897例非淋球菌性尿道炎患者支原体属培养及药敏结果分析

Analysis on mycoplasma culture and drug susceptibility testing results for 897 patients with nongonococcal urethritis

目的探讨非淋菌性尿道炎(NGU)患者支原体感染及耐药性,为临床诊疗及合理用药提供一定的依据。方法对2013年8月至2014年2月于上海长征医院收治的897例NGU患者进行解脲支原体(Uu)和人支原体(Mh)培养鉴定,并对阳性标本进行12种抗菌药物药敏试验。结果897例NGU患者支原体培养阳性420例,阳性率为46.82%(420/897),其中Uu阳性率为34.89%(313/897),Mh阳性率为2%(18/897),Uu+Mh阳性率为9.92%(89/897);女性患者Uu阳性率和Uu+Mh阳性率分别为46.60%(233/500)和13.20%(66/500),均显著高于男性的20.15%(80/397)和5.79%(23/397)(χ2值分别为68.14和13.59,P<0.05);支原体对12种抗菌药物敏感性较强的是交沙霉素、美满霉素、强力霉素和四环素,敏感率分别为94.05%(395/420)、92.86%(390/420)、92.62%(389/420)和89.29%(375/420),而对诺氟沙星、阿奇霉素和红霉素的耐药性均较高,耐药率分别为87.38%(367/420)、73.33%(308/420)和71.19%(299/420)。结论 NGU患者支原体感染以Uu和Uu+Mh混合感染为主,且耐药性严重。临床中对NGU的治疗应根据药敏结果合理使用抗菌药物,以减少耐药菌株的产生。

Objective To investigate the drug resistance of mycoplasma infections in the patients with non-gonococcal urethritis（NGU）, and provide instructions for the clinical treatment and reasonable use of antibiotics. Methods Ureaplasma urealyticum（Uu） and mycoplasma hominis（Mh） in 897 patients with NGU who enrolled in Shanghai Changzheng Hospital from August 2013 to February 2014 were cultured and tested, and the drug susceptibility test for 12 antibiotics were performed, respectively. Results Among the 897 patients with NGU, 420 cases were positive in mycoplasma culture, and the positive rate was 46.82%（420/897）, the positive rate of Uu was 34.89%（313/897）, the positive rate of Mh was 2%（18/897）, the positive rate of（Uu ＋ Mh） was 9.92%（89/897）. The positive rate of Uu of the female patients was 46.60%（233/500）, significantly higher than 20.15%（80/397） of the male patients（χ^2= 68.14,P〈0.05）. The positive rate of（Uu ＋ Mh） of the female patients was 13.20%（66/500）, significantly higher than 5.79%（23/397） of the male patients（χ^2= 13.59,P〈0.05）. Among the twelve commonly used antibiotics, the mycoplasma were highly susceptible to josamycin（94.05%, 395/420）, minocycline（92.86%, 390/420）, doxycycline（92.62%, 389/420） and tetracycline（89.29%, 375/420）, were highly resistant to norfloxacin（87.38%, 367/420）, azitromycin（73.33%, 308/420） and erythromycin（71.19%, 299/420）. Conclusions Uu and（Uu ＋ Mh） are dominant in the mycoplasma infections in patients with NGU and with highly drug-resistant. It is necessary for the hospital to reasonably use antibiotics to treat the patients with NGU and based on the results of drug susceptibility testing so as to reduce the drug resistant strains.