长沙地区支原体感染情况及耐药性变迁

Epidemiology and drug resistance of mycoplasma in Changsha area

目的:了解2008~2012年长沙地区支原体感染新的流行性病学特征,以指导临床合理用药及控制医院内感染的发生。方法:选择2008~2012年在湖南省人民医院、长沙市第一人民医院、中南大学湘雅二医院皮肤性病门诊、住院部进行支原体检查者1 447例,在应用抗生素治疗前采集男性尿道分泌物、前列腺液、精液和女性宫颈分泌物进行支原体培养、鉴定及药敏试验。结果:(1)男性精液支原体检出率最高(45.5%,15/33),尿道分泌物检出率较高(30.8%,77/250)。(2)20~【50岁年龄段感染率最高(50.4%,729/1447,40~【50岁年龄段支原体感染率逐年呈上升趋势。(3)男性单纯解脲脲原体(Uu)感染率为5.2%(75/1447),女性为32.2%(466/1 447);男性单纯人型支原体(Mh)感染率为0.3%(4/1 447),女性为0.8%(12/1447);男性Uu、Mh混合感染率为1.6%(23/1 447),女性为14.2%(206/1 447)。(4)2008~2012年786例阳性标本对米诺环素的敏感率分别为87.3%、87.7%、91.8%、87.4%、93.0%;对多西环素的敏感率分别为85.8%、90.1%、89.6%、86.0%、92.5%,对环丙沙星的敏感率分别为2.2%、3.1%、3.7%、7.7%、1.9%,对司帕沙星的敏感率分别为46.3%、44.4%、35.8%、32.9%、25.3%,对罗红霉素的敏感率分别为21.6%、16.0%、21.6%、27.3%、15.0%,对阿奇霉素的敏感率分别为26.9%、20.4%、34.3%、45.5%、36.6%,对克拉霉素的敏感率分别为70.1%、67.9%、52.2%、63.6%、59.2%。结论:(1)对长沙地区支原体检测标本的取材,建议男性为尿道分泌物,女性为宫颈分泌物;(2)长沙地区支原体感染好发人群年龄段为20~【40岁;40~【50岁年龄段支原体感染率呈上升趋势;(3)长沙地区支原体感染以单纯Uu为主;(4)对长沙地区支原体感染的治疗,建议用米诺环素、多西环素作为首选药物。

Objective:To comprehend the new epidemiological characteristics of mycoplasma in Changsha districts during 2008-2012,in order to guide clinical rational drug use and control the occurrence of nosocomial infection. Methods:Totally 1447 examinees with mycoplasma inspection in outpatient department and inpatient department in Hunan Provincial People's Hospital,Changsha Municipal First Hospital and the Second Xiangya Hospital of Central South University during 2008-2012 were selected. Mycoplasma cultivation, determination and drug sensitive test were conducted on male urethral secretion,prostatic fluid,seminal fluid and female cervical wecretion before the application of antibiotic therapy. Results:(1)Male seminal fluid had the highest detection rate of 45.5%(15/33),followed by urethral secretion(30.8%,77/250).(2)The highest infection rate appeared among people aged 20- < 50(50.4%,729/1447),and the mycoplasma infection rate among the peoples aged 40- < 50 was on the rise.(3)The simple Ureaplasma Urealyticum(Uu)infection rate was 5.2%(75/1447)in male and 32.2%(466/1 447) in female,the simple mycoplasma hominis(Mh)infection rate was 0.3%(4/1 447) in male and 0.8%(12/1 447) in female,and the mixed infection rate of Uu and Mh was 1.6%(23/1 447) in male and 14.2%(206/1 447) in female.(4)Among the 786 positive specimen during 2008-2012,the sensitive rate to minocycline was 87.3%,87.7%,90.1%,91.8% and 93.0% respectively,to doxycycline was 85.8%,90.1%,89.6%,86.0% and 92.5% respectively,ciprofloxacin was 2.2%,3.1%,3.7%,7.7% and 1.9% respectively,sparfloxacin was 46.3%,44.4%,35.8%,32.9% and 25.3% respectively,roxithromycin was 21.6%,16.0%,21.6%,27.3% and 15.0% respectively,azithromycin was 26.9%,20.4%,34.3%,45.5% and 36.6% respectively,clarithromycin was 70.1%,67.9%,52.2%,63.6% and 59.2% respectively. Conclusion:(1)The detection specimen of mycoplasma in Changsha area is recommended for male urethral secretion and femal cervical wescretion.(2)Mycoplasma infection in Changsha areas were prone to the groups aged 20- < 40,and the infection rate of mycoplasma in groups aged 0- < 20 and 40- < 50 was on rise.(3)Mycoplasma infection in Changsha is mainly simple Uu.(4)Minocycline and doxycycline are recommended as the first choice drug in the treatment of mycoplasma infection in Changsha area.