性病门诊泌尿生殖道支原体感染及耐药趋势分析

Analysis of Mycoplasma infection and drug resistance trends among patients in STD clinic

目的：分析性病门诊泌尿生殖道解脲脲原体（Uu）和人型支原体（Mh）的感染及药敏情况，为临床提供最新用药依据。方法采用支原体培养、鉴定、药敏试剂盒，对2008～2012年性病门诊4229例疑诊患者进行 Uu 和 Mh 检测及药敏试验。结果4229例标本中检出支原体1171例，总阳性率27．69％，其中单纯 Uu 感染1058例（90．36％），单纯 Mh 感染38例（3．24％），Uu 和 Mh 混合感染75例（6．40％）。单纯 Uu 感染对交沙霉素、克拉霉素、罗红霉素的耐药率较低，依次为1．04％、5．10％、5．19％；单纯 Mh 感染对交沙霉素、多西环素、四环素的耐药率较低，依次为0、2．63％、7．89％；Uu 和 Mh 混合感染对环丙沙星和红霉素耐药率最高，分别为84．00％和73．33％。2008年支原体感染率最低（25．50％），2011年最高（29．10％）。10种药物的5年耐药率差异不具有统计学意义（P ＞0．05）。结论Uu 是支原体感染的主要病原体；交沙霉素、多西环素可以作为该地区支原体混合感染的首选药物；近5年支原体感染有上升趋势，但支原体耐药性得到一定的控制，应在此基础上加强对耐药菌株的控制，增加药敏检测，为进行耐药监测、临床合理使用抗菌药物，提高疗效据。

Objective To analyze Ureaplasma urealyticum （Uu）or Mycoplasma hominis （Mh）infections of urogenital tract and resistance trends in sexually transmitted disease（STD）outpatient,so as to provide new reference for drug administration in clinic. Methods 4 229 cases of clinical doubtful patients of STD outpatient were enrolled from 2008 to 2012.Uu and Mh were detected and drug sensitivity test were performed by Mycoplasma IST kit.Results In 4 229 cases,1 171 were Mycoplasma positive （27.69%）,including 1 058 cases of Uu infection（90.36%）,38 cases of Mh（3.24%）infection,and 75 cases of mixed（Uu＋Mh）in-fection（6.40%）.Uu showed low resistance rates to josamycine,clarithromycin,and roxithromycin,which were 1.04%,5.10%, and 5.19%,respectively.Mh showed low resistance rates to josamycine（0）,deoxytetracycline（2.63%）,and tetracycline（7.89%）. Mixed infections showed high resistance rates to ciprofloxacin（84.00%）and erythromycin（73.33%）.The Mycoplasma infection rate was the lowest in 2008（25.50%）,and the highest in 2011（29.10%）.There was no significant difference among the drug resistant rates of all the 10 kinds of drugs in the past five years（P 〉0.05）.Conclusion The main pathogens of Mycoplasma infection is Uu.Josamycine and deoxytetracycline can be used as the first choice in Mycoplasma treatment.In the past five years,Myco-plasma infection rates show an upward trend,but the drug resistance rates have been controled.Clinic treatment should be based on the drug susceptibility test so as to prevent the drugresistant stains from increasing and spreading,and provide the basis for drug resistance surveillance and rational use of medicines to improve the curative effect.