解脲和人型支原体固体培养检测及抗生素研究

The solid medium for detection of Ureaplasma urealyticm and the M.humenis and study of antibiotics

目的通过支原体固体培养基的培养,提高检测泌尿系分泌物解脲脲原体(Uu)和人型支原体(Mh)的准确性,指导临床合理使用抗生素。方法收集门诊就诊的72例泌尿系感染患者的标本,同时行支原体液体和固体培养。结果以支原体固体培养基上生长的典型支原体菌落(Uu:圆形棕褐色;Mh:油煎蛋样)作为支原体检测金标准,结合液体生化反应综合评价,经固体、液体两种培养基检测Uu和Mh阳性率,差异有统计学意义(P<0.05)。472例标本中真阳性率45.34%(214/472),其中Uu单一感染占39.20%(185/472);Mh单一感染占0.64%(3/472);Uu+Mh混合感染占5.51%(26/472)。感染以Uu为主,其药敏结果显示DOX、MIN、JOS抗菌活性最强,分别为94.60%、94.05%、89.73%;NOR、CPF、OFL抗菌活性最弱,分别为3.78%、2.70%、3.24%。Uu+Mh混合感染抗菌谱除CLA、ROX、SPA、LFV差异有统计学意义(P<0.05),其余与Uu一致,但耐药率明显高于Uu单纯感染。结论支原体固体培养是检测泌尿系支原体的金标准,结合液体培养抗生素耐药情况的监测,指导临床合理使用抗菌药物。

Objective By using mycoplasma solid medium to improve the accuracy of detection for urinary system's Ureaplasma urealyticum(Uu)and M.humenis(Mh),and to guide clinical rational use of antibiotics.Methods A total of 472 suspected patients with urinary tract infection were detected by Mycoplasma solid medium and liquid medium.Results Mycoplasma typical colony grown in Mycoplasma solid medium(Uu:round brown;Mh:liked fried egg)was taken as a gold standard and combining biochemical reactions in liquid medium,the positive rate of two kinds of medium detecting Uu and Mh was statistically significant(P<0.05).The overall positive rate was 45.34%(214/472),for Uu 39.20%(185/472),for Mh 0.64%(3/472)and for Uu+Mh 5.51%(26/472).For Uu,the drug susceptibility results showed DOX,MIN,JOS strongest antimicrobial activity was 94.60%,94.05%and 89.73%,respectively.NOR,CPF,OFL the weakest,was 3.78%,2.70%and 3.24%,respectively.The antimicrobial spectrum of Uu and Mh mixed infection was same with Uu,in addition to the CLA,ROX,SPA,LFV(P<0.05),but drug resistance rate was significantly higher than Uu alone infected.Conclusions Mycoplasma solid medium is the gold standard for detecting urinary tract mycoplasma,combining drug resistance can guide clinical use of antimicrobial agents.