阴道分泌物支原体检测及耐药性分析

The mycoplasma detection of vaginal secretions and drug resistance of mycoplasma

目的:了解和探讨成年女性阴道分泌物支原体感染情况及对各类抗菌药物的耐药性,以指导临床合理治疗。方法:对2012年6月至2013年6月期间在我院就诊的589例女性患者的阴道分泌物进行支原体检测及药敏试验,药敏试验抗菌药包括:美满霉素(MIN)、强力霉素(DOX)、交沙霉素(JOS)、阿奇霉素(AZI)、克拉霉素(CLA)、罗红霉素(ROX)、红霉素(ERY)、琥乙红霉素(ECC)、甲砜霉素(THI)、环丙沙星(CPF)、左氧氟沙星(CRA)、加替沙星(GAT),观察和分析支原体检测及药敏试验结果。结果:589份阴道分泌物标本中,390例检出支原体,支原体感染率为66.21%,其中Uu占所有感染病例的67.95%,Uu+Mh占29.49%,Mh占2.56%。药敏试验结果显示:Uu、Mh、Uu+Mh三种类型的感染对强力霉素、美满霉素及交沙霉素表现了较低的耐药性,对氟喹诺酮类抗菌药物表现了较高的耐药性,甚至达50%以上;对加替沙星的耐药率均维持在20%左右;单一Uu感染对大环内酯类抗菌药耐药性多维持在20%以下,而Mh、Uu+Mh对大环内酯类耐药性维持在50%左右;单一Uu感染对强力霉素、美满霉素及交沙霉素耐药率为0,而Mh、Uu+Mh对上述三药表现了10%左右的耐药率。结论:女性生殖道支原体感染已相当普遍且比较严重,不同的感染类型对临床常用抗菌药物可表现出不同的耐药性,临床上应加强支原体培养及药敏试验,以指导合理应用抗菌药,同时应加强对重点人群的监测,预防或降低支原体感染的发生。

Objectives： To explore the adult female vaginal secretions and mycoplasma infections and various types of antimicrobial drug resistance to guide clinical treatment. Methods： The vaginal secretions of the 589 female patients in our hospital from June 2012 to June 2013 were studied with original detection and susceptibility testing. The antimicrobial susceptibility testing include： minocycline（ MIN）,doxycycline（ DOX）,josamycin（ JOS）,azithromycin（ AZI）,clarithromycin（ CLA）,roxithromycin（ ROX）,erythromycin（ ERY）,erythromycin ethylsuccinate（ ECC）,thiamphenicol（ THI）,ciprofloxacin（ CPF）,levofloxacin（ CRA） and gatifloxacin（ GAT）.The mycoplasma detection and drug susceptibility test results were recorded and compared. Results： Of the 589 vaginal specimens,390 cases were detected to have mycoplasma,an infection rate of 66. 21%,including Uu infections（ 67. 95%）,Uu ＋ Mh infection（ 29. 49%） and Mh infection（ 2. 56%）. According to the susceptibility test results,three types of infection（ Uu,Mh,Uu ＋ Mh） had low resistance against doxycycline,minocycline and josamycin while high resistance against fluoroquinolone antibiotics,even up to over 50%; the resistance rate against gatifloxacin remained at around 20%. For Uu alone,the resistance rate against doxycycline,minocycline and josamycin was 0,while that of Mh and Uu ＋ Mh was about 10%. Conclusion： The female genital tract mycoplasma infection is quite common and serious. Different types of clinical infections can exhibit different resistance to common used drugs. Therefore,mycoplasma culture and sensitivity test should be strengthened clinically,to guide the rational use of antimicrobial drugs,and monitor of focus population should be strengthened,to prevent or reduce the incidence of mycoplasma infection.