2007-2018年泌尿生殖道解脲脲原体临床株对九种抗生素的敏感性变迁分析

Changes in sensitivity of clinical strains of Ureaplasma urealyticum from the urogenital tract to nine kinds of antibiotics from 2007 to 2018

目的分析2007—2018年解脲脲原体(Uu)临床株对9种常用抗生素药物敏感性的变迁。方法回顾性分析2007—2018年在中山大学附属第三医院皮肤性病科性病实验室对19431例患者进行的Uu临床株药物敏感性实验结果。其中男6076例,女13355例,年龄15~68岁,受试抗生素包括米诺环素、多西环素、红霉素、阿奇霉素、克拉霉素、罗红霉素、环丙沙星、司帕沙星和左氧氟沙星。结果2007—2018年Uu临床株对米诺环素和多西环素的耐药率分别从2007年的10.08%、10.42%逐渐下滑到2018年的1.15%、2.61%,而敏感率则从2007年的85.88%、87.56%逐渐提高到2018年的97.02%、96.42%。Uu临床株对红霉素的耐药性和敏感性波动较大,2014—2017年耐药率波动在20%左右,敏感率波动于50%左右。Uu对阿奇霉素的耐药率在2007年为42.02%,后迅速下降,2011年降至8.39%,其后维持在10%左右;敏感率在2007年为8.40%,2011年提高到86.05%,至2018年,一直维持在80%以上。2007—2018年Uu对克拉霉素一直表现为低耐药率(10%~20%)和高敏感率(80%~90%),对罗红霉素的耐药性和敏感性与红霉素类似。Uu对环丙沙星一直呈高耐药率(2013年之后甚至超过80%)和低敏感率(持续低于10%),对司帕沙星的敏感率一直在40%左右波动,而耐药率在2011年之后维持在10%以下。Uu对左氧氟沙星的耐药性和敏感性类似于司帕沙星,但对左氧氟沙星的敏感率更低,一直维持在30%左右。结论2007—2018年Uu临床株对米诺环素、多西环素和克拉霉素保持相对稳定的低耐药率和高敏感率,对阿奇霉素在2011年之后达到相对稳定的低耐药率和高敏感率,对红霉素、罗红霉素的耐药率和敏感率波动较大,对司帕沙星和左氧氟沙星呈低耐药率和敏感率。

Objective To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum(Uu)to 9 kinds of common antibiotics from 2017 to 2018.Methods The results of drug sensitivity testing of clinical Uu strains,which were isolated from 19431 patients in Laboratory of Sexually Transmitted Disease(STD),Department of Dermatology and Venereology,The Third Affiliated Hospital,Sun Yat-Sen University from 2007 to 2018,were analyzed retrospectively.Of the 19431 patients,6076 were males,and 13355 were females.Their age ranged from 15 to 68 years.The tested antibiotics included minocycline,doxycycline,erythromycin,azithromycin,clarithromycin,roxithromycin,ciprofloxacin,sparfloxacin and levofloxacin.Results Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08% and 10.42% in 2007 to 1.15% and 2.61%in 2018,respectively,while sensitivity rates to minocycline and doxycycline gradually increased from 85.88% and 87.56% in 2007 to 97.02% and 96.42% in 2018,respectively.The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014—2017,with the resistance rate fluctuating around 20%,and the sensitivity rate fluctuating around 50%.The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02% in 2007 to 8.39% in 2011,and then fluctuated slightly around 10%.However,the sensitivity rate to azithromycin increased from 8.40%in 2007 to 86.05%in2011,and remained above 80%from then on to 2018.During 2007—2018,Uu strains showed low resistance rates(10%-20%)and high sensitivity rates to clarithromycin(80%-90%),and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin.Uu strains showed constantly high resistance to ciprofloxacin(more than 80%after 2013)and low sensitivity(persistently less than 10%).The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40%,while the resistance rate was maintained below 10% after 2011.The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin,but the sensitivity rate to levofloxacin was relatively lower,which had been maintained at about 30%.Conclusion From 2007 to 2018,clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline,doxycycline and clarithromycin,a high resistance rate and low sensitivity rate to ciprofloxacin,and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin;a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011;the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.