不孕妇女支原体感染调查与药物敏感性研究

Analysis of mycoplasma infection and drug susceptibility in infertile women

目的探讨不孕妇女支原体感染状况与药物敏感性研究,为临床诊治提供参考依据。方法回顾性分析2010年8月-2016年8月医院不孕不育专科收治的不孕不育妇女925例,提取患者宫颈分泌物进行药敏试验,统计患者的支原体感染率及药敏率和耐药率。结果 925例不孕妇女中有786例发生支原体感染,感染率84.97%,其中629例发生解脲脲支原体(Uu)感染占80.02%,45例发生人支原体(Mh)感染占5.73%,112例发生Uu+Mh混合感染占14.25%;786例支原体感染患者年龄多分布在25~30岁占总数的67.56%,各不同类型支原体感染均多分布在25~30岁,而合并感染中分布36~40岁患者比例明显增多(P<0.05);Uu对交沙霉素最敏感(92.05%),耐药率最高的是环丙沙星(67.72%),Mh对壮观霉素最敏感(86.67%),耐药率最高的是克拉霉素(93.33%),支原体阳性菌株对抗菌药物的多药耐药显示,Uu多为4~6种抗菌药物耐药比例为63.12%,Mh多药耐药多在10种以上达42.22%,合并感染多药耐药多在10种抗菌药物以上比例达51.79%。结论不孕不育妇女支原体感染率较高,尤其是Uu感染,年龄在25~30岁的妇女易感染疾病,对不孕妇女应加强支原体检测和药敏试验,其中交沙霉素、克拉霉素、壮观霉素和强力霉素可作为支原体感染的首选药物。

OBJECTIVE To investigate the infection status and drug sensitivity of mycoplasma in infertile women,so as to provide references for clinical treatment.METHODS A total of 925 infertile women admitted to our hospital from Aug.2010 to Aug.2016 were retrospectively analyzed.Cervical secretions of patients were extracted for drug susceptibility test.The mycoplasma infection rate,drug susceptibility rate and drug resistant rate were statistically analyzed.RESULTS There were 786 cases of infertility patients with mycoplasma infection in 925 cases of infertile women,with the infection rate of 84.97%,including 629 cases of Ureaplasma urealyticum （Uu） infection,45 cases of Mycoplasma hominis（Mh） infection,and 112 cases of Uu＋Mh mixed infection,accounting for 80.02%,5.73% and 14.25%,respectively.The ages of 786 patients with mycoplasma infection were mostly ranged from 25～30 years old,accounting for 67.56%,the ages of patients with different types of mycoplasma in fection were mostly distributed in 25～30 years old,and the ages of 36～40 years of patients with mixed infection were significantly increased （P〈0.05）.Uu had the highest sensitive rate to josamycin （920.5%）,and the highest resistant rate to ciprofloxacin （67.72%）,and Mh had the highest sensitive rate to spectinomycin （86.67%）,and the highest resistant rate to clarithromycin （93.33 %）.Multidrug resistance to antibiotics of mycoplasma positive strains showed that,the resistant rate to 4～6 antibiotics of Uu was 63.12%,to more than 10 antibiotics of Mh was 42.22%,and to more than 10 antibiotics of mixed infection was 51.79%,respectively.CONCLUSION The infection rate of mycoplasma is high in infertile women,especially Uu infection,and patients with the age of 25～30 are susceptible to infection.It should strengthen the mycoplasma detection and drug sensitivity test of infertile women,and josamycin,clarithromycin,doxycycline and spectinomycin can be used as the preferred drugs of mycoplasma infection.