宫颈炎239例分泌物支原体检测及抗生素敏感性分析

Detection and antibiotic susceptibility of mycoplasma isolates from 239 cervicitis patients

目的对门诊宫颈炎患者解脲脲原体(解脲支原体)和人型支原体(人型支原体)进行分析,了解抗生素敏感情况,为临床诊疗提供实验依据。方法无菌采集宫颈炎患者的宫颈分泌物,支原体相关试剂盒进行支原体的培养、鉴定和药物敏感试验。结果支原体总检出率为47.3%。解脲支原体检出率为33.10%,解脲支原体合并人型支原体检出率为13.0%,人型支原体检出率为1.3%。79例单纯解脲支原体株体外抗生素敏感性显示:对四环素族多西环素97.5%,美满霉素97.4%高度敏感;对大环内酯类敏感性不一:克拉霉素94.9%,阿奇霉素75.9%,交沙霉素96.2%,红霉素44.3%,罗红霉素32.9%;对喹诺酮类如加替沙星89.9%较敏感,而对左氧氟沙星,司帕沙星敏感性差;对克林霉素和甲砜霉素不敏感;3例人型支原体的抗生素敏感性为对四环素族多西环素、美满霉素100%敏感,对交沙霉素和克林霉素100%敏感,31例解脲支原体合并人型支原体的抗生素敏感性分别为:美满霉素83.9%,多西环素87.1%,交沙霉素83.9%,加替沙星35.5%,对司帕沙星、左氧氟沙星、司帕沙星、阿奇霉素、红霉素、克拉霉素,罗红霉素、克林霉素敏感性低。结论宫颈炎患者中支原体检出率较高,其中单纯解脲支原体检出率较解脲支原体、人型支原体混合阳性率高,对四环素类、大环内酯类族中的多数抗生素敏感,治疗选择余地大。解脲支原体、人型支原体混合敏感性抗生素种类少,可选择四环素类或大环内酯类抗生素治疗。

Objective To analyze the antibiotic susceptibility of Ureaplasma urealytium（ Uu） and Macoplasma hominis（ Mh） isolates isolated from patients with cervicitis in order to provide reference for clinical diagnosis and treatment. Methods Cervical secretions of 239 cervicitis patients were obtained. The culture,identification,susceptibility testing were carried out with complex mycoplasma kits. Results The isolation rates of Uu,Uu / Mh,and Mh were 33. 1%,13. 0%,and 1. 3%,respectively（ the total isolation rate was 47. 3%）. Susceptibility testing showed that 79 Uu positive isolates were highly sensitive to tetracycline： doxycycline 97. 5%,minocycline 97. 4%; they showed different sensitivities to macrolides antibiotics： clarithromycin94. 9%,azithromycin 75. 9%,josamycin 96. 2%,erythromycin 44. 3%,roxithromycin 32. 9%; for quinolone antibiotics,they were sensitive（ 89. 9%） to gatifloxacin,but not to levofloxacin and sparfloxacin. The 31 Uu / Mh positive isolates were susceptible to minocycline 83. 9%,doxycyline 87. 1%,josamycin 83. 9%,gatifloxacin 35. 5%,respectively. But,they were not susceptible to sparfloxacin,levofloxacin,azithromycin,erythromycin,clarithromycin,roxithromycin,and clindamycin. The 3 Mh isolates were not calculated,because the number was too small. Conclusion Mycoplasma isolation rate of cervical secretions collected from the patients with cervicitis was high. Uu isolation rate was higher than Uu / Mh,and it was susceptible to most of tetracyclines and macrolides antibiotics. Because sensible antibiotics were less,tetracyclines antibiotics should be prioritized in the treatment of patients from whom Uu and Mh were isolated.