,Uu）不同生物群的耐药性差异,分析其与患者性别及临床症状的相关性.方法 用无菌拭子采集广州军区武汉总医院皮肤性病科和妇产科门诊泌尿生殖道感染患者的分泌物,严格按照脲原体鉴定药敏试剂盒进行Uu培养及体外药物敏感试验;对Uu培养阳性标本用两种荧光定量PCR 技术进行生物群鉴别;比较Uu不同生物群耐药性的差异;统计分析Uu不同生物群与不同性别患者泌尿生殖道感染的临床症状和体征的相关性.结果 1 389份标本中416例Uu培养阳性,阳性率为29.95%,其中,Parvo生物群279例（占67.07%,279/416）,T960生物群137例（占32.93%,137/416）.两个生物群对12种抗菌药物（除阿奇霉素外）的耐药性差异无统计学意义（χ^2=0.88,P〉0.05）;Uu Parvo生物群与男性、女性临床症状阳性率差异无统计学意义（χ^2＝2.00,P〉0.05）.女性患者的Parvo生物群检出率显著高于T960生物群（P〈0.05）,但二者的临床症状和体征阳性率差异无统计学意义（χ^2＝0.07,P〉0.05）;而感染T960群的男性的症状阳性率明显高于Parvo生物群（χ^2＝5.72,P〈0.05）.结论 Uu生物分群与临床用药关系不大.女性患者检出的Uu以Parvo生物群为主,男性患者Uu不同群的检出率无差异,但T960生物群感染的临床症状和体征的阳性率更高.

Objective To investigate Ureaplasma urealyticum （Uu） biovars and their relationship between antimicrohial resistance and clinical features. Methods Urethral and cervical swabs of 1 389 patients with nongonococcal urethritis were assayed parallely by drug susceptibility tests of Uu and two Real-time fluorescence quantitative PCR for Uu grouping. Statistical analysis was carried out to determine the characteristics of the distributions of Uu biovars,and to further explore the re- lationship between Uu biovars and antimicrobial resistance. Results A total of 416 cases were Uu positive out of 1 389 spec- imens （29.95 %）. Among those positive cases, 279 （67.07 %） were Parvo biovars, and 137 （32.93 M） were T960 biovars. There was no significant difference in antibiotics resistance （except for azithromycin） between Uu biovars （Zz = 0. 88,P~ 0. 05） and just so in their clinical symptoms （χ^2 = 2.00, P〉0.05）. The incidence of clinic symptoms in male urethritis by T960 biovar was higher than that with Parvo biovar while their rates detected were almost the same. A higher ratio of that was observed in female patients infected with Parvo biovar compared with T960 biovar （P〈0. 05） ,but their symptoms had nothing to do with Uu genotyping. Conclusion Uu genotyping had are benefit with the drug usage in clinic. Uu Parvo biovar was the dominant biovar,and that may be the major pathogens in infections of female genital tract. The two biovars were observed equal rate in male patients while who infected Uu T960 biovar had much more clinic symptoms and syndromes.