黏液脓性宫颈炎中细菌感染的前瞻性临床研究

Bacterial infection in mucopurulent cervicitis: a prospective clinical study

目的:通过对黏液脓性宫颈炎(mucopurlent cervictis,MPC)患者阴道分泌物行细菌培养,确定MPC细菌感染的常见菌种并分析其感染因素和诊疗方法。方法:前瞻性入组200例MPC患者,取其阴道分泌物进行细菌培养,挑选可疑单个克隆进行培养,再用Phoenix微生物全自动鉴定仪鉴定细菌种类和药敏结果。根据药敏结果对MPC患者进行抗生素治疗并设置空白对照组,对其临床转归进行对比分析。结果:1MPC的发病与年龄、性生活、人流史、孕产史、合并宫颈柱状上皮异位有关(P<0.05),与患者文化程度、对妇科感染的了解程度、卫生习惯均无关(P>0.05);2MPC组患者阴道分泌物阳性菌株检出率显著高于对照组(P<0.05);3MPC组细菌合并支原体(UU)感染者占41.0%,UU感染在MPC组检出率高于正常对照组(P<0.05);MPC组细菌感染合并外阴阴道假丝酵母菌病者占15.0%,正常对照组真菌感染检出率为10.0%,差异无统计学意义(P>0.05);4MPC细菌阳性组行敏感抗生素治疗后,治愈率高于未使用抗生素治疗者(P<0.05)。结论:MPC除由衣原体和淋球菌感染外,部分与细菌感染有关,部分是细菌合并支原体或真菌感染,治疗上应根据分泌物细菌培养及药敏结果选用相应抗生素。

Objective： To determine the common bacteria of bacterial infection in mucopurulent cervicitis （ MPC ） and analyze theinfection factors, diagnostic and therapeutic methods by bacterial culture of vaginal secretion in patients with MPC. Methods： A total of 200 pa- tients with MPC were selected, the vaginal secretion specimens were ob- tained for bacterial culture, the suspicious single clones were selected and cultured, Phoenix microorganisms automatic ident;,fication instrument was used to identify bacterial species and drug sensitive test re- suits. The patients with MPC were treated with antibiotics acc：ording to the results of drug sensitive test, blank control group was designed, the clinical outcomes were compared and analyzed. Results： MPC was correlated with age, sexual life, history of artificial abortion, history of pregnancy and childbirth and combining with cervical colmnnar ectopy （P 〈 0. 05 ）, which was not correlated with educational level, un- derstanding degree of gynecological infection and health habit （P 〉 0. 05 ） ; the detection rate of positive bacterial strains in vaginal secretion in MPC group was statistically significantly higher than that in control group （P 〈 0. 05 ） ; in MPC group, 41.0% of the patients were found with Ureaplasma urealyticum （UU） infection, the detection rate of UU infection in MPC group was statistically significantly higher than that in control group （P 〈 0. 05） ; in MPC group, 15.0% of the patients were found with vulvovaginal candidiasis, the detection rate of fungal in- fection in control group was 10. 0%, there was no statistically significant difference （P 〉 0.05 ） ; in MPC group, the cure rate of patients treated with sensitive antibiotics was statistically significantl.y higher than that of patients not treated with antibiotics （P 〈 0. 05 ） . Conclu- sion： Excluding Chlamydia infection and Con ococcus infection, partial MPC is correlated with bacterial infection, and partial MPC is correla- ted with bacterial infection combined with Mycoplasma infection or fungal infection, corresponding antibiotics should be applied according to bacterial culture and drug sensitive test re＇suits of vaginal secretion.