育龄期妇女生殖道支原体感染现状及伴随感染情况分析

Analysis of the status of genital tract mycoplasma infection and accompanying infection in women of childbearing age

目的分析育龄期妇女生殖道支原体感染现状及对常用抗菌药物耐药情况,并探讨支原体感染者伴随感染情况,为控制支原体感染提供依据。方法采集2017年7月~2018年6月在我院进行常规产检及妇科检查的育龄期妇女生殖道分泌物标本共5666例,其中妊娠期3873例,非妊娠期1793例。应用支原体分离培养药敏试剂盒进行体外培养和药物敏感试验,分析解脲支原体(Uu)及人型支原体(Mh)感染情况,并对常用抗生素的耐药率进行分析;同时采集一份标本直接涂片进行真菌、滴虫、线索细胞镜检,探讨育龄期妇女生殖道支原体感染患者的伴随感染状况。结果妊娠期和非妊娠期支原体培养阳性率差异有统计学意义(P<0.05),其中两组间Uu阳性率差异无统计学意义(P>0.05)、Mh阳性率、Uu+Mh阳性率差异具有统计学意义(P<0.05);药敏结果显示单纯Uu感染对四环素、左氧沙星、交沙霉素、强力美素、氧氟沙星、美满美素、阿奇霉素、克拉霉素的耐药率较低(<10%),单纯Mh、Mh+Uu联合感染对红霉素、罗红霉素、阿奇霉素、克拉霉素的耐药率均较高(>90%);2176例支原体培养阳性者发生伴随感染的人数为469例,伴随感染率为21.07%。其中Uu阳性组与Mh阳性组伴随感染率差异具有统计学意义(P<0.05),Uu阳性组与Uu+Mh阳性组伴随感染率差异具有统计学意义(P<0.05)。结论育龄期妇女对支原体普遍易感,应加强孕前支原体检测及耐药分析;支原体感染者有较高的伴随感染率,且不同类型的支原体感染者之间伴随感染情况有较大差异,应结合常规镜检结果分析感染情况。

Objective To analyze the status of genital mycoplasma infection in women of childbearing age and the resistance to common antibiotics, and to explore the concomitant infection of mycoplasma infection patients, and to provide evidence for the control of mycoplasma infection. Methods A total of 5666 specimens of genital tract secretions from women of childbearing age who underwent routine obstetric examination and gynaecological examination in our hospital from July 2017 to June 2018 were collected, including 3873 cases during pregnancy and 1793 cases during non-pregnancy. In vitro culture and drug susceptibility test were performed using Mycoplasma isolation and culture susceptibility kit to analyze the infection of Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh). And the resistance rate of common antibiotics was analyzed. Simultaneously a specimen was collected for direct smear to perform fungal, trichomoniasis, and clue cell microscopy. The concomitant infection status of patients with genital tract mycoplasma infection in women of childbearing age was investigated. Results There was a significant difference in the positive rate of mycoplasma culture between pregnancy and non-pregnancy(P<0.05). There was no significant difference in Uu positive rate between the two groups(P>0.05). There was significant difference in Mh positive rate and Uu+Mh positive rate (P<0.05). Drug susceptibility results showed that the drug resistance of simple Uu infection to tetracycline, levofloxacin, josamycin, strong melanin, ofloxacin, mermaid, azithromycin, and clar ithromycin was low(<10%), and the resistance rate of Mh, Mh+Uu combined infection to erythromycin, roxithromycin, azithromycin and clarithromycin was high(>90%). The number of people with concomitant infection was 469 in 2176 cases of positive mycoplasma culture, and the concomitant infection rate was 21.07%. There was significant difference in the concomitant infection rate between Uu positive group and Mh positive group(P<0.05). The difference of concomitant infection rate between Uu positive group and Uu+Mh positive group was statistically significant(P<0.05). Conclusion Women of childbearing age are generally susceptible to mycoplasma. Pre-pregnancy mycoplasma detection and drug resistance analysis should be strengthened. Those with mycoplasma infection have a higher concomitant infection rate, and the difference in concomitant infection between different types of mycoplasma infections is significant, and should be combined with routine microscopic examination results to analyze infection.